PERMFILE102061

• Permit No: M2001001
• IBM Index Class Name: Permit File
• Doc Date: 1/8/2001
• Doc Name: CONSTRUCTION MATERIALS REGULAR 112 OPERATION RECLAMATIO PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

- 3 -
IJ. Correapondeoce rnformatioe:
APPLICANZ/OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name:
Company Name:
Street:
City'.
State:
Telephone Number:
Fae Number:
PERMITTING CONTAC7
Contact's Name:
Company Name:
Street:
City:
Slate:
Telephone Number
Fax Number:
INSPECTION CONTACT
Contacts Name:
Compaoy Name:
Street:
C uy.
State:
Aaz~l ~n~,n(ot~ Titte:Mavtacae,r
Four Sfa~-eS Am t~ne,4r_s ILC
QC~ lac 1.riG,4'~
Carle.
Colorado Zip Code: f313?J - I~
c ~lzo l- ~~s - ~~~
t °! -(O 1- .~~ ra5 - 105"i E-mail ~. Ar~:gl Ca3 Icona, f>~
(if different from applicanUoperator above)
t~(aff-tan A, P~t-i-on, PEt D~ Title: b1y~Yorxrie~l Ga~otwuzr
1la~rrn.~~ L4R. ~.~3.Cj-'~fl r ~PC
i?n F30K
CAY'{~Z_
Colnn~do Zip code: 81321- I S<ca
( ~1Z0 1- ~~- l~F3C~ of ~.F~JS~ _•. ~f21-55~~
( ~} 2 S 1 _ (~q /a - ZD ZS E-mail - SD4bP.ricy~®,~ol • Com

Telephone Number. ( ) -
Fax Number: ( 1-
CC• STA ORFFD RAf.rA O R('fagy1
Agency:
Street:
City:
State:
Telephone Nttmlxr:
Zip Cade:
Zip Cade:
CC STA OR D RAr L OWNER ('f yj
Agency:
Street:
City:
State:
Zip Code:
Telephone Number: ( 1-