PERMFILE123782

• Permit No: M1996007
• IBM Index Class Name: Permit File
• Doc Date: 1/29/1996
• Doc Name: REGULAR OPERATION 112 RECLAMATION PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

2
10. Correspondence Information:
APPLICANT/OPfiRATOR (name, address, and phone of name to be used on permit)
Individual's Name: .TnHN ACKERMAN~
Company Name: cnTnRAnn nRRARTMENT OF TRANSPORTATION
Street: 222 c BTU cT RM 4t7
City: GRANn TiINCTTnN
State• COLORADO Zip Code- 61501-2769
Area Code: 970 Telephone: [phone]
PfiRMiTTING CONTACT (if different from applicant/operato"r above)
Individual's Name:
Company Name:
Street:
City:
State:
Area Code:
INSPfiCTION CONTACT
Individual's Name:
Cca~aay Name:
Street:
City:
State:
Telephone:
Zip Code:
Zip Code:
Area Code: Telephone:
CC. STATfi OR FEDERAL LANDOYrNER Si£
pgp~cy,- USDA - US FOREST SERVICE DIVIDE DISTRICT
Street: 13308 W HWY 160 PO BOX 40
City: DEL NORTE
State: Cni.nRAnO Zip Code: 81132
Area Code: ~tg Telephone: ~° °~°.:~ ~~~- Z/
CC: STATE OR FEDERAL LALd10WNER Sif
Agency:
Street:
City:
State: Zip Code:
Area Code: Telephone: