PERMFILE135523

• Permit No: M1990144
• IBM Index Class Name: Permit File
• Doc Date: 11/28/1990
• Doc Name: REGULAR 112 PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

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10. Correspondz~nce Information
APPLICANT/(IPERATOR (name, address, and phone of name to be used on permit)
Individual's Name: John T. Ungefug
COmpillly Name: Southway Construction Co., Inc
StreE!t: 117 White Pine Drive
Ci ty:: Alamosa
StdtE!: Colorado Zip Code: 81101
Area Code: 719 Telephone: [phone]
PERMITTING CONTACT (if different from applicant/operator above)
Individual's Name:
Company Name:
Street:
City :;
State: Zip Code:
Area Code: Telephone:
INSPECTION CONTACT (if different from applicant/operator above)
Indi~~idual's Name:
Comp~~ny Name:
Street:
City:
State:
Aree Code:
Telephone:
Zip Code:
11. Primary fu~W re Cropland(CR) _ Pastureland(PL) _ General Agriculture(GA)
land use x Rangeland(RL) _ Forestry(FR) Mildlife Habitat(ML)
(check one): - Residential(RS) Recreation(RC) - Industrial/Commercial(IC)
_ Developed Water ll-esources(WR) _ Solid Naste Disposal(WD)
12. Primary pnesent Cropland(CR) _ Pastureland(PL) _ General Agriculture(GA)
land use x Rangelend(RL) Forestry(FR) Nildlife Habitat(NL)
(check one): _ Residentlal(RS) - Recreation(RC) - Industrial/Commercial(IC)
Developed Water l~sources(MR)
To the best of upr knowledge, all the information presented on this application form and
the attached Exhibits A-P are true and correct ( t be signed) by applicant/operator).
Date: /%/2~ ~90 By:, ~ -\ ~1. ~~~
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