2013-05-01_PERMIT FILE - M2013014

• Permit No: M2013014
• IBM Index Class Name: PERMIT FILE
• Doc Date: 5/1/2013
• Doc Name: 110c Application
• From: Kit Carson County Road and Bridge
• To: DRMS
• 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: Kit Carson County Commissioners Title:
Company Name: Kit Carson County
Street/P.O. Box: 251 16th Street P.O. Box: 160
City: Burlington
State: CO Zip Code: 80807
Telephone Number: ( 719 ) _ 346 -8133
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: Paula Weeks Title: County Administrator
Company Name: Kit Carson County
Street/P.O. Box: 251 16th Stre P.O. Box: 160
City: Burlington
State: CO Zip Code: 80807
Telephone Number: ( 719 ) _ 346 - 8133
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 anv)
Agency:
Street:
City:
State: Zip Code:
Telephone Number: ( ) -