REV93285

• Permit No: M1977053
• IBM Index Class Name: Revision
• Doc Date: 9/26/1996
• Doc Name: CONSTRUCTION MATERIALS REGULAR OPERATION 112 RECLAMATION PERMIT APPLICATION FORM
• Type & Sequence: CN1
• Media Type: D
• Archive: No

14. Correspondence Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name: Todd Stockebrand Title: Secretarv
Company Name: Asphalt Constructors, Inc.
street: 7040 Hwy. 160W, P.0. Box 449
City: Alamosa
State: CO Zip Code: 81101
Telephone Number: ( 719 ~ - 589-6671
Fax Number: ( 719 1 - 589-0927
PERMITTING CONTACT (if different from applicant/operator above)
Contact's Name: Title:
Company Name:
Street:
City:
State: Zip Code:
Telephone Number: ( ) -
Fax Number: L ) -
Contacts Name: Todd Stockebrand Tit le: Secretary
Company Name: Aso halt Constructors Inc
street: 7040 Hwy. 160W, P.0. Box 449
City: Alamosa
State: CO Zip code: 81101
Telephone Number: ( 719 ~ _ -
Fax Number: ( 719 ~ _
CC: STATE OR FEDERAL LANDOWNER (if anvl
Agency:
Street:
City:
state:
Telephone Number: ( ) - _
CC: STATE OR FEDERAL LANDOWNER (if anv)
Agency:
Street:
City:
State:
Telephone Number:
-3-
589-6671
589-0927
Zip Code:
Zip Code: