1995-08-16_REVISION - M1980120

• Permit No: M1980120
• IBM Index Class Name: Revision
• Doc Date: 8/16/1995
• Doc Name: DMG 112 REGULAR OPERATION APPLICATION WORKSHEET CHECKLIST
• Type & Sequence: AM1
• Media Type: D
• Archive: No

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10. Correapoadeace Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used oa permit)
Individual's Name: Greg Nelson, Materials Foreman
Company Name: Weld County
Street: P. O. Box 758
City: ~ eelev.
State: Colorado Zip Code: 80632
Area Code• 970 Telephone: [phone] Ext. 3750
TING CONTACT (if different from applicant/operatoi above)
individual's Name: Donald Carroll, Project Coordinator
Company Name: Weld (oi~n ty
Street: P. O. Box 758
City: Greeley
State: Colorado Zip Code: 80632
Area Code: 970 Telephone: [phone] F.xt. '(750
INSPHCTION CONTACT
Individual's Name:

C~any Name:

Street:

City:

State: Zip Code:

Area Code: Telephone:

CC: STATH OR FEDERAL LANDOWNER (if aavl

Agency:

Street:

City:

State: Zip Code:

Area Code: Telephone:

CC: STATE OR FHDHRAL LANDOWNER (if aavl

Ag~cY :

Street:

City:

State: Zip Code:

Area Code: Telephone: