2018-02-13_REVISION - M2001056

• Permit No: M2001056
• IBM Index Class Name: Revision
• Doc Date: 2/13/2018
• Doc Name Note: Application - Conversion
• Doc Name: Application
• From: Elbert County
• To: DRMS
• Type & Sequence: CN1
• 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: Sam Albrecht Title: County Manager
Company Name: Elbert County, County Government
Street/P.O.Box: 215 Comanche St. P.O.Box:
City: Kiowa
State: Colorado Zip Code: 80117
Telephone Number: (303 )_ 621-3106
Fax Number: ( )-
PERMITTING CONTACT (if different from applicant/operator above)
Contact's Name: H. Bruce Humphries Title: President
Company Name: Regulatory Permits Management, Inc.
Street/P.O.Box: 22151 E. Euclid PI. P.O.Box:
City: Aurora
State: Colorado Zip Code: 80016
Telephone Number: (303 )_ 854-7499
Fax Number: ( )_ email: [e-mail]
INSPECTION CONTACT
Contact's Name: Ralph Lewis Title: Foreman
Company Name: Elbert County, County Government
Street/P.O.Box: 215 Comanche St. P.O.Box:
City: Kiowa
State: Colorado Zip Code: 80117
Telephone Number: (720 1_ 245-7021
Fax Number: ( )-
CC: STATE OR FEDERAL LANDOWNER(if any)
Agency: NA
Street:
City:
State: Zip Code:
Telephone Number: ( )-
CC: STATE OR FEDERAL LANDOWNER(if any)
Agency: NA
Street:
City:
State: Zip Code:
Telephone Number: ( )-