2017-03-10_REVISION - M2014042

• Permit No: M2014042
• IBM Index Class Name: REVISION
• Doc Date: 3/10/2017
• Doc Name: Application
• From: Russell Painter
• To: DRMS
• Type & Sequence: CN1
• Email Name: ERR
• Email Name: WHE
• Media Type: D
• Archive: No

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9. Correspondence Information:
APPLICANVOPERATOR(name,address,and phone of name to be used on permit):
Contact's Name: russell painter Title: operator, miner
Company Name:
Street: 1761 pikes peak dr P.O.Box: same
City: florissant
State: Colorado Zip Code: 80816
Telephone Number: (719 ) - 684-4066
Fax Number: ( ) - none
PERMITTING CONTACT(if different from applicant/operator above):
Contact's Name: same as move Title:
Company Name:
Street: _ P.O.Box:
City:
State: Zip Code:
Telephone Number: ( )Fax Number: ( ) -
INSPECTION CONTACT:
Contact's Name: same as above Title:
Company Name:
Street: P.O.Box:
City:
State: Zip Code:
Telephone Number: ( )Fax Number: ( ) -
CC: STATE OR FEDERAL LANDOWNER if any):
Agency: national o est
Street:
City: a -
State: / Zip Code:
Telephone Number: -
CC: STATE OR FEDERAL LANDOWNER(if any).
Agency: n a rlational forest
Street: D
City:
State: Zip Code: To
Telephone Number: