PERMFILE109834

• Permit No: M1987074
• IBM Index Class Name: Permit File
• Doc Date: 4/28/1987
• Doc Name: REGULAR 112 PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

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30. Correspondence Information
APPLICANT/OPERATOR (name, address and phone of name to be used on permit)
Individual's Name: Robert E. Whitman
Company Name: Dotaero Block. Inc.
Street: P.O. Box 933
City: Glenwood SorinQe
State: Colorado Zip Code: 81602
Area Code: 303 Telephone: [phone]
PERMITTING CONTACT (if different from applicant/operator above)
Individual's Name: Stevan O'Brian
Company Name: Environment. Inc.
Street: 9989 West 60th Ave. Suite 200
City: Arvada.
State: Colorado Zip Code: 80004
Area Code: 303 Telephone: [phone]
INSPECTION CONTACT (if different from applicant/operator above)
Individual's Name:
Company Name: Dotaero Block. Inc.
Street: P. O. Box 933
City: Glenwood Sprieee
State: -Colorado Zip Code: 81602
Area Code: 303 Telephone: [phone]
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11. PRIMARY PUTURE ^ Cropland (CR) ^ Pastureland (PL) ^ General Agriculture(GA)
land use ^ Rangeland (RL) ^ Forestry (FR) (~ Wildlife Habitat (WL)
(check one): ^ Residential (RS) ^ Recreation (RC) ^ Industrial/C®ex+cial(IC)
^ Developed Water Resources (WR)
12. PRIMARY PRESENT ^ Cropland (CR) ^ Pastureland (PL) ^ General Agriculture(GA)
land use ^ Rangeland (RL) ^ Forestry (F$) ® Wildlife Habitat (WL)
(check one): ^Residential (RS) ^ Recreation (RC) ^ Industrial/Camercial(IC)
^ Developed Water Resources (WR)
To the beat of my knowledge, all the information presents n this appl~ ation form and
the attached Exhibits A-P are true and correct (moat be sig ed y/the a p Scant/operator).
Date: By: / w ~~--~-
bert E. itman
President
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