2007-08-10_REVISION - M2001107

• Permit No: M2001107
• IBM Index Class Name: Revision
• Doc Date: 8/10/2007
• Doc Name: Application
• From: Northern Colorado Constructors, Inc. Aggregate Div
• To: DRMS
• Type & Sequence: AM1
• Media Type: D
• Archive: No

-3-
11. Correstrondeoce In[ormation:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name: Gr-IRls 7i1~L Title: -7-k~ASvReIc.
Company Name: ti/cW+7r•IEKtV GoLoRMe Cotk~7Ytl~a.S~ /hIG A~y4F6~iAT~ b~V15[a.!
sheeur.o. Box: 9075 ~ to P.o. Box:
city: ~-r. 6var~t.1
State: !,O Zip Code: $o6Z/
Telephone Number: ( 30 3 1- 85'7'- l75'~
Fax Number: ( 303 1- >zi57 -x933
PERMITTING CONTACT (if different from applicant/operator above)
Contact's Name:
Company Name:
StreeUP.O. Box:
City:
State:
'telephone Number:
Fax Number:
NSPECTION CONTACT
Contacts Name:
Company Name:
StreetlP.O. Box:
"tegp Y~ Title: ~.
Jp.T Lctsyta-tr,Ik~ItJG.
ldeo W IZy"d .AU6 SUt7E lZO P.O. Box:
WGSrr~Ilnis~
`A 'Lip Code: ice' 4-
~303 )-~57-0735
(_30 3 ~ - 9zo - o3s(•3
Sr~ME .i5 ,4Ftat.ttwr~~e~te_ Title:
-~-
City:
State:
'telephone Number: ( ) -
Fax Number. ( 1-
P.O. Box:
Z.ip Code:
CC: STATE OR FEDERAL. LANDOWNER (if anvl
Agency:
Sheet:
City:
State:
Telephone Number: ( 1-
Z.ip Code:
CC: S'fA'PE OR FEDF:RAI. LANDOWNEK (ifany~
Agency: _~
Sheet:
City:
State:
lip Code:
Telephone Number: j_,~__.) -