PERMFILE44366

• Permit No: M1987012
• IBM Index Class Name: Permit File
• Doc Date: 2/4/1987
• Doc Name: REGULAR 112 PERMIT 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: John z. ongefug
Company Name: Southway Construction Co.
Street: 117 white Pine (ni<Y ~ ; f • E a f .y/, / d-2,_ I,., „~
Clty: Alamosa
State: Colorado Zip Code' aunt
Area Code: 303 Telephone: se9-slos
PERMITTING CONTACT (if different from applicant/operator above)
Individual's Name:
Company Name:
Street:
City:
State:
Area Code:
Zip Code:
Telephone:
INSPECTION CONTACT (if different from applicantloperator above}
Individual's Name:
Company Name:
Street:
City:
State:
Area Code:
Zip Code:
Telephone:
11. Primary future ^ Cropland(CR) ^ Pastureland(PL) ^ General Agriculture(GA)
land use filcRangeland(RL) ^ Forestry(FR) O Wildlife Habltat(WL)
(check one): ^ Residential(RS)^ Recreation(RC) ^ Industrial/Commercial(IC)
^ Developed Water Resources(WR) ^ Solid Waste Disposal(WD)
12. Primary present ^ Cropland(CR) O Pastureland(PL) ^ General Agriculture(GA)
land use (~ Rangeland(RL) ^ Forestry(FR) p Wildlife Habitat(WL)
(check orie): ^ 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 JlA-P are true and correct (must be signed by applicant/operator).
Date: /_/2'7/x(7 BY~ C~~v.P~
Ti e