2002-04-25_REVISION - M1984117

• Permit No: M1984117
• IBM Index Class Name: Revision
• Doc Date: 4/25/2002
• Doc Name: Amendment Application ‎(s/b M-1984-117)‎
• From: Fremont County
• To: DMG
• Type & Sequence: AM1
• Media Type: D
• Archive: No

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`14.
Correspondence Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name: Paul Garrett __
Company Name: Fremont County Board of Commissioners
Street: 615 Macon Ave, Rm. 11105
City.
Stale:
Telephone Number: ~~ -
Fax Number: ,(_~ -
City. Canon City
State: Colorado Zip Code: 81212
Telephone Number: (719 1- 276-7300

Fax Number: (719 1- 275-7626

PERMITTING CONTACT (if different from applicant/operator above)
Individual's Name: Same as above Title:

Company Name:

Street
INSPECTION CONTACT

Tide:Dist ~{3 Supervisor
Zip Code:
Individual's Name: Paul Garrett Title: Dist. 113 Supervisor

Company Name: Fremont County Road & Bridge

Street: CR 1112
City. Cotopaxi
State: Colorado Zip Code: 81223
Telephone Number: f 719 1- 942-4234
Fax Number: ( 719 1- 276-7321
CC: STATE OR FEDERAL LANDOWNER (ifanyZ N/A
Agency.

Street:
City

State: Zip Code:
Telephone Number: ( 1 -
CC: STATE OR FEDERAL LANDOWNER (if a~ N/A
Agency

Street.
City:
S[a[e:
Zip Code:
Telephone Number: ( 1 -