2009-03-06_REVISION - M1980049

• Permit No: M1980049
• IBM Index Class Name: REVISION
• Doc Date: 3/6/2009
• Doc Name: New amendment ‎(AM-01)‎
• From: Donald R Hart
• To: DRMS
• Type & Sequence: AM1
• Email Name: WHE
• Media Type: D
• Archive: No

-2-
11. Correspondence Information:
APPI.TC,kNT/OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name: Don Hart Title: Operator
Company Name: __-
Street/.P.O. Box: 3500 Clear Fork Road P.O. Box:
City: Crawford Y --_
State: CO Zip Code: 81415
Telephone Number: { 9 7 0 921-5299
Fax Number: 9 7 0921-3490
PER]V1aTING CONTACT (if different from applicant/operator above)
Contact's Name: Ryan Ellis Title: Proj ect Engineer
Company Name: Greg Lewicki and Associates
Street/P.O. Box: 11541 Warrington Ct.
^ P.O. Box:
City: Parker
State: CO Zip Code: 8 013 8
Telephone Number: ( 3 0 3. 880-6690
_
Fax Number: { 303 346-6934
INSPECTION CONTACT
Contact's Name: Don Hart _ Title: Operator
Company Name:
Street/P.O. Box: 3500 Clear Fork Road P.O. Box:
City: Crawford
State: CO Zip Code: 81415
Telephone Number: ( 9 7 0 ) 921-5299
-NV_~
Fax Number: 9 7 0 921-3490
----.----_.
CC: STATE OR FEDERAL LANDOWNER if an
Agency:
Street:
City:
State:
Telephone Number: .-------- ---------- _
CC:. STATE OR FEDERAL LANDQWN jWf any)
Agency:
Street:
Citv:
State:
Eelephone number: - --_-.__-.-.._........_....-.._.
Zip Code:
Zip Code: