2015-08-25_REVISION - M2010071

• Permit No: M2010071
• IBM Index Class Name: REVISION
• Doc Date: 8/25/2015
• Doc Name: Permit Amendment Application
• From: DRMS
• To: The City of Lafayette
• Type & Sequence: AM1
• Email Name: MAC
• Media Type: D
• Archive: No

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