2009-09-23_REVISION - M2001085

• Permit No: M2001085
• IBM Index Class Name: REVISION
• Doc Date: 9/23/2009
• Doc Name: Submittal
• From: 120th Estates Partners
• To: DRMS
• Type & Sequence: AM4
• Media Type: D
• Archive: No

-3-
11. Correspondence Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name: Les Ewegen - Title: Project Manager
Company Name: Les Ewegen LLC
Street/P.O. Box: WCR 39 P.O. Box:
City: Eaton
State: Co. Zip Code: 80615
Telephone Number: ( 303-667-1666) _
Fax Number: (970-454-3039) _
PERMITTING CONTACT (if different from applicantloperator above)
Contact's Name: Title:
Company Name:
Street/P.O. Box: P.O. Box:
City:
State: Zip Code:
Telephone Number: { ) -
Fax Number: f -
INSPECTION CONTACT
Contact's Name: Les Ewegen Title: Project Manager
Company Name:
Street/P.O. Box: P.O. Box:
City:
State: Zip Code:
Telephone Number: ( 303-667-1666) _
Fax Number: ( 90-454-3039) _
CC: STATE OR FEDERAL LANDOWNER (if My)
Agency: NA
Street:
City:
State: Zip Code:
Telephone Number: ( ) -
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency: NA
Street:
City:
State: Zip Code:
Telephone Number: ( ) -