2012-03-02_PERMIT FILE - M2012007

• Permit No: M2012007
• IBM Index Class Name: Permit File
• Doc Date: 3/2/2012
• Doc Name: 110 PERMIT APPLICATION
• From: O'ROUKE EXCAVATING
• To: DRMS
• Email Name: RCO
• Email Name: SSS
• Media Type: D
• Archive: No

-2-
11. Correspondence Information:
APPLICANT /OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name: :Zl q o A�/Q 5 O /C O W /� Title: 0 /L %�A Tot
Company Name: D j /f OG le Kr ExcA ✓A rr1✓G, /NG .
Street/P.O. Box: Z4-09 C 4 /6 P.O. Box:
City: Sou 7-H roRK
State: CO 10 44 Do Zip Code: � / /✓�4-
Telephone Number: ( 719 1- !S 8o - 960 Z
Fax Number: ( -
PERMITTING CONTACT (if different from applicant/operator above)
Contact's Name: Title:
Company Name:
Street/P.O. Box:
City:
State:
Telephone Number:
Fax Number:
P.O. Box:
Zip Code:
INSPECTION CONTACT
Contact's Name: Title:
Company Name:
Street/P.O. Box:
City:
State:
Telephone Number: ( Fax Number: ( ) -
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency: N A
Street:
City:
State:
Telephone Number: ( ) -
CC: STATE OR FEDERAL LANDOWNER (if any)
Agency:
Street:
City:
State:
Telephone Number: ( 1-
P.O. Box:
Zip Code:
Zip Code:
Zip Code: