PERMFILE40990

• Permit No: M1988037
• IBM Index Class Name: Permit File
• Doc Date: 5/24/1988
• Doc Name: REGULAR 112 PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

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10. Correspandance Information
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
PERMITTING CONTACT (if different from applicant/operator above)
Individual's Name: Same
Individual's Name: L. Dwavne Skelton & Ruth Grav
Company Name: Skelton, Inc.
Street: 1565 6ranthlAvenue
City: Norwood, is
State: Colorado Zip Code: 81423
Area Code: 303 Telephone: [phone]
Comparry Name:
Street:
City:
State:
Zip Code:
Area Code: Telephone:
• INSPECTION CONTACT (if different f rom applicant/operator above)
Individual's Name: Same
Company Name:
Street:
City:
State: Zip Code:
Area Code: Telephone:
11. Primary future Cropland(CR) Pastureland(PL) General Agriculture(GA)
land use Rangeland(RL) ores ry Wildlife Habitat(WL)
(check one): Residential(RS) Recreation(RC) Industrial/Commercial(IC)
Developed Water Resources(WR) Solid Waste Disposal(WD)
12. Primary present Cropland(CR) Pastureland(PL) General Agriculture(GA)
land use Rangeland(RL} Forestry(FR) Wildlife Habitat(WL)
(check one): Residential(RS) Recreation(RC). Industrial/Commercial(IC)
Developed Water Resources(WR)
To the best of ~ knowledge, all the information presented on this application form and
the attached Exhibits A-P are true and c orrect (must be signed by applicant/operator).