PERMFILE111559

• Permit No: M2006076
• IBM Index Class Name: Permit File
• Doc Date: 11/1/2006
• Doc Name: 112c application
• From: Moffat County Board of County Commissioners
• To: DRMS
• Media Type: D
• Archive: No

-3-
1 I. Corna~ondence Informatbn:
APPLICANT/OPERATOR (name, address, and phone of name to be used on pemtit)
contaceaName: Tom Gray (Chairman) TnleCounts Commissioner
Company Name: Moffat County Board of County Commissioners
street/P.O.Box: 221 West Victory Way p.O.Box:
C;ty: Craig. CO
stagy: Colorado Zip Code: 81625
Telephone Number: 7(9 0 ~ - 8 21'i' -Jr' S 1
Fax Number. ( 1 -
PERMITTING CONTACT (if differem from applicantloperatorahove)
contaci'sName: Marvin Moore Tiue: Consultant
Company Name:
Street/P.O.Box: 15?0 Rariney St. P.O.Box:
city:
Sm[e:
Telephone Number:
Fax Number:
INSPECTION CONTACT
Coatact's Name:
Compa~ry Name:
StreetlP.O. sox:
City:
State:
Telephone Number:
Fax Number:
co
t97o ~_824-
L ~-~
Billy Mack
Zip Code: 816 25
T;~. Director
Moffat County Road Department
822 East 1st Street p,O.sox: 667
Cr
CO
zip code: 816 26
9t 70 t_ 82~-3211 Ext. 15
c 970 ~-824-0356
CC~ STATE OR FEDERAL LANDOWNER (if am)
Agency: State Board of Land Commissioners
Stree<: 1313 Sherman St. Room 620
city:
r
State: CO ZipCode:80203
Telephone Number: (303 ~- 866-3934 (Attn: Tim Kelly)
CC STATE OR FEDERAL LANDOWNER (if aml
Agency'-
Street:
City:
Stete: Zip Code:
Telephone Number: ~ 1-