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' AIR POLLUTION CONTROL DIVISION - COLORADO DEPARTMENT OF HEALTH <br /> ' 4210 E. llth Ave. , Denver, Colorado - 80220 - Ph: 388-611T, Exe. 371 <br /> APPLICATION FOR EMISSION PERMIT <br /> tThis application shall be filled out completely; see instructions on reverse side. <br /> 1. PERMIT TO BE ISSUED TO Telephone No. 674-3919 <br /> Nelson Contractors. <br /> 1 2. MAILING ADDRESS (include Zip Code) <br /> 10221 So. Highway 73 Conifer, CO 80433 <br /> 3. TYPE OF ORGANIZATION <br /> ' ® Corporation Partnership Individual Owner Governmental Agency <br /> ' 4. GENERAL NATURE OF BUSINESS <br /> Excavating Contractors <br /> ' 5. EQUIPMENT - Pursuant to Regulation No, 3 of the Colorado Air Pollution Control <br /> Commission, application is hereby made for an Emission Permit for <br /> the following equipment: (Attach separate sheet where necessary) <br /> See attached sheet for Item 5 <br /> ' 6. EQUIPMENT LOCATION ADDRESS: <br /> Shaffers Crossing, Colorado County: Jefferson <br /> ' 7. ESTIMATED COST OF EQUIPMENT OR ALTERATIONS <br /> Air Pollution Control Equipment Basic Equipment $150,000 <br /> Days per year equipment will be operated 255 <br /> ' 8. STATUS (Check and complete applicable items) <br /> 7 New Air Contamination Source Estimated Date Estimated Date <br /> ' Construction Construction <br /> ❑ Control Equipment Being Added Will Begin Will be Completed <br /> to Existing Source Aupust, 1978 June, 1982 <br /> ' 9. Check is enclosed to cover APPLICATION FILING FEE x0 $40.00 <br /> ' 10. SI� OF LE Y ORIZED PERSON 11. DATE OF APPLICATION <br /> !n June 9 1978 <br /> ' 12. Type OW print name and official title of person signing this application. <br /> Larry A. Nelson Vice-President <br /> ' Date Received <br /> t ' <br /> 1 <br /> APCD 200C , ; <br />