REV00300

• Permit No: M1991060
• IBM Index Class Name: Revision
• Doc Date: 4/24/2000
• Doc Name: CONSTRUCTION MATERIALS REGULAR 112 OPERATION RECLAMATION PERMIT APPLICATION FORM
• Type & Sequence: CN1
• Media Type: D
• Archive: No

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14. Correspondence Infortoatioe:
APPLICANT/OPERATOR (name, address, and phone of mme to be used on pemvt)
Contact's Name: Pete Aragon
Company Name: Lincoln County
Sweet: P.O. Box 39, 103 3rd Ave.
City: Hugo, Colorado 80821
State: Zip Code:
Telephone Number: (719 ~_ 7 4 3- 2 3 3 7
Fax Number: (719 1_ 7 4 3- 2 81 5
PERMITTING CONTACT (if di$'erent from appficanUoperator above)
Contact's Name: same as above Title:
Company Nmme:
Street.
City:
State:
Telephone Number
Fax Nttmber:
2~lSPECTION CONTACT
Contact's Name:
Cotnpmy Name:
Sheet:

Land Use Administrator
Title:
same as above
Zip Code:
City:
State:
Telephone Nnmber: ( 1-
Fax Number: ( 1-
CC: TA ORFEDERai OWNER ('fsnvl
~~~~
Street:
Citv
State:
Telephone Number: ( 1 - _
CC: STATE OR FEDERAL LANDOWNERlLfany,)
Agency:
Street
Citv:
State:
Zip Code:
Zip Code:
Zip Cade:
Telephone Number