PERMFILE50244

• Permit No: M1987013
• IBM Index Class Name: Permit File
• Doc Date: 2/4/1987
• 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: John T. Ungefug
Company Name: Southway construction Co., Inc.
Street: 117 White Pine
City: Alamosa
State: coloraao Zip Code: 91101
Area Code: 303 Telephone: 5a9-s1o5
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:
Telephone:
Zip Code:
11. Primary future ^ Cropland(CR) ^ Pastureland(PL) ^ General Agriculture(GA)
land use (~ Rangeland(RL) ^ Forestry(FR) ^ Wildlife Habitat(WL)
(check one): ^ Residential(RS) ^ Recreation(RC) ^ Industrial /Commercial(IC)
^ Developed Water Resources(WR) ^ Solid Waste Disposal(WD)
12. Primary present ^ Cropland(CR) ^ Pastureland(PL) ^ General Agriculture(GA)
land use fr} Rangeland(RL) ^ Forestry(FR) ^ Wildlife Habitat(WL)
(check one): ^ Residential(RS) ^ Recreation(RC) ^ Industrial/Commercial(IC)
^ Developed Water Resources(WR) xx Existing puarry
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 by applicant/operator).
Date: /~3lJ~fs'7 ey: /l',~!!~o~'~
Time