2016-03-25_REVISION - M1989029

• Permit No: M1989029
• IBM Index Class Name: Revision
• Doc Date: 3/25/2016
• Doc Name: Application AM04
• From: Aggregate Industries - WCR, Inc.
• To: DRMS
• Type & Sequence: AM4
• Email Name: PSH
• Email Name: WHE
• Media Type: D
• Archive: No

-3-
I I. Correspondence Information:
APPLICANT/OPERATOR (name,address,and phone of name to be used on permit)
Contact's Name: Connie N.Davis rifle: Land Manager
Company Name: Aggregate Industries-WCR. Inc.
Street/P.O. Box: 1687 Cole Boulevard, Suite 300 P.O.Box:
City: Golden
State: CO Zip Code: 80401
Telephone Number: (970 I- 396-5252
Fax Number: (303 ). 716-5295
PERMITTING CONTACT (if different from applicant/operator above)
Contact's Name: Connie N. Davis Title:
Company Name:
Street/P.O. Box: P.O.Box: 337231
City: Greeley
State: CO Zip Code: 80633
Telephone Number: I )-
Fax Number: ( i-
INSPECTION CONTACT
Contact's Name: Same Title:
Company Name:
Street/P.O. Box: P.O. Box:
City:
State: Zip Code:
Telephone Number: ( )-
Fax Number: ( )-
CC: STATE OR FEDERAL LANDOWNER(if any)
Agency:
Street:
Cite:
State: Zip Code:
Telephone Number: ( 1-
CC:
-CC: STATE OR FEDERAL LANDOWNER(if any)
Agency:
Street:
City:
State: Zip Code:
Telephone Number: ( )-