PERMFILE65220

• Permit No: M2003019
• IBM Index Class Name: Permit File
• Doc Date: 3/5/2003
• Doc Name: Permit Application
• From: Baca County
• To: DMG
• Media Type: D
• Archive: No

3-
14. Corresoondeece Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Contacts Name: 'troy Crane Title: County Commissioner
Company Name: Baca County
Street: _~ a 7 rs a ; r,
City: Springfield
State: Colorado Zip Code: ff7Jb7.3^.
Telephone Number: ( % 19 ~_ 5 2 3- 6 5 3 2
Fax Number: ( 719 ~_ 523-65$4
PERMITTING CONTACT (if different from applicant/operator above)
Contact's Name: 'troy Crane
Company Name: Baca C:;un.ty
Street: 7 41- Nia i n
City:
StateY
Telephone Number.
Fax Number:
INSPECTION CONTACT
Contact's Name:
County Cotnmissior.er
Springfield
Col rad~ Zip Code: :`£410%Y3
( 719 ~ 523-6532
( 719 1- 52"t- F584
Cla.rer.ce Stevenson
Foremar.
CompaayName: Baca County District 3
Street: &WX 160/ 26607 County Road 12.5
Pritchett
City:
State: Colorado Zip Code: 81064
Telephone Number: ( 7 19 ~ _ 5 2 3 - 4 0 21
Fax Number: { 7 7 0 1- F 7,- F 5 R 4
CC: STATE OR FEDERAL LANDOWNER (if anyj
Agency:
Street:
City:
State: Zip Code:
Telephone Number: ( 1-
CC STATE OR FEDERAL LANDOWNER (if any]
Agency:
Street:
City:
State: Zip Code:
Telephone Number: ( ) _ -