2006-01-03_REVISION - M1989004

• Permit No: M1989004
• IBM Index Class Name: Revision
• Doc Date: 1/3/2006
• Doc Name: Application
• From: Kit Carson County
• To: DMG
• Type & Sequence: CN1
• Media Type: D
• Archive: No

-2-
11. Correspondence Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name: ~~klJ ~~-t~Ww>F \~ ~ ~C,F35dt
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Company Name: ~tK~'~ ~1Z-S(lh1 ~U.t,l)Z~-~
Stree[/P.O. Box: ~1' l> ~h~. `lQ ~~ P.O. Box:
city: ~.
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Slate: ~.U
Telephone Number: r
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Fax Number: ~- ~~ ~~
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PERMITTING CONTACT (if different from applicandoperatorahove)
Contact's Name:
Company Name:

Street/P.O. Box:

City:

Stale:
Telephone Number: ( 1-

Fax Number. ( ) -
INSPECTION CONTACT
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Contacts Name: V~ N ~ `WW f~
lJ r ~~~
Company Name: ~~ ~,~{l.A(~ ~ A 1

Street/P.O. Box:
city: ~,p t,\ ~,,~.,-rn rJ

State: ~~
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Telephone Number: (~~ ~ 1- ~' I,
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nr ~~
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Fax Number: (~ ~ ~ 1 - 3' 1
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CC: STATE OR FEDERAL LANDOWNER (if anvl

Agency:

S[reet:
aty:

Stale:
Telephone Number. ( 1 -

CC: STATE OR FEDERAL LANDOWNER (if anvl
Agency:

Stree[:
City:

State:
Telephone Number: ( ) -
Zip Code:
Title:
P.O. Box:
Zip Code:
Zip Code:
Code:
Title: W v\ ~ l ~ ~ P'1 I P~ iS1i~%02
Tile: (t iY..t l'~{ ~ a1 f ~~ Z~ ~w is
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