REV104908

• Permit No: M1980246
• IBM Index Class Name: Revision
• Doc Date: 7/1/1994
• Doc Name: REGULAR OPERATION 112 RECLAMATION PERMIT APPLICATION FORM
• Type & Sequence: CN1
• Media Type: D
• Archive: No

-2-
9
Street: znni cR 300
Clty: Durango
State: rn Zip Code: 81301
Area Code: 303 Telephone: [phone]
Correspondence Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Individual's Name: nnrhnnv ~Pii;rr;
Company Name:
PERMITTING CONTACT (if different from applicant/operator above)
Individual's Name: Anthonv zellitti
Company Name:
Street:
City:
State:
Area Code:
INSPECTION CONTACT
Individual's Name
Company Name:
Street:
City:
State:
Area Code:
2001 CR 300
Durango
Co Zip Code: 81301
303 Telephone: [phone]
Anthony Zellitti
2001 CR 321
Durango
co Zip Code: 81301
303 Telephone: [phone]
CC: STATE OR FEDERAL LANDOWNER (if anv)
Agency:
Street:
city:
State: Zip Code:
Area Code: Telephone:
CC: STATE OR FEDERAL LANDOWNER (if anv>
Agency:
Street:
City:
State: Zip Code:
Area Code: Telephone: