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APPLICATION FOR A>~LL[TIION EI-IISSION PERMTf OR~ERMIT MODIFICATION <br />This application must be filled out completely except for N14 and N15: otherwise, application will be tbosiderod incomplete -SEE <br />INSTRUCTIONS ON REVERSE SIDE. Mail completed applirJtion APENs and filing fee to: <br /> Colorado Deparanent ojAeaLh <br />RECEIVED <br /> ePCass-BI <br /> 4300 Cherry Cnek Drip South <br />691 <br />3150 <br />APR 0 6 1995 <br /> - <br />Tikphonr: (303) <br />Drover, Colorado 80221.1530 <br />1. Permit to be issued to: , <br />+mu+eraistf<Geology <br /> Hocker Construction Ofvisiono <br />2. Mailing Address: State: CO <br /> P. 0. Box 627, Ignacio ZipCode.•81137 <br />3a. Agent jot Service (See No. 3 on mrrseJ: N/A <br />36, Federal Tas IdentifienrionNumber: 84-0754505 <br />4a. General Nature ojBusiness: 4b. SIC Code.• <br /> Gravei crushing <br />Sa. Air Pollution Sourre Drscriplion: 56. Days per year sourre will <br /> Gravel crushing equipment (see attached) operate: 260 <br />6a. Source Location Address (Include Location MapJ: Sec 34 , T 34 N 6b. I/7DI Coordinates (in kmJ <br /> 2001 C.R. 300 R 9 W ___._H ____._V <br /> Durango, CO 81301 12 miles SW of Durango, CO <br /> ate:VTR.a.~...ri...~.avr..ore.~.....~~o~ County: La Plata <br />7. ESTa1ATED COSTS: Air Pollution Control Ptncedures or Equipment <br />7a. Source, Procrss Equipment or Projeer: 7b. Capita! Cosr.• S 5 , 000.00 <br /> Cap. Cost S 179 , 500.00 7c. Operating Cosr: f 2 , 500.00 <br />Ha. STATUS <br />^ New<• Air Pollution Source <br />^ Mod cation to Permitted Sourre (Control Equipment added, proress change, ere. J: <br />^ Tratujer of Ownership - Transferred from: <br />~ Esisring Source- not pnmittrd (Jnclude Date ojSourre Scarf-upJ: A l re a d V existing . <br />^ Other: <br />Projrctrd Dales jot Coastructioa ro: Projeued Sourn Startup Dbtc: <br />86 . Begin: Present 8c. End: ? Sd. Already existing. <br />9. Enclose check ro rovrr MEN FQ.ING FEES. One MEN should 6e filed for each rmission point <br /> ,VOTE: Add~tiona! processing jeer must also be paid prior to it issuanre. <br /> APENS ®5100.00 per APEN = S 100.00 <br />10 . SIGNATURE OF LEGALLY A RII~-D ERSON (NOT Vendor or 11n. Date Signed: l lb. Telephone No.: <br />Eq uipment Manujaauro} 11 <br />r=-42o 3/27/95 ~ 303) 563-9533 <br />I'_ . Type or Print name and official title of s n signing item 10. <br /> - Agencv Use Only <br /> Roy Hocker, owner 14. DATE RECEIVED: <br />13 . Check apprnpriete box if you want: <br />e ^ Ca <br />relimina <br />Division <br />v oj <br />anal <br />ris rotuiuRed b <br />. p <br />p <br />ry <br />y <br />y <br />b. ^ Ta revirw a draft ojrhe permit prior [o issuanre? li. PERMIT NUMBER <br />n~ ~ ~.ea .:s, :om ~a ,.w ::....a a .aia ~~a ~. ss t...R. <br />uc ~ u ar .z.. w:..N <br />