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2 <br />C <br />Correspondence Information <br />APPLICANT/OPERATOR <br />Individual's Name: <br />Company Name: <br />Street: <br />city: <br />State: <br />Telephone: <br />PERMITTING CONTACT <br />Individual's Name: <br />Company Name: <br />Street: <br />City: <br />State: <br />Telephone: <br />INSPECTION CONTACT <br />Individual's Name: <br />Company Name: <br />Street: <br />City: <br />State: <br />(Name, Address and Phone of Name to be used on Permit) <br />Ben Moline <br />Molson Coors Beverage Company <br />PO Box 4030 <br />Golden <br />CO <br />3�03_�77-3342 <br />(If different from ApplicanUOperator above) <br />�� <br />(If different from Applicant/Operator above) <br />Telephone: �� <br />7. Location Information: The center of the operation lies in - <br />County: Weld <br />USGS Quadrangle: Kluq RanCh & Tamp _ <br />Principal Meridian (check one): �`� 6th (Colorado) �_ 10th (New Mexico) '_ Ute <br />Township (Write number and check direction): �3 _ ''� North = 5outh <br />Range (Write number and check direction): 64_ East!_ Wesi�'� <br />Section: 25 Quarter Section (Check one): __ NE f_ NW �'� SE �_ SW <br />�_� __ �..._ _.__ <br />Quarter-Quarter Section (Check one): �_ NE !_ NW E_ SE ''� SW <br />Longitude (Write number): 104 _ Degrees (102-110) 29 _ Minutes (0-60) <br />_ 48 0 Seconds (0.00-60.0) <br />Latitude (Write number): 40 __ Degrees (37-41) � � _ Minutes (0-60) <br />_ 36 0 Seconds (0.00-60.0) <br />