2018-07-16_REVISION - M1998103

• Permit No: M1998103
• IBM Index Class Name: REVISION
• Doc Date: 7/16/2018
• Doc Name Note: Request for Conversion
• From: Town of Limon
• To: DRMS
• Type & Sequence: CN1
• Email Name: PSH
• Email Name: MAC
• 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: Dow Stom Title: Town Manager
Company Name: Town of Limon
Street/P.O.Box: 100 Civic Center DR. P.O.Box:
city: Limon
State: Colorado Zip Code: 80828
Telephone Number. (719 _ 775-2346
Fax Nmuber: ( )-
PERXIITTING CONTACT (if different fioni 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 Nwnber: ( )_ email: [e-mail]
INSPECTION CONTACT
Contact's Name: Dave Stone Title: Town Manager
Company Name: Town of Limon
Street/P.O.Box: 100 Civic Center DR. P.O.Box-
city: Limon
State: Colorado Zip Code. 80828
Telephone Numnber: (719 )_ 775-2346
Fax Number: ( )-
CC- STATE OR FEDERAL LANDOWNER(if any)
Agency: NA
Street:
City:
State. Zip Code:
Telephone Nunnber: ( )-
CC: STATE OR FEDERAL LANDOWNER(if any)
Agency: NA
Street:
City:
State: Zip Code:
Telephone Nu niber:
9