2011-01-24_REVISION - M1979142

• Permit No: M1979142
• IBM Index Class Name: REVISION
• Doc Date: 1/24/2011
• Doc Name: Ammendment application ‎(AM-02)‎
• From: CDOT
• To: DRMS
• Type & Sequence: AM2
• Email Name: DMC
• 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: Rex Goodrich Title: Materials Engineer
Company Name: Colorado Department of Transportation
Street/P.O. Box: 222 South 6th Street, Room 317 P.O. Box:
City: Grand Junction
State: Colorado Zip Code: 81501
Telephone Number: ( 970 ) - 683-6222
Fax Number: (970 ) - 683-6227
PERMITTING CONTACT (if different from applicant/operator above)
Contact's Name: Title:
Company Name:
Street/P.O. Box: P.O. Box:
City:
State: Zip Code:
Telephone Number: ( ) -
Fax Number: ( ) -
INSPECTION CONTACT
Contact's Name: Title:
Company Name:
Street/P.O. Box: P.O. Box:
City:
State: Zip Code:
Telephone Number: ( ) -
Fax Number: ( 1-
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: j ) -
I II II IIVIII I II I I VI I I VI II VI I I VI II VI II I II I II II
20110520 1/19/20113:09 PM Lila Herod
Moffat County Clerk
3 of 8 MI R$46.00 D$0.00