PERMFILE122124

• Permit No: M1990140
• IBM Index Class Name: Permit File
• Doc Date: 10/25/1990
• Doc Name: LIMITED IMPACT OPERATION 110 2 APPLICATION FORM
• From: Marvin Moore
• Media Type: D
• Archive: No

10. Correspondance Information
-2-

APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Individual's Name:
Company Name:
Street:
c; ty:
PERMITTING CONTACT (if different from applicant/operator above)
State:
Area Code:
fni nRnnn Zip Code:
303 Telephone: [phone]
Individual's Name: MARVIN MOORE

Company Name: (CONSULTANT)
Street: 1570 RANNEY ST
City: CRAIG
State: COLORA00 Zip Code: 81625
Area Code: 3~3 Telephone: R~4-n~44
INSPECTION CONTACT (if different from applicant/operator above)
Individual's Name: Nie
Company Name:
Street:
City:
State:
Area Code:

Zip Code:
Telephone:
11. Primary future XXX Cropland(CR) _ Pastureland(PL) _ General Agriculture(GA)
land use _ Rangeland(RL) Forestry(FR) _ Wilulife Habitat(WL)
(check one): _ Residential(RS) ` Recreation(RC) Industrial/Commercial(IC)
Developed Water l~sources(WR) - Solid Waste Disposal(WD)
12. Primary presentX~ Cropland(CR) _ Pastureland(PL) _ General A9riculture(GA)
land use Rangeland(RL) _ Forestry(FR) _ Wildlife Habitat(WL)
{check one): -_ Residential(RS) Recreation(RC) _ Industrial/Commercial(IC)
Developed Water ~esources(WR)
345 WOODBURY DRIVE
CRAIG COLO.