2017-03-08_PERMIT FILE - M1997015

• Permit No: M1997015
• IBM Index Class Name: Permit File
• Doc Date: 3/8/2017
• Doc Name: Addendum To Application
• From: Washington County
• To: DRMS
• Type & Sequence: AM2
• Email Name: ECS
• Email Name: WHE
• Media Type: D
• Archive: No

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Company
3 -
11. Correspondence Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name: Jason Loekard Title: Road Supervisor
Company Name: Washington County
Street/P.O. Box: 501 4th Avenue P.O. Box:
City; Akron
State: CO Zip Code: 80743
Telephone Number:
970 ).246-3347
Fax Number;
9770 )-246-3347
PERMITTING CONTACT
(if different from applicant/operator above)
Contact's Name:
Randy Schafer Title:
Company Name:
S
40586 Co Rd 21
treet/P.O. Boa: P.O. Box:
City: Haxtun
State: CO Zip Code: 80731
Telephone Number: ( 970 ) _ 520-0502 (Cell)
Fax Number: ( 970 )-854-3811
INSPECTION CONTACT
Contact's Name: Jason Lockard Title:
Company Name:
Street/P.O. Box:
P.O. Box:
City: SAME AS ABOVE
State:
Zip Code:
Telephone Number: L
Fax Number: (_ _
CC: STATE OR FEDERAL, LANDOWNER (if any
Agency:
Street:
City.
State:
Zip Code:
Telephone Number: ( _
CC: STATE OR FEDERAI. I.ANDOWNIll (if any)
Agency:
Street:
City:
State:
Zip Code:
Telephone Number: f -