PERMFILE121454

• Permit No: M1988022
• IBM Index Class Name: Permit File
• Doc Date: 3/18/1988
• Doc Name: Application
• 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:
Company Name: Lincoln County
Street: Courthouse
Area Code: 303' Telephone: [phone]
PERMITTING CONTACT (if different from applicant/operator above)
individual's Name: J.R. Owen
City : Hueo
State: Colo. Zip Code: $0$21
Company Name:
:itreet:
21$ $th St.
I;ity: Hu6o
:itate: Cnln. Zip Code: R0~21
Area'Code: 303 Telephone: [phone]
INSPE(:TION CONTACT (if different from applicant/operator above)
Individual's Name:
(:ompany Name:
~~treet:
C'.i ty
State:
Area Code:
Telephone:
Zip Code:
11. Primary future ^ Cropland(CR) ^ Pastureland(PL) ^ General Agriculture(GA)
land use CI Rangeland(RL) ^ Forestry(FR) ^ Wildlife Habitat(WL)
(check one): ^ Residential(RS)^ Recreation(RC) ^ Industrial/Commercial(IC)
^ Developed Water Resources(WR) ^ Solid Waste Disposal(WD)
12. Primary present ^ Cropland{CR) ^ Pastureland(PL) ^ General Agriculture(GA)
land use ~1 Rangeland(RL) ^ Forestry(FR) ^ Wildlife Wabitat(WL)
(check one): ^ Residential(RSI ^ Recreation(RC) ^ Industrial/Commercial(IC)
^ Developed Water Resources(WR)
To the best of my knowledge, all the information presented on this application form and
the attached Exhibits A-G are true and correct (must be signed (bey applicant/o/~perator).
Date: BY:-, ~ ~ ~~~~ -1~
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