1997-09-10_REVISION - M1992054

• Permit No: M1992054
• IBM Index Class Name: Revision
• Doc Date: 9/10/1997
• Doc Name: CONSTRUCITON MATERIALS LIMITED IMPACT OPERATION 110 RECLAMATION PERMIT APPLICATION FORM
• Type & Sequence: AM1
• Media Type: D
• Archive: No

-3-
14. correspondence Information;
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name: Jack Gilleland Title:_12,
Company Name: f R 1 fraval Prnd,wrrj. Tye,
Street: _ 27661 US Hwy 16nR
City: Duranso
State: CO Zip Code: 31301
Telephone Number: ( 970 1 - 385-4112
Fax Number: ( 970 1 - 335-5014
PERMITTING CONTACT (if different from applicant/operator above)
Individual's Name: Title:
Company Name:
Street:
City:
State: Zip Code:
Telephone Number: d 1 -
Fax Number: ( 1 -
INSPECTION CONTACT
Individual's Name:
Company Name:
Street:
City:
State: Zip Code:
Telephone Number: ( 1
Fax Number: ( i
CC: STATE OR FEDERAL LANDOWNER (if anvl
Agency:
Street:
City:
State: Zip Code:
Telephone Number: ( 1 -
r'
CC: STATE OR FEDERAL LANDOWNER (if anyl
Agency:
Street:
City:
State: Zip Code:
Telephone Number: ( 1