2013-02-27_REVISION - M1979163

• Permit No: M1979163
• IBM Index Class Name: REVISION
• Doc Date: 2/27/2013
• Doc Name: CN01 APPLICATION
• From: OPERATOR
• To: DRMS
• Type & Sequence: CN1
• Email Name: TOD
• Email Name: TAK
• 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: Phi Darardcamp Title: R &B Supv
Company Name: Las Animas County
Street/P.O. Box: 2000 N. Linden Ave. P.O. Box:
City: Trinidad
State: CO Zip Code: 81082
Telephone Number: ( 719 ) - 846 - 2931
Fax Number: ( 719 ) - 846 - 0434
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: sam Title:
Company Name:
Street/P.O. Box: P.O. Box:
City:
State: Zip Code:
Telephone Number: ( ) -
Fax Number: ( ) -
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: ( ) -