2011-06-08_REVISION - M1977256

• Permit No: M1977256
• IBM Index Class Name: Revision
• Doc Date: 6/8/2011
• Doc Name: Complete Application Form
• From: Grand County Dept. of Road & Bridge
• To: DRMS
• Type & Sequence: AM1
• Email Name: PSH
• 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: Gary Bumgarner Title: Commissioner, Chariman
Company Name: Grand County Department of Road and Bridge
Street/P.O. Box: 308 Byers Ave. P.O. Box: 264
City: Hot Sulphur Springs
State: CO Zip Code: 80451
Telephone Number: (970 _ 725-3100
Fax Number: (970 725-0565
PERMITTING CONTACT (if different from applicant/operator above)
Contact's Name: Steve O'Brian Title: President
Company Name: Environment, Inc
Street/P.O. Box: 7985 Vance Dr. #205A P.O. Box:
City: Arvada
State: CO Zip Code: 80003
Telephone Number: (303 _ 423-7297
Fax Number: (303 _ 423-7599
INSPECTION CONTACT
Contact's Name: Ken Haynes or Bill Clark Title: Road Superintendent
Company Name: Grand County Department of Road and Bridge
Street/P.O. Box: P.O. Box: 9
City: Granby
State: CO Zip Code: 80446
Telephone Number: (970 _ 887-2123
Fax Number: (970 887-3168
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: