2019-11-22_PERMIT FILE - M2019057

• Permit No: M2019057
• IBM Index Class Name: PERMIT FILE
• Doc Date: 11/22/2019
• Doc Name: Comment
• From: Park County
• To: DRMS
• Email Name: ERR
• Media Type: D
• Archive: No

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9. Correspondence Information:
APPLICANT/OPERATOR(name,address,and phone of name to be used on permit):
Contact's Name: Jacob Ulrich Title:
Company Name: n/a
Street: 17619 Leisure Lake Dr P.O.Box:
City: Monument
State: Colorado Zip Code: 80132
Telephone Number: (303 1 - 328-8726
Fax Number: ( 1 -
PERMITTING CONTACT(if different from applicant/operator above):
Contact's Name: Same as move Title:
Company Name:
Street: P.O.Box:
City:
State: Zip Code:
Telephone Number: ( -
- Number: -
INSPECTION CONTACT:
Contact's Name: same as above Title:
Company Name:
Street: P.O.Box:
City:
State: Zip Code:
Telephone Number: ( 1 Fax Number: ( 1 -
CC: STATE OR FEDERAL LANDOWNER(if any):
Agency: South Park Ranger District
Street: 320 Highway 285
City: Fairplay
State: Colorado Zip Code: 80440
Telephone Number: (719-836- -
CC: STATE OR FEDERAL LANDOWNER(if any):
Agency:
Street:
City:
State: Zip Code:
Telephone Number: ( -