PERMFILE57041

• Permit No: M2004027
• IBM Index Class Name: Permit File
• Doc Date: 4/15/2004
• Doc Name: Reviewed Application
• From: West Otero Timpas Conservation District
• To: DMG
• Media Type: D
• Archive: No

-3-
14. Corresootodence Information:
APPLICANT/OPERATOR (name, address, end phone of name to be used on pecmiq
Contact's Name: KENNETH S. PARKER
Compa~Name: OTERO COUNTY
Street/P.O. Hoar: 13 W. 3rd STREET, P.O. Box: 511
City: LA JUNTA
State: COLORADO Zip Code: 81050

TelephaceNumber f 719 1- 383-3035
.
Fax Numbs ( 719 ) - 383-3935
.
_
PERMITTING CONTACT (d'differwt from apphcant/operator above)
Contest's Name: Title:

Compa[ty Name:

Sireet/P.O. Box: P.O. Box:

City
.
State: Zip Code:
Telephone Number. ( 1-
Fax N®ber: ( ) -
INSpECTIONCONTACT
Contact's Namc:
Compmry Name:
StreeUP.O. Box:
City:
State:
Telephone Number. ( 1--
Fax Ntmmber: ( 1-
CC• STATE OR FIDERAL LANDOWNER (tf anvl
Age N/A
Street:
City:
State:
Telephone Number. ( 1--
CC' STATE OR FIDERAL LANDOWNER (if anyl
Agency: N/A
Street:
City:
State:
Telephone Number:
Title: PUBLIC WORKS SUPERVISOR
Title:
P.O. Box:
Zip Code:
Zip Code:
Zip Code: