2011-01-25_REVISION - M2005065 ‎(14)‎

• Permit No: M2005065
• IBM Index Class Name: REVISION
• Doc Date: 1/25/2011
• Doc Name: Coversion application ‎(CN-01)‎
• From: Upper Animas Sand & Gravel
• To: DRMS
• Type & Sequence: CN1
• 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: J a k Mark., ,7 r_ Title: Owner
Company Name:
Street/P.O. Box:
City: S i lverton
State: Colorado Zip Code: 81 4 3 3
Telephone Number: f 9 7 0 )-387-5243
Fax Number. ( ) - _
PERMITTING CONT'ACT' (if different from applicant/operator above)
Contact's Name: Charles R. Ponchak Title:Geological Consultant
Company Name:
Street/P.O. Box:
City:
State:
15292 6050 Rd P.O.Box:
Montrose
Colorado Zip Code: 81403
Telephone Number: 970 )--249-2081 970-249-4434
Fax Number: ( 970 )-249-2081
INSPECTION CONTACT
Contact's Name: ,T a k (1-1 ark., 7 r_ Title: own a r
Company Name:
Street/P.O. Box::
City:
State:
Telephone Number:
Fax Number:
CC: STATE OR FEDERAL LANDOWNER (if an
Agency:
Street:
City:
State:
Telephone Number:
CC: STATE OR FEDERAL LANDOWNER (if an
Agency:
Street:
City:
State:
P.O. Box: 7 h 7
P.O. Box:
Zip Code:
Zip Code:
Telephone Number. 1-
Zip Code: