2004-08-19_REVISION - M2003037 ‎(3)‎

• Permit No: M2003037
• IBM Index Class Name: Revision
• Doc Date: 8/19/2004
• Doc Name: 112c Amend Appl
• From: Haldorson and Sons Inc
• To: DMG
• 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: Mgfk Hp ~OOrS
O~ Title: ~WnCr
Company Name: HQ~dor~on J
and SonS~ ZnL.
Street/P.O. Box: P, 0. (3o X 1019 P.o. Box:
city: Mon~ro se .
State: C O Zip Code: g I~ O a
Telephone Number: ( Q 70 ) - ~-~i - 1~..,.s 4'10 - e? a aj - / 9` ~3
Fax Number: ( q 7 ~ ) - 3 ~ ~ - 6 S5 I

PERMITTING CONTACT (if different from applicanUoperator above)
Contact's Name: Gf 2g ~i i b so n Title: E~ i na_u-
CompanyName: Greg I-e W ~ek~ And Q SS'OGia~'P S
Street/P.O. Box: 115 4 i ~r1 n rr. nn ~-o n GO N r~- P.O. Box:
Ciry: ~grkcr
State: C'O Zip Cade: ~O 13 R
Telephone Number: ( 30 3 ~ - 3 `I ~ .5 I ej 6
Fax Number: ( 303 ~- 3ti6- 6934

INSPECTION CONTACT
Contact's Name: M
o r k H a I rI o r SO n Title: O W ~ g r
Company Name: I
HgIOOrSOn Rnd Sons. ZnG.
StreeUP.O. Box: ~. O. 'SO Y I O I~ P.O. Box:
city: Mnn~-rose_
State: C_ ~ ~ ~-~ - ~ ~b~ Fyr~. Zip Code: $ I ~ ~` roZ
Telephone Number: (Q ~ G ) - ~~=~-~1' 3.,,s 9 ~o - ~ 0 9 - / 9 3 ~
Fax Number: { ~ 70 ) - ~j a~ - 6 gs-
CC: STATE OR FEDERAL LANDOWNER (if an
Agency:
Street:
Ciry:
State: Zip Code:
Telephone Number: ( )-
CC STATE OR FEDERAL LANDOWNER (if an}]
Agency:
Street:
City:
Stale: Zip Code:
Telephone Number: ( ) -