2018-07-02_PERMIT FILE - M2018032

• Permit No: M2018032
• IBM Index Class Name: Permit File
• Doc Date: 7/2/2018
• Doc Name: Application
• From: Dolores County Road & Bridge
• To: DRMS
• Email Name: THM
• Email Name: WHE
• Media Type: D
• Archive: No

-3 -
11. Correspondence Information:
APPLICANT/OPERATOR (name,address,and phone of name to be used on permit) n n 9
Contact's Name: ST e o C 'I)c�y;S n Title: S;U per
Company Name: 'Do 142(es CRd, '
©a dL/
�
Street[P.O.Box: q 7 7 !mod', 7, 7 P.O.Box: OF
City: re-e k-
State: Ce/d rct dn Zip Code: 8�3
Telephone Number: (( T 2 o ))- 477 - 23 2'V_
Fax Number: ( q 7 Q )- 6j 7 7 - 2.2 q`�/
PERMITTING CONTACT (if different from applicant/operator above)
Contact's Name: Same C(5 U b© )e Title:
Company Name:
Street/P.O.Box: P.O.Box:
City:
State: Zip Code:
Telephone Number: ( )Fax Number: ( -
INSPECTION CONTACT T Kn /J
Contact's Name: S 2U DC,L),S Title: oc"I St(�'r i i1 P�1GCc�n�
Company Name: Do coua
00 1 f?
r d.Street/P.O.Box: ��-1 77 , P.O.Box:
City: c Pp-
Ic-
State: YC( 0 Zip Code:
Telephone Number: ( T76 )- 6 77- oC 3 2-
Fax Number: ( e'7 0 )- 6 77- v7 Q T L4
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: ( )-