2011-11-02_REVISION - M2003019 ‎(5)‎

• Permit No: M2003019
• IBM Index Class Name: REVISION
• Doc Date: 11/2/2011
• Doc Name: Submittal
• From: Baca County
• To: DRMS
• Type & Sequence: CN1
• Media Type: D
• Archive: No

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11. Correspondence Information:
APPLICANT /OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name: Troy Crane
Title: Commisssioner
Company Name: Baca County
Street/P.O. Box: 741 Main St Suite #1 P.O. Box:
City: Springfield
State: Colorado Zip Code: 81073
Telephone Number: (719 523 6532 )
Fax Number: ( 719 523 6584 )
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: Clarence Stevenson Title: FOREMAN
Company Name: Baca County Dist # 3
Street/P.O. Box: Hwy 160 /26607 County Rd 12 P.O. Box:
City: Ptitchett
State: Colorado Zip Code: 81064
Telephone Number: (71 9 523 40212 )
Fax Number: ( 719 523 6484 -
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency:
Street:
City:
State: Zip Code:
Telephone Number: ( ) -
CC: STATE OR FEDERAL LANDOWNER if an
Agency:
Street:
City:
State: Zip Code:
Telephone Number: ( ) -