REV13342

• Permit No: M1984041
• IBM Index Class Name: Revision
• Doc Date: 10/18/2000
• Doc Name: CONSTRUCTION MATERIALS REGULAR 112 OPERATION RECLAMATION PERMIT APPLICATION FORM
• Type & Sequence: AM3
• Media Type: D
• Archive: No

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14. Correaooadeece nfotmation:
APPLICANT/OPERATOR (name, address. and phone of name to be used on permit)
Contact's Name: Sre_nhen A_ Onnrnfck;o Title: Mine Manager
Company Name: Centex Eagle Gypsum Company, LLC
Street: 740 Hwy 1i6, P.O. Box 980
City: ~ ~- Gy -
State: CO
Same as above
Telephone Number: f 970 1- 524-9700
Far Number: ( 970 1- 524-8140
PER[vtITTING CONTACT (if differrnt from applicant/operator above)
ContaCYsNerve: Same ac ahnve Title:
Company Name:
SVeet:
City:
State:
Telephone Number:
Fax Number:
INSPECTION CONTACT
Contact's Name:
Company Name
i
Stteet:
Zip Code: 81637
Zip Code:
City:
State: Zip Code:
Telephone Number: ( 1-
Far Number: ( 1-
CC: STATE OR FEDERAL LANDOWNER f if anvl
Agency: BLM- Glenwood SP~P.s Resnnrce Area Offire
Street: 50629 Hwv 6424. P.O. Rnx 1009 _ ____ _ _ _ __
Cilv: Glenwood Springs
State: r„ Zip Code: 81602
Telephone Number: ( 970 ~
CC: STATE OR FEDERAL LANDOWNER (if any,)
Agency:
Street:
City:
State:
947-2800
Zip Code:
Telephone Number: / 1-