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s. <br />• <br />z <br />Correspondence Information <br />APPLICANT/OPERATOR (Name, Address and Phone of Name to be used on Permit <br />Individual's Name: <br />Company Name: <br />Street;` <br />city: <br />State: <br />~EV~ Wo.rsua <br />rz,M.~e« <e.~ i__o..a_, <br />o y '-~ 5~. <br />/30.,0 <br />co <br />Telepho~ _ - (3=3 1 ts3- 3-/0o f,~,, b+8f <br />PERMITTING CONTACT (lf different from Applicant/Operator above) <br />Individual's Name: T£FFRE v ~Ro«. <br />Company Name: L,4aan..,etq,c /~EC~~~..Ar~oar /.vc. <br />Street: 49oi So.~r~i W/NDE,~MERE Sr. <br />City: L ~ rr cE ro a <br />State: ~ o Soi 20 <br />Telephone: (303) ~4s- 2sez <br />INSPECTION CONTACT Ilf different from Applicant/Operator above) <br />• Individual's Name: SA-...E .e,c PER~+i>r~~ a Co~rA~r <br />Company Name: <br />Street: <br />City: <br />State: <br />Telephone: ( 1 <br />7. Location Information: The center of the operation lies in - <br />County: Lo,s A^~~^~AS <br />USGS Quadrangle: TixiN~n.o.o 4asr <br />Principal Meridian (check onel: X 6th (Colorado) _ 10th (New Mexico) _ Ute <br />Township (Write number and check directionl: 3 3 _ North x South <br />Range (Write number and check directionl: 6 3 x East _ West <br />Section: 2g Quarter Section (Check onel: _ NE x NW _ SE _ SW <br />Quarter-Quarter Section (Check onel: ~c NE _ NW _ SE _ SW <br />Longitude (Write numberl: L o y Degrees (102-110) ?- ~ Minutes 10-601 <br />0 0 o Seconds (0.00-60.0) <br />Latitude (Write number): _ 3 -~ Degrees (37-41) ~ o_ Minutes (0-60) <br />Y s o Seconds (0.00-60.01 <br />General Description (Miles and direction from nearest town and approximate elevationl: <br />• ~ wo /"~~aES Sear'+~AST GG /RI~J~D~O ~ CQ <br />~rFU.+r~o-a 6¢SO FFET <br />