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,,.. ~- <br /> <br />L' ~J <br />-2- <br />10. Correspondance Information <br />N <br />APPLICANT/OPERATOR (name, address, and phone of name to be used on permit) <br />IndlYidudl's Name: Fremont Countv Board of Countv Commissioners <br />Company Name: Fremont Countv (Road District fll - Comm. Griffin) <br />Street: 6th Street b Pfason Avenue (P.O.Box 1007) <br />City: Canon Citv <br />State: Colorado Zip Code: 81212 <br />Area Code: 719 Telephone: z75-1515 <br />PERMITTING CONTACT (if different from applicant/operator above) <br />Individual's Name: Ma shall B~ l r. Ascis am Planning DIrPnYnY <br />i;ompolly Name: Fremnnh fn nnh~ ila~rhmPnh of Plannin~ Inning <br />St?'ee~%: 6th Street fi Macon Avenue (P.O.Box 349) <br />City: Canon Citv <br />Stater Coloraao Zip Code: Bt21z <br />Area (:ode: 719 Telephone: vs-751n <br />INSPECTION CONTACT (if different from applicant/operator above) <br />Individual's Name: Marshall butler. Assistant Planning Director <br />Company Name: Fremont Countv Department of Planning & Zoning <br />Street.: 6th Street 6 Macon Avenue (P.O.Box 349) <br />City: Canon Gity <br />State: coloraao Zip Code: alzlz <br />Area Code: >>9 Telephone: ~~s-Sin <br />11. Primary future Cropland(CR) Pastureland(PL) _ General Agriculture(GA) <br />land use ~ Rangeland(RL) _ Forestry(FR) _ Wildlife Habitat(WL) <br />(check one): Residential(RS) Recreation(RC) Industrial/Commercial(IC) <br />Developed Water l~sources{WR) _ Solid Waste Disposal(WD) <br />12. Primary present Cropland(CR) _ Pastureland(PL) _ General Agriculture(GA) <br />land use g. RangelandiRL) _ Forestry(FR) _ Wildlife Habitat(WL) <br />(check one): _ Residential(RS) Recreation(RC) _ Industrial/Commercial(IC) <br />Developed Water tiZesources{WR) <br /> <br />