PERMFILE106832

• Permit No: M1990059
• IBM Index Class Name: Permit File
• Doc Date: 5/3/1990
• Doc Name: TWO ACRE LIMITED OPERATION 110 1 APPLICATION FORM
• Media Type: D
• Archive: No

10. Cocrespondenee Information
APPLICANT/OPERATOR (na'ne, address, and phone of name to be used on permit)
Individual's Name: ~~~1- Mosc~(
Company Name: CSarna~
Street: \89 f ~~nc ~:J.oe look
C lty: ~yr a~n eau ~
State: Colorado Zip Code: Ai3o1
Area Code: 303 Telephone: 2y7-2322
PERMIT'T'ING CONTACT (if different from Applicant/Operator, above)
Individual's Name:
Company Name:
Street:
City:
State: Zip Code:
Area Code: telephone:
INSP4CTION CONTACT (if different Erom Applicant/Operator, above)
Individual's Name:
Company Name:
Street:
City:
State:
Area Code:
telephone:
Zip Code:
11. Priaary post- Cropland(CR) _ Pastureland(PL) _ General Agriculture(Ga)
minim land ~_ Rangeland(RL) _ Forestry(FR) _ Wildlife Habitat(WL)
use (check one): _ Residential(RS)~ Recreation(RC) _ Industrial/Concnercial(IC)
_ Developed Water ResourcesikR) _ Solid haste Disposal(.JD)
12. Primary present _ Cropland(CR) _ Pastureland(PL) _ General Agriculture(GA)
land use _ Rangeland(RL) _ Forestry(FR) _ Wildlife Habitat(WL)
(check one): _ Residential(RS) _ Recreation(RC) Industrial/Com^nercialiIC)
_ Developed Water Resources(~R) X lfining(!~!)
8236v -5-