PERMFILE120479

• Permit No: M1991083
• IBM Index Class Name: Permit File
• Doc Date: 7/18/1991
• Doc Name: 110 PERMIT APPLICATION
• From: MLRD
• To: CUSTER CNTY CONCRETE
• Media Type: D
• Archive: No

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9. Corrf~spondence Information:
APPL:[CANT/OPERATOR (name, address, and phone of name to be used on Dermitl
Individual's Name: M;xa Colaman and ,Tn rrv Sa;PPrt
Company Name:
Street: 60160 Highway 69 North i3~~ 30C
Clty: S4or:Ynl i ffa
State: ( nlnradn Z;p Code: 81252
Area Code: ~~ g Telephone: ~Ra_~~F~
PERM]:TTING CONTACT (if different from applicant/operator abovel
Individual's Name:
Company Name:
Street:
City:
State:
Area Code:
INSPECTION CONTACT
Individual's Name:
Company Name:
Street:
City:
State:
Ar Code•
Zip Code:
Telephone:
Jerry Seifert
60160 Hiaheray 69 Nortli
Colorado Z;D Code: 81252
ea -,T9 Telephone: _~n•1_~~s~
CC: STATE OR FEDERAL LANDOWNER (if anyl
Agency: Sratn Rnarrl of T.a nrl f'nmmiccinnarc
Street: ~2n C`anf annial Rlr7n_ 777"1 Charman $t
C;ty: _ nenvPr
.State: Cp Zip Code: 8020"1
4rea Code: 3p3 Telephone: [phone]
CC: .STATE OR FEDERAL LANDOWNER (if a
Urea Code: Telephone:
.4gency:
:Street:
r,; ty:
:State:
Zip Code: