PERMFILE60929

• Permit No: M1990134
• IBM Index Class Name: Permit File
• Doc Date: 10/9/1990
• Doc Name: LIMITED IMPACT OPERATION 110 2 APPLICATION FORM
• Media Type: D
• Archive: No

1
1
1
1
1
~j
_2_
10. Correspondance Information
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Individual's Name: James H ~ Kathleen H Ross
Company Name: n/a
Street: 5529 Hwy dk394
City : GYaig
State: Colo. Zip Code: 81625
Area Code: 303 Telephone: [phone] off 8 4-595 nmP
PERMITTING CONTACT (if different from applicant/operator above)
Individual's Name: Jaynes Rr~ss (all rhP c~r,pL
Company Name:
Street:
City:
State: Zip Code:
Area Code: Telephone:
INSPECTION CONTACT (if different from applicant/operator above)
Individual's Name: James Ross (all the sarne)
Company Name:
Street:
City:
State: Zip Code:
Area Code: Telephone:
11. Primary future _ Cropland(CR) _ Pastureland(PL) General Agriculture(GA1
land use Rangeland(RL) _ Forestry(FR) ~ Wildlife Habitat(WL)
(check one): ~ Residential(RS) Recreation(RC) Industrial/Commercial(IC)
~ Developed Water l~sources(WR) _ Solid Waste Disposal(WD)
12. Primary present Cropland(CR) _ Pastureland(PL) _ _ General Agriculture(GA)
land use x Rangeland(RL) _ Forestry(FR) _ Wildlife Habitat(WL)
(check one): Residential(RS) Recreation(RC) _ Industrial/Commercial(IC)
imDeveloped Water ~ebo+xxas(WR)
stagnalit pond
3