PERMFILE130709

• Permit No: M1992003
• IBM Index Class Name: Permit File
• Doc Date: 1/10/1992
• Doc Name: LIMTED IMPACT OPERATION 110 2 REALMATION PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

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9. Correspondence Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Individual's Name: sna,-a of rn, + r~ ~
Company Name: ~„P,-fa rn ,.,+ ,
Street: 401 Main Street
City: Walsenburg
State: Colorado Zip Code: 81089
Area Code: ~~g Telephone: ~,R_~z~r,
PERMITTING CONTACT (if different from applicant/operator above)
Individual's Name:
Company Name:
Street:
City:
State:
Area Code:
Zip Code:
Telephone:
INSPECTION CONTACT
Individual's Name: SAMF
Company Name:
Street:
City:
State: Zip Code:
Area Code: Telephone:
CC: STATE OR FEDERAL LAN'DOhNER (if any)
Agency: N~NF
Street:
City:
State: Zip Code:
Area Code: Telephone:
CC: STATE OR FEDERAL LANDOWNER (if an
Agency: NONE __
Street:
City:
State: Zip Code:
Area Code: Telephone: