2005-12-16_REVISION - M1988044

• Permit No: M1988044
• IBM Index Class Name: Revision
• Doc Date: 12/16/2005
• Doc Name: Regular 112 Application
• From: Schmidt Construction Company
• To: DMG
• Type & Sequence: AM3
• Media Type: D
• Archive: No

3-
] 1. Correaoondeoce Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name:
Company Name: Scott Davis
Schmidt Construction Company Title: Vice-President
Street/P.O. Box: 2635 Delta Drive P.O. Box:
Ciry: Colorado Springs
State: CO Zip Code: 80901
Telephone Number: ( 719 ) - 392-4207
Fax Number: L 719 )- 392-4245
PERMITTING CONTACT (if different from epp]icanUopera[or above)
Contact's Name: Mark Heffner Titlc:
Company Name: Southwestern Ecological Services
Street/P.O. Box: 37 East Colorado Avenue P.O. Box:
Ciry: Denver

Stale: CO Zip Code: 80210
Telephone Number: { 303 ) - 722-9067
Fax Number: ( 303 1- 778-8937
INSPECTION CONTACT
Contact's Name: Don Opheim Title: Operations Manager
Company Name: Schmidt Construction Company
StreeUP.O. Box: 1101 Topeka Way P.O. Box
City: Castle Rock
State: CO Zip Code: 80104
Telephone Number: ( 303 ) - 688-3242
Fax Number: f 303 1-
CC: STATE OR FEDERAL LANDOWNER (if anvl
Agency: Colorado Board of Land Commissioners
Street: 1313 Sherman Street Room 620
City: Denver
State: CO Zip Code: 80203
Telephone Number: ( 303 )- 866-3454
CC: STATE OR FEDERAL LANDOWNER (if env)
Agency:
Street:
City:
State: Zip Code:
Telephone Number: ( 1- _