2015-08-05_REVISION - M2010071

• Permit No: M2010071
• IBM Index Class Name: Revision
• Doc Date: 8/5/2015
• Doc Name: Application AM01
• From: City of Lafayette
• To: DRMS
• Type & Sequence: AM1
• Email Name: MAC
• Email Name: WHE
• Media Type: D
• Archive: No

3-
11. Correspondence Information:
APPLICANT/OPERATOR name, address, and phone of name to be used on permit)
Contact's Name: Gary Klaphake Title: City Administrator
Company Name: The City of Lafayette
Street/P.O. Box: 1290 S Public Road P.O. Box:
City: Lafayette
State: Colorado Zip Code: 80026-2706
Telephone Number: 303 1-665-5588
Fax Number: 303 1-665-2153
PERMITTING CONTACT if different from applicant/operator above)
Contact's Name: Peter Wayland Title: President
Company Name: Weiland, Inc.
Street/P.O. Box: P.O. Box: 18087
City: Boulder
State: Colorado Zip Code: 80308
Telephone Number: 303 ) _ 443-9521
Fax Number: na ) _
INSPECTION CONTACT
Contacts Name: Brad Dallam Title: Water Resource Manager
Company Name: City of Lafayette
Street/P.O. Box: 1290 South Public Road P.O. Box:
City: Lafayette
State: Colorado Zip Code: 80026-2706
Telephone Number: 303 _ 665-5588
Fax Number: 303 ) _ 665-2153
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency:
Street:
City:
State: Zip Code:
Telephone Number:
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency:
Street:
City:
State: Zip Code:
Telephone Number: