2010-11-18_PERMIT FILE - M2010075

• Permit No: M2010075
• IBM Index Class Name: PERMIT FILE
• Doc Date: 11/18/2010
• Doc Name: New 110c Application
• From: Washington County
• To: DRMS
• 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: Don Riemenschnieder Title: District 3 R&B Supervisor
Company Name: Washington County Road and Bridge Department
Q+_ _+/D O B • 11920 Co. Rd. CC P.O. Box:
ox.
Cit
: Anton
y
State: CO
Telephone Number: ( 970 ) - 383-2216
Fax Number: (970 1-383-2213
PERMITTING CONTACT (if different from applicant/operator above)
Contact's Name: Randy Schafer

Company Name:

Street/P.O. Box: 40586 Co. Rd. 21
City: Haxtun
Zip Code: 80801
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: Don Riemenschnieder
Company Name: SAME AS ABOVE
Street/P.O. Box:
City:
State:
Telephone Number: ) -
Fax Number: ( ) -
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency:
Street:
City:
State:
Telephone Number: ( ) -
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency:
Street:
City:
State:
Telephone Number: ( ) -
Title:
P.O. Box:
Title:
P.O. Box:
Zip Code:
Zip Code:
Zip Code: