2010-08-16_REVISION - M1991078

• Permit No: M1991078
• IBM Index Class Name: Revision
• Doc Date: 8/16/2010
• Doc Name: Conversion Application
• From: Kiowa County
• To: DRMS
• Type & Sequence: CN1
• 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: Title:
Company Name: Kiowa County
Street/P.O. Box: 1305 Goff St P.O. Box: 100
City: Eads
State: Colorado Zip Code: 81036
Telephone Number: ( 719 ) _ 438-5810
Fax Number: ( 719 ) _ 438-5615
PERMITTING CONTACT (if different from applicant/operator above)
Contact's Name: Peggy Dunlap, Rick Spady Title: Administrator/Road Sup
Company Name:
Street/P.O. Box: same P.O. Box:
City:
State: Zip Code:
Telephone Number: ( ) -
Fax Number: ( ) -
INSPECTION CONTACT
Contact's Name: Donald Oswald, Rick Spady Title: Commissioner/Road Supv
Company Name:
Street/P.O. Box: P.O. Box:
City:
State: Zip Code:
Telephone Number: ( )
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: ) -