1994-05-25_REVISION - M1982129

• Permit No: M1982129
• IBM Index Class Name: Revision
• Doc Date: 5/25/1994
• Doc Name: REGULAR OPERATION 112 RECLAMATION PERMIT APPLICATION FORM
• Type & Sequence: AM1
• Media Type: D
• Archive: No

-Z-
9. Correspondence Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
IndividuaI 's Name: L. Otto Goemmer and Jacque Goemmer (Mrs. Otto)
Company Name: Rocky Flat Gravel
Street: P. O. Box #165
City: La Veta.
State: Colorado Zip Code: 81055
Area Code: 719 Telephone: [phone] (messages only)
PERMITTING CONTACT (if different from applicant/operator above)
Individual ' s Name: Same as above
Company Name:
Street:
City:
State: Zip Code:
Area Code: Telephone:
INSPECTION CONTACT
Individual 's Name: Same as above
Company Name:
Street:
City:
State: Zip Code:
Area Code: Telephone:
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency:
Street:
City:
State: Zip Code:
Area Code: Telephone:
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency:
Street:
City:
State: Zip Code:
Area Code: Telephone: _