2005-04-13_REVISION - M1981075

• Permit No: M1981075
• IBM Index Class Name: Revision
• Doc Date: 4/13/2005
• Doc Name: Amend Appl
• From: Phillips Stone Company
• To: DMG
• Type & Sequence: AM1
• Media Type: D
• Archive: No

2-
6. Conesoondence Information:
APPLICANT/OPERATOR (name, addcess, and phone of Dame to be used on permit)
Contact's Name: Robert or Frances Phillips
...,--Company Name:
StreeNP.O. Box:
City:
RECEIVED
APR 13 2005
t]ivisian of Minerala and Geology
Owners
Phillips Stone Company.
7850 Ute Hwy, P.O.Box:
Longmont
State: CO Zip Code: 30503
Telephone Number. (_303 )_ 823-6395
FaxNwnber: 1 303 )- 485-2706
d1TTfNG CONTACT (if different fmm appGcant/operator above)
ContacPsName: Cheri Vandergrift Titte: Attvo
Company Name: Chervlin K. Vandergrift. LLC
Street/P.o.Box: 350 Indiana Street, Suite 150 P.o.Box:
Ciry: Golden

state: CO zip code: 80401
Telephone Number. ( 303 )- 271-0222
Fax Number: ~ 3 03 } _ 2 71-0101
INSPECTION CONTACT
Conraa'sName: Robert 3. Phillips
Company Name: Phillips Stone Company, Inc,
Owner
Street/P.O. Box: 7850 Ute Hwyo P.O. Box:
Longmont
City:
State: CO Zip Code: 80503
Telephone Number: ( 303 }_ 823-b395
Fax Number. ( 303 ~- 485-2706
CC: STATE OR FEDERAL LANDOWNER ~f anvl
Agency: N ~ A
Street:
City:
State:
Telephone Number ( }-
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency: N/A
street:
c;ry:
State:
Telephone Number: ( ) -
Zip Code:
Zip Code:
-3-