2009-01-21_REVISION - M1978085

• Permit No: M1978085
• IBM Index Class Name: REVISION
• Doc Date: 1/21/2009
• Doc Name: Amendment application
• From: Moffat County
• To: DRMS
• Type & Sequence: CN1
• Email Name: GRM
• Media Type: D
• Archive: No

-3-
11. Correspondence Information:
APPI ICAN'T/OPERA'.1'OR (name, address, and phone of name to be used on permit)
(Chairman) Title: Commissioner
Contact's Name:
Name:
C Moffat County Board of County Cominiasioners
ompany
Box:
O
Street/P 221 West Victory Way ____ P.O. Box:
.
.
City: Craig, CO _ - N
Colorado Zip Code: 81625
State:
e Number:
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T 970 ) - 8 24 - 5 517
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PERMITTING COIN TACT (if different from applicant/operator above)
' Marvin Moore Title: (Consultant)
s Name:
Contact
:
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ame
ompany
Street/P.O..Box: 1570 Ranney, P.O. Box:
City: Craig
CO Zip Code: 81625
State:
ber:
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Fax Num
INSPECTION CONTACT
' Billy Mack Title: Director
s Name:
Contact
Company Name: Moffat County Road Department
822 East 1st. Street Box: 667
P
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Street/P.O.Box: .
.
City: Craig
CO- Zip Code: 81626
State:
hone Number:
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T 9 7 0 )-824-3211 Ext. 15 _
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CC. STATE OR FEDERAL LANDDMNLF-R-Cif-a-n-YJ
BLM Little Snake Field Office
Agency:
Street: 455 Emerson

City: Craig
State: Co
._.__.____..._._.....__.___.__....?..?_.?_?.?? .?..._._.____...._..._ _ Zip Code: 816 25
_._._...._..._..
Telephone Number: 0 7 -0--j - 8 2 6- 5 0 0 0
STATE OR FEDERAL LANI70WNER if an

Agency:
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treet: - - -
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ty:
State: Zip Code: -______.
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