2013-04-04_REVISION - M1977075

• Permit No: M1977075
• IBM Index Class Name: REVISION
• Doc Date: 4/4/2013
• Doc Name: Conversion Application
• From: Holyoke Gun Club
• To: DRMS
• Type & Sequence: CN1
• Media Type: D
• Archive: No

Telephone Number: ( 308 ) _ 249 -5294
- 3 -
11. Correspondence Information:
APPLICANT /OPERATOR (name, address, and phone of name to be used on permit)
Contact's Name: Kendra Scher' Title: Treasurer
Company Name: Holyoke Gun Club
Street/P.O. Box: 45037 Co. Rd. 24 P.O. Box:
City: Holyoke
State: CO Zip Code: 80734
Fax Number: ( ) -
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: ( ) -
INSPECTION CONTACT
Contact's Name: Stacy Reuter Title: President
Company Name: Holyoke Gun Club
Street/P.O. Box: P.O. Box:
City: Holyoke
State: CO Zip Code: 80734
Telephone Number: ( 970 ) - 520 - 7758
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: ( ) -