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PERMFILE121750
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PERMFILE121750
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Entry Properties
Last modified
8/24/2016 10:20:01 PM
Creation date
11/25/2007 9:41:33 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1992100
IBM Index Class Name
Permit File
Doc Date
10/2/1992
Doc Name
Limited Impact Operation 110 2 Reclamation Permit Application Form
Media Type
D
Archive
No
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11 <br />~~ ~~ <br />-z- <br />9. Correspondence Information: <br />APPLICANT/OPERATOR (name, address, ~~a77nd,phone of name to be used on permit) <br />Individual's Name: 12;dE2 ,oo7TUM Lg r.)D ('vaA <br />Company Name: 12~ Je2 r3.,tl•~,~,-. L.u..,.~ C`orn <br />Street: 14a.S NnnS Lvi <br />city: ~~.,-,-, ; <br />State: !`~, Zip Code: 814x$ <br />Area Code: 303 Telephone: Sal-'f'/3~ <br />PERMITTING CONTACT <if different from applicant/operator above) <br />Individual's Name: I~c~~-,-;cic Fa.r~air~or`I-t~ <br />Company Name: IZi JQ IZ '. )'Jo~vv~ Lo,~,r~ Cn r~7 <br />Street: <br />City: <br />State: <br />Area Code: <br />INSPECTION CONTACT <br />Individual's Name <br />Company Name: <br />Street: <br />City: <br />State: <br />Area Code: <br />Telephone: <br />Zip Code: <br />CC: STATE OR FEDERAL LANDOWNER (if any) <br />Agency: ~~a <br />Street:. <br />City: <br />State: <br />Area Code: Telephone: <br />Zip Code: <br />CC: STATE OR FEDERAL LANDOWNER (if any) <br />Agency: `"x`10. <br />Street: <br />City: <br />State: <br />Area Code: <br />Telephone: <br />Zip Code: <br />12iJER BoTto rv~ 1-AN~ CORM <br />Telephone: <br />Zip Code: <br />
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