2016-09-12_REVISION - M1991069

• Permit No: M1991069
• IBM Index Class Name: Revision
• Doc Date: 9/12/2016
• From: DRMS
• To: Kit Carson County
• Type & Sequence: AR1
• Email Name: ERR
• Media Type: D
• Archive: No

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10. Correspondance Information
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Individual 's Name: Edgar Pratt ( Commissioner )
Company Name: Kit Carson County
Street: PO Box 249
City: Burlington
State: Colorado Zip Code: 80807
Area Code: 719 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:
City:
State: Zip Code:
Area Code: Telephone:
11 . Primary future Cropland(CR) 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 7e sources(WR) = Solid Waste Disposal (WD)
12. Primary present 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 lFesources(WR)
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