2017-08-18_REPORT - M1979097

• Permit No: M1979097
• IBM Index Class Name: REPORT
• Doc Date: 8/18/2017
• Doc Name: Annual Fee/Report/Map
• From: City of Fort Collins
• To: DRMS
• Annual Report Year: 2016
• Email Name: AME
• 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: Daylan Figgs Title: Env. Program Manager
Company Name: City of Fort Collins
Street/P.O.Box: P.O. Box: 580
City: Fort Collins
State: Colorado Zip Code: 80522
Telephone Number: (970 )_ 218-2814
Fax Number: ( )-
PERMITTING CONTACT (if different from applicant/operator above)
Contact's Name: same as above Title:
Company Name:
Street/P.O. Box: 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: P.O. Box:
City:
State: Zip Code:
Telephone Number: ( )Fax Number: ( -
CC: STATE OR FEDERAL LANDOWNER(if any)
Agency:
Street:
City:
State: Zip Code:
Telephone Number: ( )-
CC: STATE OR FEDERAL LANDOWNER(if any)
Agency:
Street:
City:
State: Zip Code:
Telephone Number: ( )-