PERMFILE135222

• Permit No: M1988087
• IBM Index Class Name: Permit File
• Doc Date: 8/30/1988
• Doc Name: APPLICATION WORKSHEET CHECKLIST
• Media Type: D
• Archive: No

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10. Correspondence Information
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Individual's Name: John T. Ungefug
Company Name: Southway Construction Co., Inc.
Street: 117 White Pine Drive
City: Alamosa
State: Colorado Zip Code: eIIOI
Area Code: ~i9 Telephone: sag-slo3
PERMITTING CONTACT (if different from applicant/operator above)
Individual's Name:
Company Name:
Street:
c; ty:
State:
Area Code:
Telephone:
Zip Code:
INSPECTION CONTACT (if different from applicant/operator above)
Individual's Name:
Company Name:
Street:
City:
State:
Area Code: Telephone:
Zip Code:
11. Primary future ^ Cropland(CR) ^ Pastureland(PL) ^ General Agriculture(GA)
land use ® Rangeland(RL) ^ Forestry(FR) ^ Wildlife Habitat(WL)
(check one): ^ Residential(RS) ^ Recreation(RC) ^ Industrial/Commercial(IC)
^ Developed Water Re sources(WR) ^ Solid Waste Disposal(WD)
12. Primary present ^ Cropland(CR) ^ Pastureland(PL) ^ General Agriculture(GA)
land use ® Rangeland(RL) ^ Forestry(FR) ^ Wildlife Habitat(WL)
(check one): ^ Residential(RS) ^ Recreation(RC) ^ Industrial/Commercial(IC)
^ Developed Water Re sources(WR)
To the best of my knowledge, all the information presented on this application form and
the attached Exhibits A-G are true and correct (must be signed by plicant/operator)'.
Date: s/a/sa By:
n ineer
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