REV101935

• Permit No: M1990016
• IBM Index Class Name: Revision
• Doc Date: 12/4/1992
• Doc Name: LIMITED IMPACT OPERATION 110 2 APPLICATION FORM
• Type & Sequence: AM1
• Media Type: D
• Archive: No

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10. Correspondance Information
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Individual's Name: Scor.t Wagner
Company Name: ~iiQh Plains Stone Co.
Street: P.0. Box 100
Clty: Castle Rock
State: Colorado Zip Code: 80104
Area Code: 303 Telephone: [phone]
1 PERMITTING CONTACT (if different from applicant/operator above)
Individual's Name: Same
Company Name:
Street:
City:
State: Zip Code:
Area Code: Telephone:
INSPECTION CONTACT (if different from applicant/operator above)
Individual's Name: Same
Company Name:
Street:
City:
State: Zip Code:
Area Code: Telephone:
11. Primary future Cropland(CR)
Pastureland(PL) General Agriculture(GA)
land use g _
Ranyeland(RL) ForestryiFR) _ Wildlife Habitat(WL)
(check one): Residential(RS) - Recreation(RC) Industrial/Commercial(IC)
_ Developed Water 1Fesources(WR) _ Solid Waste Disposal(WD)
12. Primary present Cropland(CR)
Pastureland(PL) General Ayriculture(GA)
land use g _
Rangeland(RL)
Foi°estry(FR) _
Wildlife Habitat(WL)
(check one): _
Residential(RS) Recreation(RC) _ Industrial/Commercial(IC)
- Developed Water l~esources(WR)

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