PERMFILE43037

• Permit No: M1987027
• IBM Index Class Name: Permit File
• Doc Date: 2/19/1987
• Doc Name: LIMITED IMPACT OPERATION 110 APPLICATION FORM
• Media Type: D
• Archive: No

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10. Correspondance Information
APPLICANT/OPERATOR (name, address. and phone of name to be used on permit)
Individual's Name: Bill Tezak
Company Name: Colorado Quarries, Inc.
Street: 15th 8 Water Sts. P.O. Box 1389
City: C'annn c'jty.
State: Colorado Zip Code: Biziz
Area Code: 303 Telephone: z~s-6B9a
PERMITTING CONTACT (if different from applicant/operator above)
Individual's Name:
Company Name:
Street:
City:
State: Zip Code:
Area Code: Telephone:
INSPECTION CONTACT (if different from applicant/operator above)
Individual's Name:
Company Name:
Street:
City,:
State:
Area Code:
11. Primary future
land use
~~ (check one):
12. Primary present
land use
(check one):
•
Zip Code:
Telephone:

^ Cropland(CR) ^ Pastureland(PL) ^ General Agriculture(GA)
® RangelandCRL) ^ Forestry(FR) O Wildlife Habitat(WL)
^ Residential(RS) ^ Recreation(RC) ^ Industrial/Commercial(IC)
^ Developed Water Resources(WR) ^ Solid Waste Disposal(WD)
^ Cropland(CR) ^ Pastureland(PL) . ^ General Agriculture(GA)
® Rangeland(RL) ^ Forestry(FR) ^ Wildlife Habitat(WL)
^ Residential(RS) ^ Recreation(RC) ^ Industrial/Commercial(IC)
^ Developed Water Resources(WR)
To the best of my knowledge, all the information presented on this application form and
the attached Exhibits A-G are true and correct (must be signed Dy applicant/operator).
Date: ~ ~l, ~~ BY: ~.
President
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