2015-10-30_REVISION - M1988112 ‎(6)‎

• Permit No: M1988112
• IBM Index Class Name: Revision
• Doc Date: 10/30/2015
• Doc Name: Notice to BOCC AR03
• From: DRMS
• To: BOCC
• Type & Sequence: AR3
• Email Name: WHE
• Media Type: D
• Archive: No

I 0. Corrc,pondance Infos wtion
APPLiCAmu OPERATOR (name, addFess_ and phone of name to be used on permit)
Individual's Rome: A. Walter wise
Company Name:
,3treet:
0 ty:
State:
Area Lode;
PERMITTING CUNTALT
ear-r.le mouiltAlll Resources. j 11c.
333 Clay street, 42nd Floor
:o u0 tv-11
xexan Zip Code: 77002
iij Telephone: 650-64uu
(if different from applicant/operator above) —�—
Individual's Name-
s ame
Cropland(CR) u
Company Name:
❑
General Agricultare(GA)
Street:
0
El
r
City:
13
❑
wildlife Habitat(WL)
Induszr;a]7Commeruial(IC)
State;
❑
Zip Cude:
Area Code:
Telephone:
12. Primary present
INSPECTION CONTACT (if
aa;rfereot from applicant/ove,ator above)
Individual's Nave:
Gary Dodson
Generai Auviculture(GA)
Company Name:
Battle mnunr..i .
hp!_M . r -es !Bo
Street:
P-0. Box 16 u 0
Wilaiife Habitat(WL)
Industrial/Commercia l( IC)
City;
Alamosa
Deve+oped Water Resources(NK)
State:
Colorado
Zip Code: 840.L
Area Cade:
71 Telephone:
b/2 ---.J-462
lt. Primary future
D
Cropland(CR) u
rostureland(PL)
❑
General Agricultare(GA)
land use
(check one):
0
El
Ranveland(RL) 0
Residential(RS)O
Foreszry(FR)
Recreazivn(RCI
13
❑
wildlife Habitat(WL)
Induszr;a]7Commeruial(IC)
❑
Developed water Resources(WR)
Q
Svlid Waste Oisposal(wu)
12. Primary present
p
Cropland(CR) 0
Pasturejand m)
Q
Generai Auviculture(GA)
lana use
tchmk une):
❑
❑
Rangeland(RL) p
Residenziai(RS) p
rorestry(FR)
Recreation(RC)
13
❑
Wilaiife Habitat(WL)
Industrial/Commercia l( IC)
❑
Deve+oped Water Resources(NK)
To the oast or r—r knowledge, all the infarmazion presented on this application form aTa
the attached Exhibits A -P are true and correct (must be signed by applicant/operate,-).
Daze: By; 7
title