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

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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 Name: Martin Marietta I440-114te,, Zy,�, r (BDO a.�+ 4�It R�
Street/P.O. Box: 1 P.O. Box:
City: fir+ CDtttrtS
State: Colorado Zip Coders
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: ( )-