2008-03-31_PERMIT FILE - M2008020

• Permit No: M2008020
• IBM Index Class Name: PERMIT FILE
• Doc Date: 3/31/2008
• Doc Name: New 110c Appl
• From: Dolores County
• To: DRMS
• Media Type: D
• Archive: No

® EXHIBIT I
3.i I'\ +~ 1
11. Corresttonden~e Information:
APPLICANT/OP:ERATQ$ {Warne, address, and phone of name to be used on permit}
Contact's Name: Tim Hu s ke y Title: Road S u p e r v i s o r
CompanyNam+~ -.Do~ores_'County =Road..&_ SY;,dg~~,fi
Street/P.O. Boz: ._.._.~. Q A N. Guyrene P.O. Box: __ 608
C1ty: nOVA ~YPPk
State: _ CO Zip Code: _ _.81324
,Telephone Number: 9j____ 7 0 ,~ - 6 7 7- 2 3 2 8
Fax Number: ( 970 )-__577-3759
P~RMITTINCI CONTACT (if different fram applicant/operator above)
Contact's Name: Title:
Company Name
Street/P.O. Box: P.O.. Box•
city:
State: Zip Code:
Telephone Number: {, 1-
Fax Nwnber. { 1
1NSFECTION CON'~ACT
Contact's Name: ___Tim Huskey Title• .Road Suggzvi~o~-
Company Narrne: Dolores . o L n,~y R o ,c RY ; ~a q P nP= t _
Strret/P.O. Box: ],O 1 0 t~L {,r, yY P n p P.O..Box: X 0 8
City: - Dove Creek
State: C O Zip Code: 813 2 4
Telephone Number., {„ 9 7 0 )- 6 7 7- 2 32 8
Fax Number: ( 9 ~ 0 1-~ 7__ 7 -,~ 7 ,~~
CC• STATE O~,F,>*'QERAI. LANDOWNER (if a
Agency: ...~
Street:
City:
State:
Zip Code:
Telephone Number: (, ) -
CC• STATE ~ FEDERAL LANDOWNER (i_f ~y~
Agency:
Street:
City: _.....,.
State: Zip Code:
Telephone Nuxtrber: ~,____,,.,,,,,,_,~ = ~ ~ ~ _