PERMFILE106045

• Permit No: M1990114
• IBM Index Class Name: Permit File
• Doc Name: 112 PERMIT APPLICATION FOR SAGUACHES PROPOSED NOLAND GULCH PIT
• From: SAGUACHE CNTY ROAD AND BRIDGE DEPT
• To: MLRD
• Media Type: D
• Archive: No

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10: Correspondence Ynformation
APPLICf~NT/OPERATOR (name, address, and phone of name to be used on permit)
:Individual's Name
Company Name:
Street:
City:
State:
Area Code:
ROBERT PREVOST
ACHE COUNTY ROAD AND BRIDGE DEPARTMENT
310 DENVER AVENUE-P.O. BOX 47b
SAGUACHE ,COUNTY
COLORADO gip Code: 81149
719 Telephone: [phone]
PERMITTING CONTACT (if different from applicant/operator above)
Individual's Name: SAME AS ABOVE
Company Name:
Street:
City:
State:
Area Code:
Telephone:
Zip Code:
INSPI_CTION CONTACT (if different from applicant/operator above)
Individual's Name: SAME AS ABOVE
Company Name:
Street:
City:
State:
Area Code:
Yip Code:
Telephone:
11. Primary future Cropiand(CR) Pastureland(PL) General Agriculture(GA)
land use ~ Rangeland(RL) _- Forestry(FR) ` Wildlife Habitat(WL)
(check one): Residential(RS) Recreation(RC) Industrial/Commercial(IC)
_ Developed Water lie sources(WR) _ Solid Waste Disposa](WD)
12. Primary present Cropland(CR) Pastureland(PL) General Agriculture(GA) "
land use ~ Rangeland(RL) ~_ Forestry(FR) ` Wildlife Wabitat(WL)
(cneck one): Residential(RS) Recreation(RC) Industrial/Commerciai(IC)
_ Developed Water Resources(WR) `
To the best of my knowledge; all the information presented on this application form and
the ati:ached Exhibits A-P are true and correct (must~jbe~~'signed by applicantj/-op-erator).
Date:".]UNE 5, 1990 By:_~~,/:ti,~j/~''~_,if,rud '
ROAD AND BRIDGE SUPERVISOR
e
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