REV89646

• Permit No: M1978051
• IBM Index Class Name: Revision
• Doc Date: 2/18/2000
• Doc Name: CONSTRUCTION MATERIALS LIMITED IMPACT 110 OPERATION RECLAMATION PERMIT APPLICATION FORM
• Type & Sequence: AM1
• Media Type: D
• Archive: No

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14.
Cnrresoondence Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name: Pete Aragon
Company Name: Lincoln County
Street: 103 3rd Street, P.0. Box 39
City; Huqo
State: Colorado Zip Code: 80821
Telephone Number: 7( 19 )- 743-2337
Fax Number: (719 ~- 743-2815
PERMITTING CONTACT (if different from applicanr/operatorahove)
Individual's Name:
Company Name:
Street:
Ciry:
State:
Telephone Number: L~-
Fax Number. L~ -
INSPECTION CONTACT
Individual's Name: Pete Aragon Title: Land Use Administrator
Company Name: Lincoln County
Street: 103 3rd Street, P.0. Box 39
Ciry: Hugo
gam; Colorado Zip Code: 80821
Telephone Number: 7L 19 1-743-2337
Fax Number: 7C 19 1-743-2815
OC: STATE OR FEDERAL LANDOWNER (if anvl
Agency:
Sheet:
CC: STATE OR FEDERAL LANDOWNER (ifanv
Ciry:
State:
Telephone Number:

Ti[Ie:Land Use Administrator
Title:
Zip ^_,. _.
Agency:
Stree[:
Ciry:
State:
Telephone Number
Zip Code:
Zip Codz: