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.f,,. <br />4 <br />~. <br />.. <br />_'.y' <br />j <br />t`t <br />~~'' <br />1./ <br />pondance Infon <br />•.,:;.k <br />'~Compa~y Name: . <br />•:.: =Street: <br />City: <br />State: Zip Code: <br />., '' Area Code: Telephone: <br />IN$pEC'tION CONTACT (if different from applicant/operator above) <br />Individual's Name: Same <br />`~ ~ Company Name: <br />' ~`~~: Street: <br />,' city: <br />" State: Zip Code: <br />Area Code: ~ Telephone: <br />!tee -iy: - <br />~ - ,.::,; <br />~ <br /> <br />E4Uf , ~.. . <br />;~, <br />,. <br />_:.. , <br /> <br /> <br /> <br /> <br />~ 1 ~.+ ~ <br /> <br />-:T. •-,. <br />,,., <br />~t i c Y,S• •lr ~ <br />. u. :A' <br />r,'~APPI.ICANT/OPERATOR :! (names="address. and phone of. <br />name: to;:be <br />;used on permit) <br />•Individual'S Name r <br />~'~~ <br />; , <br />, <br />Mike Horner ° ~ ' ' <br />~ <br />, <br />b ~ <br />','~:~zy`;Compdriy Name: <br />; +,~;' <br />, <br />~ .: r' ~ i . ~ n1~1 1 1 t '11 ~ ~Ili1i I ~ Plii <br />San M~.'guel County Road "Department <br />~~s;v 3~treet: .. <br />~ . ... ` <br />~` <br />`' 1510 Grand 'Ave PO `Box' 426 <br />.;s, <br />;r: City:. <br />~! <br />Norwood - ;,...,.., <br />~~;':,, , i;~~$tate: ~ Colorado Zip. Code: 81423 <br />~~ Area Code::: • '303.' <br />,: Telephone: =°327-4835 <br /> , <br />`'PERMITTING CONTACT (if .different from applicant/operator above) <br />'-~~'~~Individual's Name:':' ~ Same <br />I,. n. <br />;L~ <br />11. Primary future Cropland(CR), _ Pastureland(PL) General Agriculture(GA) <br />land use x Rangeland(RL) _ Forestry(FR) x Wildlife Habitat(WL) <br />(check one): Residential(RS) Recreation(RC) Industrial /Commercial(IC) <br />Developed Water l~esources(WR) _ Solid Waste Disposal(WD) <br />12. Primary' present Cropland(CR) _ Pastureland(PL) General Agriculture(GA) <br />land use ~ Rangeland(RL) _ Forestry(FR) ~ Wildlife Habitat(WL) <br />(check ene): _ Residential(RS) Recreation(RC) _ Industrial /Commercial(IC) <br />' _ Developed Water t~esources(WR) <br />