REV92924

• Permit No: M1978078
• IBM Index Class Name: Revision
• Doc Date: 7/16/1997
• Doc Name: application
• From: DMG
• To: LINCOLN CNTY BOARD OF CNTY
• Type & Sequence: AM1
• Media Type: D
• Archive: No

-3-
14.
Corresvondence Information:
APPLICANT/OPERATOR (name, addres8~
Contact's Name: Pete Ara.pi
Company Name: L i n c o l n C

phone of name to be used on permit)
Title: r,anrl ((GP a,rm ~+,.~+,, ,.
-s-
Street: P.O, Box 67 103 3rd Street
City: Hugo Colorado
State: Colorado Zip Code: AnA~i
Telephone Number: ( 719 ) - 7 4't- ~ 2 "3 7
Fax Number: ( ) -
ITTING CONTACT (if different from applicant/operator above)
Individual's Name: Title:
Company Name:
Street:
City:
State:
Telephone Number:
Fax Number:
INSPECTION CONTACT
Individual's Name:
Zip Code:
( ) -
~ r -
Pete Aragon Land Use Office
~Pany Name: Lincoln County
P,O, Box 67 103 3rd Street
Street:
City: Hugo
State: Colorado Zip Code: 80821
Telephone Number: ( 719 ) _ 743 -2337 Home phone: X19- 446-5A59
Fax Number: ( 719 )_ 7 4 3- 2 8 3 8
CCe STATE OR FEDERAL LANDOWNER (if anv)
Agency:
Street:
City:
State: Zip Code:
Telephone Number: ( ) - .
CC• STATE OR FEDERAL LANDOWNER (if anv)
Agency:
Street:
City:
State:
Telephone Number:
Zip Code: