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:
APPLICANTfOPERATOR (name, address, and phone afname to be rased on permit)
Contact's Name: 5~e/e 1~L+~d Tide: ,~e/ibnpl /I/IoAa'4e/
Compun}•Name: la~cai~e L/e5~}Inc.
Stree1/P.O. Box: P. D. Dia use/ 368 P.O. Box:
~~: ~ierw~d o„ has
State: ~o/oioL/O ZrpCode: 8/(a02
Telephone Ntunber: ( 97/~ } - 904 - ~,5YJ0
Fax'~umber: ( 970 ? - 9/03 - 4/37
PERMITTING CONTACT (ff ditleaent from applicanVoperator above)
ContacYS Name: ~bo/~ Title:
Company Name:
Street/P.O. Box: P.O. Box:
City:
State: Zip Code:
Telephone Number: ( ) -
Fax Number: ( ) -
pVSPECTIONCONTACT
Contact's Name: .~fJO /G Titre:
Company Name:
Street/P.O. Box: P.O. Box:
City.
State: Zip Code:
Telephone Number: ( 1-
Fax Number: ( ) -
CC: STATE OR FEDERAL LANDOWNER (if any
Ames: n/. A
street:
city:
State: Zip Code:
Telephone Number. ( ) -
CC: STATE ORFEDERAL LANDOWNER (ffauv)
Agency: it/. A.
Street:
cits:
State: Zip Code:
Telephone Number: ( ) -