PERMFILE61002

• Permit No: M1991133
• IBM Index Class Name: Permit File
• Doc Name: REGULAR OPERATION 112 RECLAMATION PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

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9. Correspondence Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Individual's Ndme: Demetrio Valdez
Company Name: ~/ai~P Rs~ondido
Street: P.O. Box 184
City: Conejos,
State: Colorado Zip Code: 81129
Area Code: 719 Telephone: [phone]
PERMITTING CONTACT (if different from applicant/operator above)
Individual's Name:
Company Name:
Street:
City:
State:
Area Code:
INSPECTION CONTACT
Individual's Name
Company Name:
Street:
City:
State:
Area Code:
Telephone:
Zip Code:
Same as above
Telephone:
Zip Code:
CC: STATE OR FEDERAL LANDOWNER (if anv)
Agency: N/A
Street:
City:
State:
Area Code: Telephone:
CC: STATE OR FEDERAL LANDOWNER (if anv)
Agency: pin
Street:
City:
State:
Zip Code:
Zip Code:
Area Code: Telephone: