2023-07-19_REVISION - M2021052 ‎(3)‎

• Permit No: M2021052
• IBM Index Class Name: Revision
• Doc Date: 7/19/2023
• Doc Name Note: Application Form
• Doc Name: Adequacy Review Response
• From: IHC Scott
• To: DRMS
• Type & Sequence: AM1
• Email Name: ACY
• Email Name: THM
• 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: John Medberry Title: VP of Administration
Company Name: IHC Scott, Inc(dba Scott Contracting, Inc)
Street/P.O.Box: 9200 E. Mineral Avenue, Suite 400 P.O.Box:
City: Centennial
State: Colorado Zip Code: 80112
Telephone Number: (720 )_ 889-4442
Fax Number: )-
PERMITTING CONTACT (if different from applicant/operator above)
Contact's Name: Title:
Company Name:
Street/P.O.Box: P.O.Box:
City:
State: Zip Code:
Telephone Number: ( )Fax Number: ( )-
INSPECTION CONTACT
Contact's Name: John Medberry Title: VP of Administration
Company Name: IHC Scott, Inc (dba Scott Contracting, Inc)
Street/P.O.Box: 9200 E. Mineral Avenue, Suite 400 P.O.Box:
City: Centennial
State: Colorado Zip Code: 80112
Telephone Number: (720 )_ 889-4442
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: f )-