2010-06-01_PERMIT FILE - M2010036

• Permit No: M2010036
• IBM Index Class Name: PERMIT FILE
• Doc Date: 6/1/2010
• Doc Name: New 110c Application
• From: Randy Schafer
• To: DRMS
• Media Type: D
• Archive: No

-2-
11. Correspondence Information:
APPLICANVOPERATOR (name, address, and phone of name to be used on permit)
Contact's Name: Timothy J. Hansel Title: Owner
Company Name:
Street/P.O. Box: 5222 Marit Drive P.O. Box:
City: Santa Rosa
State: CA Zip Code: 95409-3823
Telephone Number: (707 )483-/089
Fax Number: ( -
PERNUTTING CONTACT (if different from applicant/operator above)
Contact's Name: Randy Schafer Title: Consultant
Company Name:
Street/P.O. Box: 40586 Co. Rd. 21 P.O. Box:
City: Haxtun
State: CO Zip Code: 80731
Telephone Number: ( 970 854-3778 (Work) 970-774-6264 (Home) 970-520-0502 (Cell)
Fax Number. (970 ) _ 854-3811
INSPECTION CONTACT
Contact's Name: Tim Hansel Title: Owner
Company Name:
Street/P.O. Box: 5222 Marit Drive P.O. Box:
City: Santa Rosa
State: CA Zip Code: 95409-3823
Telephone Number: (707 _ 483-/089
Fax Number: ( ) _
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency:
Street:
City:
State: Zip Code:
Telephone Number: ( ) -
CC: STATE OR FEDERAL LANDOWNER (if any,)
Agency:
Street:
City:
State: Zip Code:
Telephone Number: ( 1-