2016-10-31_PERMIT FILE - M2016074

• Permit No: M2016074
• IBM Index Class Name: PERMIT FILE
• Doc Date: 10/31/2016
• Doc Name: Application
• From: Layboum Pit
• To: DRMS
• Email Name: ERR
• Email Name: WHE
• Media Type: D
• Archive: No

-2-
11. Corr esnondence Information:
APPLICANT/OPERATOR (name,address,and phone of name to be used on permit) Road Supervisor
Steve Williams Title:
Contact's Name:
Company Name: Washington County Road District 3
11920 Co. Rd. CC P.O.Box:
Street/P.O.Box:
City: Anton Zip Code: 80801
CO
State: 383-2216
Telephone Number: (970 l- 383-2213
Fax Number: (970 --_
PERMITTING CONTACT (if different from applicant/operator above)
Contact's Name:
Randy Schafer Title:
Company Name:
40586 Co. Rd. 21 P.O.Box:
Street/P.O.Box:
Haxtun
City: 80731
State:
CO Zip Code:
Telephone Number: (970 1- 774-6264(Home)970-520-0502(Cell)970-854-3778 (Work)
Fax Number: (970 1- 854-3811
INSPECTION CONTACT Road Supervisor
Contact's Name:
Steve Williams Title: p
Company Name: Washington County Road District 3
11920 Co. Rd. CC P.O.Box:
Street/P.O.Box:
City: Anton 80801
State:
CO Zip Code:
Telephone Number: (970 _ 383-2216
Fax Number: (970 _ 383-2213
CC: STATE OR FEDERAL LANDOWNER(if anv)
Agency:
Street:
City:
State: Zip Code:
Telephone Number: ( 1-
CC: STATE OR FEDERAL LANDOWNER(if any)
Agency:
Street:
City:
State: Zip Code:
Telephone Number: ( )-