PERMFILE57054

• Permit No: M1987009
• IBM Index Class Name: Permit File
• Doc Date: 1/29/1987
• 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 Carder
Company Name: Carder, Inc.
Street: P.0. Box 721
City: Lamar
State: Colorado Zip Code: 81052
Area Code: 303 Telephone: [phone]
PERMITTING CONTACT (if different from applicant/operator above)
Individual's Name: Donald A. Rann
Company Name:
Street: 8730 W. Mtn. View Ln.
City: Littleton
State: Colorado Zip Code: 80175
Area Code: X03 Telephone: [phone]
INSPECTION CONTACT (if different from applicant/operator above)
Individual's Name: Ira Paulin or John Carder
Company Name: Carder, Inc.
Street:
City:
State: Zip Code:
Area Code: Telephone:
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 ^ Rangeland(RL) ^ Forestry(FR) ^ Wildlife Habitat(WL)
{check one): ^ 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 A-G are true and correct (mu 'gned by a plica /operator).
Date: ~/ / 7 By: ~~~/~
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