2003-01-29_REVISION - M1998014

• Permit No: M1998014
• IBM Index Class Name: Revision
• Doc Date: 1/29/2003
• Doc Name: Amendment Application
• From: DMG
• To: Lafarge West Inc
• Type & Sequence: AM1
• Media Type: D
• Archive: No

_ 3 _
14. Correspondence Information:
APPLfCANT(OPERATOR {name, address, and phone of name to be rased on permit)
Contact's Name: S~N2 N/OOd Tit1e:.PBQiona / /1//oAPge/
Company Name: ~ ~o/fit G/PS~ Inc .
Street/P.O. Box: PD. Dro we/ 3(08 P.O. Box:
State: l'a/oio c% Zip Code: 8/602
Teleohone'_'aumber: ( 970 ) - 904 - ADO
Fax ]cumber: ( 970 ) - 903 - 4/37
PERMITTING CONTACT {if different from applicanUoperatot above)
Ccmtact'sName: /~bo/~ Title:
Company Name:
StreeUP.O. Box:
City:
State:
Telephone Numbet:
Fax Number:
Contact's Name:
Company Name:
StreeUP.O. Box:
City:
State:
~/bo /e
P.O. Box:
Zip Code:
Ztp Coda:
Telephone Nomber: ( ) -
Fax Namber: ( ) -
CC STATE OR FF.DI.RAI,LANDOWNER(ifanv)
Amy: n!. R.
street:
city:
Slate:
Telepbone N~ber. L ) - _
CC: STATE OR FEDERAL LANDOWNER (if aav)
Agency: ~t/..Q.
Street:
City:
State:
Telephone Number.
P.O. Box:
Zip Code:
Zip Code: