2016-07-29_REVISION - M1991073

• Permit No: M1991073
• IBM Index Class Name: Revision
• Doc Date: 7/29/2016
• Doc Name: Notice of Final Release Request
• From: DRMS
• To: Various
• Type & Sequence: SL1
• Email Name: ERR
• Media Type: D
• Archive: No

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9. Correspondence Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Individual 's Name:
Company Name: KIOWA COUNTY, COLORADO
Street: P.O. BOX 591
C ity: EADS
State: COLORADO Zip Code: 91036
Area Code: 719 Telephone: [phone]
PERMITTING CONTACT (if different from applicant/operator above)
Individual 's Name: SAME
Company Name:
Street:
City:
State: Zip Code:
Area Code: Telephone:
INSPECTION CONTACT
Individual 's Name: SAME
Company Name:
Street:
City:
State: Zip Code:
Area Code: Telephone:
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency: . M1 - - —
Street:
City:
State: Zip Code:
Area Code: Telephone:
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency: NIA - - -
Street:
City:
State: Zip Code:
Area Code: Telephone: