2010-11-04_REVISION - M2006047

• Permit No: M2006047
• IBM Index Class Name: REVISION
• Doc Date: 11/4/2010
• Doc Name: Submittal
• From: Kit Carson County
• To: DRMS
• Type & Sequence: AM1
• Media Type: D
• Archive: No

-2-
11. Correspondence Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name: Dave Gwyn (District #2) Title: County Commissioners
Company Name: Kit Carson County
Street/P.O. Box: 251 16th Street P.O. Box: 160
City: Burlington
State: CO Zip Code: 80807
Telephone Number: (719 )_ 346-8139
Fax Number: (719 1-346-7242
PERMITTING CONTACT (if different from applicant/operator above)
Contact's Name: Randy Schafer Title:
Company Name:
Street/P.O. Box:
City:
State:
40586 Co. Rd. 21
P.O. Box:
Telephone Number:
Fax Number:
Haxtun
CO Zip Code: 80731
(970 774-6264 (Home) 970-854-3778 (Work) 970-520-0502 (Cell)
(970 _ 854-3811
INSPECTION CONTACT
Contact's Name: Wait Isenbart
Company Name:
Street/P.O. Box:
City:
State:
Telephone Number: ( 719 _ 349-1985
Fax Number: (719 ) _ 346-7242
CC: STA E OR FEDERAL LANDOWNER of M)
Agency:
Street:
City:
State:
Title: Road & Bridge Manager
Kit Carson County
251 16th Street, Suite 201 P.O. Box:
Burlington
CO Zip Code: 80807
Zip Code:
Telephone Number: ( ) -
CC: STATE OR FEDERAL LANDOWNER if an
Agency:
Street:
City:
State:
Zip Code:
Telephone Number: ( 1-