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Colorado Department of Agriculture DO NOT WRITE IN THIS SPACE. <br /> Division of Plant Industry <br /> Pesticide Section 644 - LC <br /> 700 Kipling Street, Suite 4000 646 - PA <br /> Lakewood, Colorado 80215-5894 <br /> (303) 239-4146 <br /> APPLICATION FOR REGISTRATION OF A LIMITED <br /> COMMERCIAL/PUBLIC APPLICATOR FOR 2003 <br /> Registrant Number: 11357 Good Through: 12/31/2002 <br /> Mailing Address: Records Address: <br /> COLORADO DEPARTMENT OF NATURAL RESOURCES <br /> 1313 SHERMAN ST. 101 SOUTH 3RD ST. <br /> #215 #301 <br /> DENVER, CO 80203-8020 GRAND JUNCTION, CO 81501-8150 <br /> Doing Business As Name(s) (DBA) : <br /> DIVISION OF MINERAL AND GEOLOGY <br /> Contact: STEVEN RENNER Phone: (970) 241-0336 Aerial: N <br /> This application, issued on 11/05/2002, is valid for the following categories ONLY. <br /> Agricultural: 107 109 <br /> Ornamental: None <br /> Structural: None <br /> Qualified Supervisors <br /> Lic. # Last Name First Name MI Lic. Expires <br /> 05387 RENNER STEVEN G. 10/01/2004 <br /> License Categories: 107 109 <br /> APPLICATION CONTINUES ON REVERSE SIDE. <br /> DPI-PA-50 (Revised 10/1995) Page 1 <br />