2017-02-02_REVISION - M2003091

• Permit No: M2003091
• IBM Index Class Name: REVISION
• Doc Date: 2/2/2017
• Doc Name: Request For Amendment To Permit
• From: Martin Marietta Materials, Inc.
• To: DRMS
• Type & Sequence: AM1
• Email Name: PSH
• Email Name: WHE
• Media Type: D
• Archive: No

-3-
11. Correspondence Information:
APPLICANT/OPERATOR (name,address,and phone of name to be used on permit)
Contact's Name: Julie Mikulas Title: Land Manager
Company Namc: Martin Marietta N�Gl etr cL(S, �. ram + 41i It
Street/P.O.Box: 1 '� P.O.Box:
City: Fbr+ CD[{.tl1S
State: Colorado Zip Code:' a`�
Telephone Number: (970 _ 227-4041
Fax Number: (970 )_ 407-3900
PERMITTING CONTACT (if different from applicant/operator above)
Contact's Name: Jared Dains Title: Water Resource Engineer
Company Name: Applegate Group, Inc.
Street/P.O.Box: 1490 W. 121 st Ave, Suite 100 P.O.Box:
City: Denver
State: Colorado Zip Code: 80234
Telephone Number: (303 452-6611
Fax Number: (303 1. 452-2759
INSPECTION CONTACT
Contact's Name: Same as owner 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: n/a
Street:
City:
State: Zip Code:
Telephone Number:
CC: STATE OR FEDERAL LANDOWNER(if any
Agency: n/a
Street:
City:
State: Zip Code:
Telephone Number: ( 1-