REV93639

• Permit No: M1989023
• IBM Index Class Name: Revision
• Doc Name: SPECIAL OPERATION 111 APPLICATION FORM
• Type & Sequence: SO1
• Media Type: D
• Archive: No

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10. C respondence Information [['~ ~ ;' ,
APPLICANT/OPERATOR (name, address, and phone of name to be u ed~on~permit)
Individual's Name:
Company Name: sect-way Paving co.
Street: P.O. sex 3189
Clty: Greelev
$tdte: Colorado Zip Code: 80633
Area Code: 303 Telephone: [phone]
PERMIT'iING CONTACT (if different from applicant/operator above)
Individual's Name: same
Company Name:
Street:
City:
Sate: Zip Code:
~rea Code: Telephone:
((( INSPECTION CONTACT (if different from applicant/operator above)
II1d1V1dUd1's Ndme: Carl Hill or Herman Alterrzott
Company Name:
Street:
City:
S1:ate:
Area Code:
Telephone:
Zip Code:
11. Primary future _ Cropland(CR) Pastureland(PL) General Agriculture(GA)
land use _ Rangeland(RL) _- Forestry(FR) -_ Wildlife Habitat(WL)
(check one): Residential(RS) Recreation (RC) Industrial/Commercial(IC)
Developed Water T~esources(WR) - Solid Waste Disposal(WD)
12. Primary present _ Cropland(CR) _ Pastureland(PL) General Agriculture(GA)
land use _ Rangeland(RL) _ Forestry(FR) - Wildlife Habitat(WL)
(check one): _ Residential(RS) Recreation (RC) - Industrial/Commercial(IC)
Developed Water l~sources(WR)
To the best of rqy knowledge, all the information presented on this application form and
the~a ached Exhibits A-G are true and correct ( st be signed by applicant/operator).
`/flats: Dec=tuber 6, 1988
Herman Altergott
Vice Presiden
i e