PERMFILE127582

• Permit No: M2001015
• IBM Index Class Name: Permit File
• Doc Date: 2/23/2001
• Doc Name: CONSTRUCTION MATERIALS LIMITED IMPACT 110 OPERATION RECLAMATION PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

- 3 -
14.
Corresooodence Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name: Phil Dorenkamp Title: Road & Brdg Sup.
Company Name: Las Animas County
Street: 2000 N. Linden Ave.
Ciry: Trinidad
State: CO• ZipCode:81082
TelephoneNtunber: 71~ 9 1-846-4766
Fax Number: 71( 9 1- 846-0434
PERMITTING CONTACT (if different from applicanUoperator above)
Individual's Name: Same as above
Company Name:
Street:
Ciry:
State:
Telephone Number: L_~-
FaxNumber: L_~-
Title:
Zip Code:
INSPECTION CONTACT
Individual's Name: Same as above Title:
Company Name:
Street:
City:
State: Zip Code:
Telephone Number: ~_~-
Fax Number: L_~-
CC: STATE OR FEDERAL LANDOWNER (ifanvl
Agency:
Street:
Ciry•:
State: Zip Code:
TelephoneNumber: (_~-
CC: STATE OR FEDERAL LANDOWNER (if an
Agency:
Street:
City:
Stare:
Zip Code:
Telephone Number: ( 1 -