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• <br />-2- <br />10. Correspondence Information <br />APPLIf.ANT/OPERATOR (name, address, and phone of name to be used on permit) <br />Individual's Name: L. Dwayne Skelton <br />Company Name: Skelton, Inc. <br />Street: 1565 Grand Avenue <br />City: Norwood, <br />State: Colorado Zip Code: 81423 <br />Area Code: 303 Telephone: 327-4389 or 327-4586 <br />PERMITTING CONTACT (if different from applicant/operator above) <br />Individual's Name: Ruth Grav <br />u <br />• <br />Company Name <br />Street: <br />City: <br />State: <br />Area Code: <br />INSPECTION CONTACT (if <br />Individual's Name: <br />Skelton. Tnc. <br />1565 Grand Avenue <br />Norwood <br />Colorado Zip Code: 81423 <br />303 Telephone: 327-4389 or 327-4586 <br />different from applicant/operator above) <br />Company Name: <br />Street: <br />City: <br />State: <br />Area Code: <br />Telephone: <br />Zip Code: <br />11. Primary future ^ Cropland(CR) ® Pastureland(PL) ^ General Agriculture(GA) <br />land use ^ Rangeland(RL) ^ Forestry(FR) ^ Wildlife Habitat(WL) <br />(check one): ^ Residential(RS) ^ Recreation(RC) ^ Industrial/Commercial(IC) <br /> ^ Developed Water Resources(WR) ^ Solid Waste Disposal(WD) <br />12. Primary present ^ Cropland(CR) ^ Pastureland(PL) ^ General Agriculture(GA) <br />land use ^ Rangeland(RL) ^ Forestry(FR) ^ Wildlife Ilabitat(lJL) <br />(check one): ^ Residential(RS) ^ Recreation(RC) p Industrial/Commercial(IC) <br /> ^ Developed Water Re sources(WR) <br />To the best of my knowledge, all the information presente on this application form and <br />the attached Exhibits A-G are true and correct (must be ig ed by applicvan/t/operator). <br />Date: `~/~3~/,~5~ By: ~ ~,[/e.li L~ ~/~i///<, <br />izie <br />