PERMFILE106280

• Permit No: M1988048
• IBM Index Class Name: Permit File
• Doc Date: 4/29/1988
• Doc Name: REGULAR 112 PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

_2_

10. Correspondence Information
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Individual's Name: R. A. Everist Jr.
Company Name: Andesite Rock Company
Street: ~ n„+h Phillinc Street ~ S
o7.Z
City: Ci ~~~ T~'~l lc- _ n
State: ~-rn,~,•r-h- ~~~-t„ Zip Code: =57-~1a= l~°~c-~J(''`~
`" ~DYoI
Area Code: n~ Telephene• ~~9 '~6i8
PERMITTING CONTACT (if different from applicant/operator above) ( 3) a79 -~6 7~
Individual's Name: ,ary Tuttle
Company Name: Tuttle Aooleaate Rindahl, Inc.
Street: 11990 Grant Street, Suite 410
City: Denver,
State: rn,n,-aa~ Zip Code: an~~is
Area Code: 303 Telephone: [phone]
INSPECTION CONTACT (if different from applicant/operator above)
Individual's Name: R. A. Everist. Jr.
Company Name: anria~; tP Rork (~C]m D3nV
Street: -3-;-=~,;,;~~v~ ~ - - mot /~y~ ~~r 8~~`~"
_ ---- - - ~"~ ~
City: c • n_ ,
State: -meta Zip Code: - 5711-~-~ ~
0 soya l
Area Code: X0"5-Telephtlne:~7~-~$+ ~~,~1
d7~
11. Primary future O Cropland(CR) ^ Pastureland(PL) ^ General Agriculture(GA)
land use ~ Rangeland(RL) ^ Forestry(FR) O Wildlife Habitat(WL)
(check one): ^ Residential(RS)O Recreation(RC) ^ Industrial /Commercial(IC)
^ Developed Water Resources(WR) O Solid Waste Disposal(WD)
12. Primary present ^ Cropland(CR) ^ Pastureland(PL) ^ General Agriculture(GA)
land use ~ Rangeland(RL) p Forestry(FR) ^ Wildlife Habitat(WL)
(check one): O Residential(RS) ^ Recreation(RC) ^ Industrial/Commercial(IC)
O Developed Water Resources(NR)
~~~777

To
the best of my knowledge. all the information presente '''
his appl atlon form and
the attached Exhibits A-P are true and correct (must be appl operator).
Date: /~~Y,~/L G J ~ ~~G~ By: