2016-02-18_REVISION - M1977081

• Permit No: M1977081
• IBM Index Class Name: Revision
• Doc Date: 2/18/2016
• Doc Name: Notice AR03
• From: DRMS
• To: Various
• Email Name: PSH
• Email Name: WHE
• Media Type: D
• Archive: No

6
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10. Correspondance Information
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Individual 's Name: John F. Hickman - contact
Company Name: Western-Mobile, Inc.
Street: 1400 W. 64th Avenne
City: Denver
State, Colorado Zip Code: 8b22i
Area Code: 303 Telephone: [phone]
PERMITTING CONTACT (if different from applicant/operator above)
Individual 's Name:
Company Name:
Street:
City:
State: Zip Code:
Area Code: Telephone:
INSPECTION CONTACT (if different from applicant/operator above)
Individual 's Name:
Company Name:
Street:
Ci ty:
State: Zip Code:
Area Code: Telephone:
11. Primary future x Cropland(CR) x Pastureland(PL) General Agriculture(GA)
land use Rangeland(RL) Forestry(FR) — Wildlife Habitat(WL)
(check one): Residential(RS) — Recreation(RC) — Industrial/Commercial(IC)
Developed Water 17eesources(WR) + Solid Waste Disposal(WD)
12. Primary present Cropland(CR) _ Pastureiand(PL) General Agriculture(GA)
land use Rangeland(RL) Forestry(FR) — Wildlife Habitat(WL)
(check one): Residential(RS) — Recreation(RC) X Industrial/Comnercial(IC)
Developed Water IFesources(WR)
To the best of my knowledge, all the information presented on this application form and
the attached Exhibits A-P are true and correct (must be signed by applicant/operator).
Date: May 23, 1989 By:
John F. Hickman
Manager of Land b Resources
Title