PERMFILE108642

• Permit No: M2005039
• IBM Index Class Name: Permit File
• Doc Date: 5/19/2005
• Doc Name: regular operation Reclamation Permit Application Form
• From: dmg
• To: bent county
• Media Type: D
• Archive: No

-3-
]4. Corresoondencelnformation:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)

Contact's Name: CoAg.a t-..'"PfiTTGr}giev Title: Co. AaMZwrssra.~ro~
Cornpatry Name: E N T C o.~ N 7^ Y
J
StreeUP.O. Box: ''1 2 5~ E hrT A V E N u f_ P.O. Box: 3 SD
City: t._ A S A w~ s nn SAS
State: C o ~. o R AO o Zip Code: g I o 5+J - 0 3 5m
Telephone Number: (r7/ 9 ,~- ~ 5V - ~ s s 3
Fax Number: f `7 / 9 1- 't'{ 5 ~. - 0 3'75
PERMITTING CONTACT (if different from applicanUoperator above)
Contact's Name:
Corripa~ Name:
Street/P.O. Box:
Ciry:
State:
Telephone Number:
Fax Number:
ECTION CONTAC'
Contad's Nam:
Company Name:
Street/P.O. sox:
Clty:
State:
Telephone Number:
Fax Number:
Title:
P.O. Box:
Zip Code:
CeLiRti L-_~PP-STCHARO Ti@e:GO. A»MSNSSra.oraQ,
~EnJ'r- CCa/AITY
'y ~ 5 ,~ E N r R-v E N u E P.O. Box: 3.50
L- R S ANS M W S
Colo RAOa Zip Code: $1d5+f '-0 3So
~~- -~ s~ - n 3 ys
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency: .J{/ ~
Street:
City:
State: Zip Code:
Telephone Number: ( 1-
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency: YlV / !-Y
Street:
Ciry:
State: Zip Code:
Telephone Number: ( 1-