PERMFILE69582

• Permit No: M1989003
• IBM Index Class Name: Permit File
• Doc Date: 1/9/1989
• Section_Exhibit Name: REGULAR 112 PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

f.

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10. Correspondance Information

APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Individual's Name: Kit Cars on County
Company Name:
Street: 251 16th
City : l~r~tU er} '
State: Colo. Zip Code: $0$07
Area Code: 719 Telephone: 346-$133
PERMITTING CONTACT (if different from applicant/operator above)
Individual's Name: J.R. Owen
Company Name:
S1:reet: 21$ $th St.
City: Hugo,
State: Go].o. Zip Code: $0$21
Area Code: 719 Telephone: [phone]
INSPECTION CONTACT (if different from applicant/operator above)
Individual's Name: Same
Company Name:
Street:
City:
State: Zip Code:
Area Code: Telephone:
11. Primary future O Cropland(CR) ^ Pastureland(PL) p General Agriculture(GA)_
Tand use ~ Rangeland(RL) O Forestry(FR) O Wildlife Habitat(WL)
(check one): O Residential(RS)O Recreation(RC) ^ Industrial /Commercial(IC)
^ Developed Water Resources(WR) O Solid Waste Disposal(WD)
12, Primary present ^ Cropland(CR) ^ Pastureland(PL) ^ General Agriculture(GA)
Land use LI Rangeland(RL) p Forestry(FR) ^ Wildlife Habitat(WL)
(check one): O Residential(RS) ^ Recreation(RC) ^ Industrial/Commercial(IC)
O Developed Water Resources(WR)
To the best: of my knowledge, all the information presented on this application form and
the attached E/x`hibits A-P are true and correct (must be signed by applicant/operator),
Date: ~' / - ~ ~ Y ~ By: ~ ~ L `
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