REV96047

• Permit No: M1973021
• IBM Index Class Name: Revision
• Doc Date: 8/25/1998
• Doc Name: CONSTRUCTION MATERIALS REGULAR 112 OPERATION RECLAMATION PERMIT APPLICATION FORM
• Type & Sequence: AM5
• Media Type: D
• Archive: No

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14. Correapoadenca Znformatioa:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name: Rick Mergens Title:
Company Name: CAMAS Colorado Inc./Aggregate Division
Street: 3605 South Teller Street S~'1~-.~Q
City: Lakewood
state: Colorado Zip code; 80235
Telephone Number: ( 303 ) _ 989-0300
Fax Number: ( 303 ) - 989-1655
PERMITTING CONTACT (if different from applicant/operator above)
Contact's Name: SAME Title:
Company Name:
Street:
City:
State: Zip Code:
Telephone Number: ( ) -
Fax Number: { ) -
IN:~PECTION CONTACT
Contact's Name: SAME Title:
Company Name:
Street:
City:
State: Zip Code:
Telephone Number: ( ) -
Fax Number: ( ) -
CC: STATE OR FEDERAL LANDOWNER (if anv)
Agency: N/A
Street:
City:
State: Zip Code:
Telephone Number: ( ) -
CC: STATE OR FEDERAL LANDOWNER (if anV)
Agency: N/A
Street:
City:
State: Zip Code:
Telephone Number: ( ) -