2010-11-04_REVISION - M1982189

• Permit No: M1982189
• 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. Corresnondence Information:
APPLICANT/OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name: Dave Gwyn Title: County Commissioner
Company Name: Klt Carson County
Street/P.O. Box: P.O. Box: 160
City: Burlington
State: CO _ Zip Code: 80807
Telephone Number: (719 1-346-8139
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: 40586 co. Rd. 21 P.O. Box:
City: Haxtun
State: Co Zip Code: 80731
Telephone Number: (970 774-6264 (Home) 970-854-3778 (Work) 970-520-0502 (Cell)
Fax Number: (970 ) _ 854-3811
INSPECTION CONTACT
Contact's Name: Walt Isenbart Title: Road & Bridge Manager
Company Name: Kit Carson County
Street/P.O. Box: P.O. Box: 160
City: Burlington
State: Colorao Zip Code: 80807
Telephone Number: ( 719 ) _ 349-1985
Fax Number: (719-346-7242 ) _
CC: STATE OR FEDERAL LANDOWNER (if anv)
Agency:
Street:
City:
State: Zip Code:
Telephone Number: ) -
CC: STATE OR FEDERAL LANDOWNER (if anv)
Agency:
Street:
City:
State: Zip Code:
Telephone Number: ( ) -