2011-02-16_REVISION - M2005060

• Permit No: M2005060
• IBM Index Class Name: REVISION
• Doc Date: 2/16/2011
• Doc Name: Conversion Application
• From: Weld County
• To: DRMS
• Type & Sequence: CN1
• 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: David Bauer Title: County Engineer
Company Name: Weld County Public Works
Street/P.O. Box: 1111 H Street P.O. Box: 758
City: Greeley
State: Colorado Zip Code: 80525
Telephone Number: ( 970 304-6496
Fax Number: ( 970 304-6497
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: Jay McDonald Title: Mining Supervisor
Company Name: Weld County Public Works
Street/P.O. Box: 1111 H Street P.O. Box: 758
City: Greeley
State: Colorado Zip Code: 80525
Telephone Number: ( 970 304-6496
Fax Number: ( 970 _ 304-6497
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency: N/A
Street:
City:
State: Zip Code:

Telephone Number: ( ) -
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency: N/A
Street:
City:
State: Zip Code:

Telephone Number: ( ) -