PERMFILE110592

• Permit No: M1990112
• IBM Index Class Name: Permit File
• Doc Date: 7/31/1990
• Doc Name: Regular 112 Permit Application Form
• Media Type: D
• Archive: No

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10. Correspondance Information
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Individual's Name: Mac Graham
Company Name: Broderick & Gibbons, Inc.
Street: ~40o W. 6Qth Ave.
c; ty
State:
Area Code:
Denver
Colorado Zip Code: 80222
303 Telephone: [phone]
PERMITTING CONTACT (if different from applicant/operator above)
Individual's Name: Mac Graham
Company Name: As Above.
Street:
City:
Zip Code:
State:
Area Code:
Telephone:
• INSPECTION CONTACT (if different from applicant/operator above)
Individual's Name:
Company Name:
Street:
City:
State:
Zip Code:
Area Code:
Telephone:
il. Primary future Cropland(CR) _ Pasturetand(PL) _ General Agriculture(GA)
land use x Rangeland(RL) _ Forestry(FR) Wildlife Habitat(WL)
(check one): Residential(RS) Recreation(RC) _ Industrial/Commercial(IC)
_ Developed Water llesources(WR) _ Solid Waste Disposal(WD)
12. Primary present Cropland(CR) _ Pastureland(PL) _ General Agriculture(GA)
land use x Rangeland(RL) _ Forestry(FR) Wildlife Habitat(WL)
(check one): Residential(RS) Recreation(RC) - Industrial/Commercial(IC)
Developed Water ~sources(WR) _
To the best of my knowledge, all the information presented on this application form and
the attached Exhibits A-P are true and correct (must b si ned yam/p/licant/operator).
~e: July 27, 199G gY~ ~~ f``~---~- ~
Frank M. Graham, Jr.
it e Land & Resource Manager