PERMFILE105534

• Permit No: M1991133
• IBM Index Class Name: Permit File
• Doc Name: REGULAR OPERATION 112 RECLAMATION PERMTI APPLICATION FORM
• Media Type: D
• Archive: No

•~ ~ ~ ,
13K. 350
PG. 46

2-
9
Correspondence Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Individual's Name: pemeCrio Valdez
Company Name: v,ttP Fsr•ond;dn
Street: P.O. Bax 184
City: Conejos,
State: Colorado Zip Code: 81129
Area Code: 719 Telephone: [phone]
PERMITTING CONTACT (if different from applicant/operator above)
•Indlvidual's Name: 4~m as abov
Company Name:
Street.
Ci t y
State: Zip Code:
Area Code: Telephone:
INSPECTION CONTACT
Individual's Name
Company Name:
Street.
city.
State:
Area Code:
Same as above
Zip Code:
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency: N/A
~t •.r,
!~:~;.~ ,,~~ Telephone:
CC: SAIL Ok
Agency:
Street
City:
State:
Are.: ~"r~rte
FEDERAL LANDOWNER (if a
Telephone:

Zip Code:
Zip Code:
_ , __ ___ _ _ Telephone: