REV13538

• Permit No: M1992017
• IBM Index Class Name: Revision
• Doc Date: 6/8/1998
• Doc Name: CONSTRUCTION MATERIALS REGULAR OPERATION 112 RECLAMATION PERMIT APPLICATION FORM
• Type & Sequence: CN1
• Media Type: D
• Archive: No

-3-
14. CorreeDOndence Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
contact•e xame: Earl Sires Title: County Adminlstator
company xame: f4ontrose County
street: PO. Box 1289 or 320 S 1st
I.7ontrose
City:
state: Colorado zip coae: 81402
Telephone Number: ( 970 ~ _ 249- 7755
Fax Number: ( 970 1 - -
PERMITTING CONTACT (if different from applicant/operator above)
contact•e xame: Brian Wilson Title: ihanager
company Name: Earth / Stone Ltd.
po box
Street:
City:
State:
Telephone Number:
Fax Number:
INSPECTION CONTACT
Contact's Name:
Company Name:
Street:
city:
State:
Telephone Number:
Fax Number:
CC: STATE OR FEDERAL LANDOWNER (if an
Zip Code:
Agency: BLDI C/0 Lynn Lewis
street: 2505 S. Townsend Ave.
city: 1•lontrose
state: Colorado ~ zip coae: 81401
Telephone Number: ( 970 ) _
CC: STATE OR FEDERAL LANDOWNER (if anvl
Agency:
Street:
City:
State: Zip Code:
Telephone Number: 1 1 -
Delta
Colorado zip coae: 81401
970 874-5183
(~-~ _ - 3
Brian Wilson
Same as above
Title:
240-5300