2020-12-15_REVISION - M1990144

• Permit No: M1990144
• IBM Index Class Name: Revision
• Doc Date: 12/15/2020
• Doc Name: Request For Amendment To Permit
• From: R. Lewis Fillmore
• To: DRMS
• Type & Sequence: AM2
• Email Name: JPL
• Email Name: JLE
• Email Name: AWA
• 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: R.Lewis Fllmore Title: Landowner
Company Name:
Street/P.O.Box: 63985 Highway 96 East P.O.Box: 258
City: Boone
State: Colorado Zip Code: 81025
Telephone Number: (719 )_ 568-6712
Fax Number: ( )-
PERMITTING CONTACT (if different from applicant/operator above)
Contact's Name: Jodi Schreiber Title: Chief of Operations
Company Name: Fremont Paving and Redi Mix
Street/P.O.Box: 839 Mackenzie Ave. P.O.Box: 841
City: Canon City
State: Colorado Zip Code: 81212
Telephone Number: (719 )_ 529-0916
Fax Number: )-
INSPECTION CONTACT
Contact's Name: Title:
Company Name:
Street/P.O.Box: P.O.Box:
City:
State: Zip Code:
Telephone Number: ( )Fax Number: ( )
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: ( )-