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<br />-z- <br />10. Correspondance Information <br />APPLICANT/OPERATCIR (name, address, and phone of name to be used on permit) <br />Individual'<; Name: phillios County Road Department <br />Company NamE~: phillios Countv <br />Street: 221 S. Interocean <br />City: Holyoke. <br />State: C~l~radn Zip Code: 80734 <br />.Area Code: ~Dq Telephone: 854-3778 <br />PERMITTING CONTA(:T (if different from applicant/operator above) <br />Individual's Name: Randy Schafer <br />Company Name: ph;tl;ps Cnnnry <br />Street: 221 S. Interocean <br />City: Holyoke, <br />State: CO Zip Code: 80734 <br />Area Code: 303 Telephone: 854-3778 <br />INSPECTION CONTA(:T (if different from applicant/operator above) <br />Individual's Name: Randy Schafer <br />Company Name: Phillips County <br />Street: 221 S. Interocean <br />City: Holyoke <br />State: CO Zip Code: 80734 <br />Area Code: 303 Telephone: 854-3778 <br />11. Primary future Pastureland(PL) <br />Cropland(CR) General Aariculture(GA) <br />land use _ <br />_ <br />Rangeland(RL) <br />Forestry(FR) g Wildlife Habitat(WL) <br />(check one): _ <br />_ <br />Residential(RS) Recreation(RC) - Industrial/Commercial(IC) <br /> -_ Developed Water T~esources(WR) ~_ Solid Waste Disposal(WD) <br />~~ X Creekbed <br />(12: Primary present Pastureland(PL) <br />Cropland(CR) General Aariculture(GA) <br />land use _ <br />Ranaeland(RL) <br />Forestry(FR) Wildlife Habitat(WL) <br />(check one): _ <br />- <br />Re sidential(RS) Recreation(RC) Industrial/Commercial(IC) <br />/ _ Developed Water ~sources(WR) <br />! X Creekbed <br />~~ (.aq~Q lr.... .CiG'~iL/ti /1 <br />~uD .~/~/9 y ~~ <br />