2004-03-08_REVISION - M1998052

• Permit No: M1998052
• IBM Index Class Name: Revision
• Doc Date: 3/8/2004
• Doc Name: Conversion Application
• From: Everist Materials LLC
• To: DMG
• Type & Sequence: CN1
• Media Type: D
• Archive: No

-3-
14. Correspondence Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name: Greg Norwick
Company Name: Everist Materials, LLC
Street/P.O.Box: 28755 Hwv ll9
City:
State:
Telephone Number: ( 970 1- 468-2521
Fax Number: ( 970 )_ 468-2756
PERMITTING CONTACT (if different from applicant/operator above)
Contact's Name: same as above
Company Name:
Street/P.O. Box:
Ciry:
State:
Telephone Number:
Fax Number:
Silverthorne
Colorado Zip Code: 80498
Zip Code:
INSPECTION CONTACT
Contact's Name: same as above Title:
Compatry Name:
Street/P.O. Box:
Ciry:
State:
Telephone Number: L ) -
Fax Number: ( ) -
CC' STATE OR FEDERAL LANDOWNER (if anv)
Agency: N/A
Street:
City:
State:
Telephone Number: I ) -
CC' STATE OR FEDERAL LANDOWNER (if any]
Agency: N!A
street:
City:
State:
Telephone Number: ( ) - _
Title: President
P.O. Box: 1150
Title:
P.O. Box:
P.O. Box:
Zip Code:
Zip Code:
Zip Code: