REV11265

• Permit No: M1994007
• IBM Index Class Name: Revision
• Doc Date: 1/2/1997
• Doc Name: CONSTRUCTION MATERIALS REGULAR 112 OPERATION RECLAMATION PERMIT APPLICTION FORM
• Type & Sequence: CN1
• Media Type: D
• Archive: No

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14. Correeyoadence Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
contact's Name: Randy Schafer Title: County Planner
Company Name: Phillips County
street: 221 South Interocean
City:
State:
Telephone Number
Fax Number:
PERMITTING CONTACT
Contact's Name:
Company Name:
Street:
City:
State:
Holyoke
Colorado zip cone: 80734
( 970 ) _ 854-3778
L 970 ) - 854-3811
(if different from applicant/operator above)
Judv Foy Title:Envir. Planner
Tuttle Applegate, Inc.
11990 Grant Street. Suite 555
Denver
Colorado Zip Code: Rn933
( 303 ) _ 452-6611
( an3 ) - ati~_z~~4
Telephone Number:
Fax Number:
INSPECTION CONTACT
Contact's Name:
Randy Schafer
Title: County Planner
company Name: Phillips County
street: 221 South Interocean
city: Holyoke
state: Colorado zip cone: 80734
Telephone Number: ( 970 ) - 854-3778
Fax Number: ( 970 ) - ~ 854-3811
CC: STATE OR FEDERAL LANDOWNER (if anv)
Agency:
Street:
City:
State:
Telephone Number: ( ) - _
CC: STATE OR FEDERAL LANDOWNER (if anv)
Agency:
Street:
City:
State:
Zip Code:
Zip Code:
Telephone Number: ( ) -