PERMFILE42458

• Permit No: M2002108
• IBM Index Class Name: Permit File
• Doc Date: 10/1/2002
• Doc Name: Permit Application
• From: Lincoln County
• To: DMG
• Media Type: D
• Archive: No

i ., _ 3 .
14. _Correspondepce Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name: Don Blake
Company Name: Lincoln County
Street/P.O. Box: 10 3 3rd S t
City: Huao
State: ColoTad0
Telephone Number: ( 719 )- 743-2337
Fax Number: ! 719 ~_ 743-2815
PERMITTING CONTACT (if different from applicant/operator above)
P.O. Box:
Zip Code: 80821
Contact's Name: Tide:
Company Name:
StreetlP.O. Box: P.O. Box:
City:
State: Zip Code:
Telephone Number: ( ) -
FaxNumber: ( )-
INSPECTION CONTACT
Contact's Name: Don Blake Title: Land Use Adm.
Company Name: Lincoln County
Street/P.O. Box: P.O. Box:
City:
State: Zip Code:
Telephone Number: ( 719 -)- 7 4 3- 2 3 3 7
Fax Number: ( 1-
CC~ STATE OR FEDERAL LANDOWNER of anvl
Agency:
Street:
City:
State: Zip Code:
Telephone Number: ( ) -
CC' STATE OR FEDERAL LANDOWNER (if anvl
Agency:
Street:
City:
State:
Telephone Number: ( 1-
Title: Land Use Adm.
Zip Code: