2016-09-26_REVISION - M1988087

• Permit No: M1988087
• IBM Index Class Name: REVISION
• Doc Date: 9/26/2016
• From: DRMS
• To: various
• Type & Sequence: SL3
• Email Name: SJM
• 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: John T. Ungefug
Company Name: Southway Construction Co. , Inc.
Street: 117 White Pine Drive
City: Alamosa
State: Colorado Zip Code: 81101
Area Code: 719 Telephone: [phone]
PERMITTING CONTACT (if different from applicant/operator above)
Individual 's Name:
Company Name:
Street:
Ci ty:
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) 0 General Agriculture(GA)
land use ® Rangeland(RL) O Forestry(FR) ❑ Wildlife liabitat(WL)
(check one): O Residential (RS)O Recreation(RC) ❑ Industrial/Commercial (IC)
O Developed Water Resources(WR) Q Solid Waste Disposal(WD)
12. Primary present O Cropland(CR) O Pastureland(PL) O General Agriculture(GA)
land use ® Rangeland(RL) ❑ Forestry(FR) ❑ Wildlife Habitat(WL)
(check one): O Residential (RS) ❑ Recreation(RC) ❑ Industrial/Commercial (IC)
❑ Developed Water Resources(WR)
To the best of my knowledge, all the information presented on this application form and
the attached Exhibits A-G are true and correct (must be signed by applicant/operator)'.
Date: 8/8/88 By:
n ineer
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