REV106846

• Permit No: M1977439
• IBM Index Class Name: Revision
• Doc Date: 12/11/1987
• Doc Name: REGULAR 112 PERMIT APPLICATION FORM
• Type & Sequence: AM2
• Media Type: D
• Archive: No

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Correspondance Information
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Individual's Name: MICHAEL C. REFER
Company Name: STERLING SAND & GRAVEL CO.
Street: 1800 NORTH TAFT HILL ROAD / P.0. BOX 2187
City: FORT COLLINS,
State: COLORADO Zip Code: 80522
Area Code: (303) Telephone: [phone]
Individual's Name:
Company Name:
Street:
City:
State:
Area Code:
GAh1BIT, INC.
1510 YORK ST.. #329
State: COLORADO Zip Code: 80206
Area Code: (303) Telephone: [phone]
INSPECTION CONTACT (if different from applicant/operator above)
Company Name:
Street:
City:
Individual's Name: BRADFORD JANES
PERMITTING CONTACT (if different from applicant/operator above)
Zip Code:
Telephone:
11. Primary future O Cropland(CR) ^ Pastureland(PL) O General Agriculture(GA)
land use ^ Rangeland(RL) ^ Forestry(FR) O Wildlife Habitat(WL)
(check one): O Residential(RS)^ Recreation(RC) O Industrial/Commercial(IC)
O Developed Water Resources(WR) ^ Solid Waste Disposal(WD)
12. Primary present ^ Cropland(CR) ^ Pastureland(PL) ^ General Agriculture(GA)
land use ^ Rangeland(RL) ^ Forestry(FR) ^ Wildlife Habitat(WL)
(check one): O Residential(RS) O Recreation(RC) ^ Industrial/~:ommercial(IC)
^ Developed Water Resources(WR)
To the best of my knowledge, all the information presented on this application form and
the attached Exhibits A-P are true and correct (must be signed by a(~~/,~~~li~canjt~;opera r).
Date: 10 DECEMBER 1987 By: EDWARD G. SH~rC~-Z~~"'~'
PRESIDENT
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