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RECE~~l~® <br />3 NOV 0 62003 <br />la. co~oeaeeee Lormation: <br />APPLICANT/OPERATOR (name, address, and phone of Dame to be used Son st_ _ tii!ag(ats and 3ec8ot7y <br />Contact's Name: Judy DeVincentis Title: CEO <br />Company Name: Western Gravel, Inc. <br />Ste; 3001 N. Townsend <br />City: Montrose - <br />State: Colorado Zip Code: 81401 <br />Tehphoac Numbed: j 970 1- 249-2431 <br />Fax N~rber: ( 970 1- 249-0590 <br />PF!?M!'!" l't??C+CONTACT (if different from applicant/operatodobove) <br />Contacts Name: <br />Company Name: <br />Street: <br />City: <br />State: <br />Michael Ripp Title: President <br />MVR Resources, Inc. <br />P.O. Box 54 <br />Delta <br />Colorado Zip Code: 81416 <br />Telaphom Nmnber: ( Q7n 1- 874-5127 <br />Fax Number. ( 970 1- 874-3161 <br />CorttactsName: Judy DeVincentis Titlb: CEO <br />Company Name: Western Gravel, Inc. <br />gam; 3001 N. Townsend <br />Cm,; Montrose <br />~: Colorado Zip Code: 81401 <br />Telephone Number: (970 1- 249-2431 <br />Fax Nmnber: (970 1- 249-0590 <br />Agency: <br />Sweet: <br />City: <br />State: Zip Code: <br />Telephone Number: ( 1- <br />('r• STATE OR FEDER.At LANDOWNER (if soul <br />Agency: <br />Sheet: <br />City: <br />State: <br />Zip Cade: <br />Telephone Nt®ber: <br />