REV106055

• Permit No: M1977062
• IBM Index Class Name: Revision
• Doc Date: 3/14/1994
• Doc Name: CONVERSION APPLICATION REGULAR OPERATION RECLAMATION PERMIT APPLICATION PACKAGE
• Type & Sequence: CN1
• Media Type: D
• Archive: No

-z-
9. Correspondence Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)•
Individual's Name: Dwight D. Benson b T. Edward Benson dba
Company Name: Benson Brothers Truck ~ Equipment
Street: 2138 J-50 Road
City: Austin, 1~ Vin/V~
State: Colorado Zip Code: 81410 ~
Area Code: 303 Telephone: [phone]
PERMITTING CONTACT (if different from applicant/operator above)
Individual's Name: Same
Company Name:
Street:
City:
State:
Area Code:
INSPECTION CONTACT
Individual's Name
Company Name:
Street:
City:
State:
Area Code:
U~
Zip Code:
Telephone:
Same
Telephone:
CC: STATE OR FEDERAL LANDOWNER (if anv)
Agency: N/A
Street:
City:
State:
Area Code: Telephone:
Zip Code:
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency: N/A
Street:
City:
State:
Area Code:
Telephone:
Zip Code:
Zip Code:
~l