PERMFILE63138

• Permit No: M1987072
• IBM Index Class Name: Permit File
• Doc Date: 4/24/1987
• 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: k Stanley J. Conner
Company Name:
Street: i~r~ ennth rlarLcnn
City: Denver
St~3te: Colorado Zip Code: 80210
Area Code: 303 Telephone: 772_gpg5
PERMITT[NG CONTACT (if different from applicant/operator above)
Individual's Name:
Conpany Name:
Street:
Ci i:y
State:
Zip Code:
Area Code: Telephone:
INSPECTION CONTACT (if different from applicant/operator above)
Individual's Name: Sane
Con~pany Name:
Street:
City
State:
Area Code: Telephone:
Zip Code:
11. Primary future ^ Cropland(CR) PasturelandlPL) ^ General Agriculture(GA)
land use ^ Rangeland(RL) Forestry(FP.) ^ Wildlife Habitat(WL)
(check one): ^ Residential(RS)^ Recreation(RC) ^ Industrial/Commercial(IC}
^ Developed Water Resources('WR) ^ Solid Waste Disposal(IJD)
12. Primary present ^ CroplandiCR) ~ Pastureland(PL) ^ General Agriculture(GA)
land use ^ Rangeland(RL) ~ Forestry(FR) ^ Wildlife Habitat(WL)
(check one): ^ Re sidential(RS) ^ P,ecreation(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 (must Psigne by a licant/operator).
Date: i~_23.1987 BY:
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