PERMFILE56930

• Permit No: M2000099
• IBM Index Class Name: Permit File
• Doc Date: 8/4/2000
• Doc Name: CONSTRUCTION MATERIALS LIMITED IMPACT 110 OPERATION RECLAMATION PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

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Corresoondeocelnformatioo:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
•
Contact's Name: Marilyn F Vazquez Title: Owner
Company Name:
Street: ~~.
Ciry:
State:
26520 County Road 301
~Pna vista
(`olorado Zip Code: 81211
Telephone Number: (719 1- X45-8631
Fax Number: (719 1- 5-8670
PERMLTTiNG CONTACT (if different from applicantJoperator above)
individual's Name: rnnatl,an A Roorda Title: Professional Iand Surveyor
Company Name: ~rlc~nana valley SurvevinR
Street: C~- v0 Aox 1111 ~31i20 County Road 3B4A)
Ciry: n..e.... ,.; a+a
State: rn 7 n a n Zip Code: 81211
Telephone Nttmber: (719 1- 395-1185
Fax Number: 7l 19 1- 395-3185
INSPECTION CONTA
Individual's Name: Marilyn E. Vazquez Title: Owner
Company Name:
Street: ~ ~ 26520 County Road 301
Ciry: Auena Vista
State: rnl ora do Zip Code: 81211
Telephone Number: I 719 1 - 395-$631
Fax Number: ( 719 ~ - 395-8670
CC: STATE OR FEDERA L LANDOW NER (if anvl
Agency:
Street:
Ciry:
State: Zip Code:
Telephone Number: L_1 -
CC: STATE OR FEDERAL LANDOWNER (if any)
Telephone Number: ~~-
Agency:
Street:
Ciry:
State:
Zip Code: