2012-11-16_PERMIT FILE - M2012048

• Permit No: M2012048
• IBM Index Class Name: Permit File
• Doc Date: 11/16/2012
• Doc Name: 110 LIMITED IMPACT APPLICATION
• From: KIT CARSON COUNTY
• To: DRMS
• Email Name: TAK
• Media Type: D
• Archive: No

I I. Correspondence Information:
APPLICANT /OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name: Walt Isenbart Title: Road & Bridge Foreman
Company Name: Klt Carson County
Street/P.O. Box: P.O. Box: 160
City: Burlington
State: Colorado Zip Code: 80807
Telephone Number: ( 719 ) _ 349 - 1985
Fax Number: ( 719 ) _ 346 - 7242
PERMITTING CONTACT (if different from applicant/operator above)
Contact's Name: Randy Schafer Title:
Company Name:
Street/P.O. Box: 40586 Co. Rd. 21 P.O. Box:
City: Haxtun
State: CO Zip Code: 80731
Telephone Number: ( 970 ) _ 774 -6264 (Home) 970 -854 -3778 (Work) 970 -520 -0502 (Cell)
Fax Number: ( 970 ) _ 854 -3811
INSPECTION CONTACT
Contact's Name: Walt Isenbart Title: Road & Bridge Foreman
Company Name: Kit Carson County
Street/P.O. Box: P.O. Box: 160
City: Burlington
State: CO Zip Code: 80807
Telephone Number: ( 719 1 _ 349 - 1985
Fax Number: ( 719 ) _ 346 - 7242
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: ( ) -