2021-05-04_PERMIT FILE - M2021029

• Permit No: M2021029
• IBM Index Class Name: PERMIT FILE
• Doc Date: 5/4/2021
• Doc Name: Application
• From: Phillips County
• To: DRMS
• Email Name: BFB
• Email Name: MAC
• 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: Phillips County Title:
Company Name:
Street/P.O.Box: 221 S Interocean Ave P.O.Box:
City: Holyoke
State: CO Zip Code: 80734
Telephone Number: (970 )_ 854-3778
Fax Number: (970 _ 854-3811
PERMITTING CONTACT (if different from applicant/operator above)
Contact's Name: Laura L. Schroetlin Title: Administrator
Company Name: Phillips County
Street/P.O.Box: 221 S Interocean Ave P.O.Box:
City: Holyoke
State: co Zip Code: 80734
Telephone Number: (970 1 _ 854-3778
Fax Number: ( 970 _ 854-3811
INSPECTION CONTACT
Contact's Name: Mike Salyards I itle: Road Manager
Company Name: Phillips County
Street/P.O.Box: 221 S Interocean Ave P.O. Box:
City: Holyoke
State: CO Zip Code: 80734
Telephone Number: (970 )_ 854-3778
Fax Number: (970 _ 854-3811
CC: STATE OR FEDERAL LANDOWNER(if any)
Agency: Colorado State Board of Land Commissioners
Street: 1127 Sherman St, Suite 300
City: Denver
State: co Zip Code: 80203
Telephone Number: ( 303 _ 866-3454 x3313
CC: STATE OR FEDERAL LANDOWNER(if any)
Agency:
Street:
City:
State: Zip Code:
Telephone Number: ( )-