2018-09-25_REVISION - M2015045

• Permit No: M2015045
• IBM Index Class Name: REVISION
• Doc Date: 9/25/2018
• Doc Name: Request For Amendment To Permit
• From: Weld County
• To: DRMS
• Type & Sequence: AM1
• Email Name: ECS
• 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: Jay McDonald Title: Director of Public Works
Company Name: Weld County Public Works
Street/P.O.Box: 1111 H Street P.O.Box: 758
City: Greeley
State: CO Zip Code: 80632
Telephone Number: {970 _ 304-6496
Fax Number: (970 )_ 304-6497
PERMITTING CONTACT (if different from applicant/operator above)
Contact's Name: Clay Kimmi Title: Senior Engineer
Company Name: Same as above
Street/P.O.Box: P.O.Box:
City:
State: Zip Code:
Telephone Number: { )Fax Number: ( )-
INSPECTION CONTACT
Contact's Name: Clay Kimmi Title: Senior Engineer
Company Name: Same as above
Street/P.O. Box: P.O.Box:
City:
State: Zip Code:
Telephone Number: { )Fax Number: ( )-
CC: STATE OR FEDERAL LANDOWNER(if any)
Agency: N/A
Street:
City:
State: Zip Code:
Telephone Number: ( )-
CC: STATE OR FEDERAL LANDOWNER(if M)
Agency: N/A
Street:
City:
State: Zip Code:
Telephone Number: ( )-