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J <br />• <br />-2 <br />10. Correspondance Information <br />APPLICANT/OPERATOR (name, address. and phone of name to be used on permit) <br />Individual's Name: Bill Tezak <br />Company Name: Colorado Quarries, Inc. <br />Street: 15th 8 Water Sts. P.O. Box 1389 <br />City: C'annn c'jty. <br />State: Colorado Zip Code: Biziz <br />Area Code: 303 Telephone: z~s-6B9a <br />PERMITTING CONTACT (if different from applicant/operator above) <br />Individual's Name: <br />Company Name: <br />Street: <br />City: <br />State: Zip Code: <br />Area Code: Telephone: <br />INSPECTION CONTACT (if different from applicant/operator above) <br />Individual's Name: <br />Company Name: <br />Street: <br />City,: <br />State: <br />Area Code: <br />11. Primary future <br />land use <br />~~ (check one): <br />12. Primary present <br />land use <br />(check one): <br />• <br />Zip Code: <br /> Telephone: <br /> <br />^ Cropland(CR) ^ Pastureland(PL) ^ General Agriculture(GA) <br />® RangelandCRL) ^ Forestry(FR) O Wildlife Habitat(WL) <br />^ Residential(RS) ^ Recreation(RC) ^ Industrial/Commercial(IC) <br />^ Developed Water Resources(WR) ^ Solid Waste Disposal(WD) <br />^ Cropland(CR) ^ Pastureland(PL) . ^ General Agriculture(GA) <br />® Rangeland(RL) ^ Forestry(FR) ^ Wildlife Habitat(WL) <br />^ Residential(RS) ^ Recreation(RC) ^ Industrial/Commercial(IC) <br />^ Developed Water Resources(WR) <br />To the best of my knowledge, all the information presented on this application form and <br />the attached Exhibits A-G are true and correct (must be signed Dy applicant/operator). <br />Date: ~ ~l, ~~ BY: ~. <br />President <br />e <br />