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Alternate Phone Number <br />Used only to follow up. <br />Alternate Phone Extension <br />Connection to Operation'K <br />Select all that apply <br />Land Owner of affected land <br />Mineral Owner <br />Adjacent Land Owner <br />Government Agency <br />Structure Owner within 200' of affected land <br />� Nearby Resident <br />Concerned Citizen <br />Other <br />DESCRIPTION OF COMMENT OR OBJECTION <br />(Please be as specific as possible) <br />Comment/Objection Narrative'k <br />Do not need another Quary and more traffic and wear on the Roads. Do not need the mountains wasted! <br />Permit Number * <br />Enter valid letter and then numbers, for example M122112211 or C123456789. <br />M2021009 <br />Permitting Action Type <br />Technical Revision <br />Permitting Action Sequence * <br />1000 <br />Permit Type <br />County * <br />Gil pin <br />Site Name <br />Permittee/Operator Name <br />Comment or Objection'k <br />Objection <br />Support <br />General Comment <br />Agency Comment <br />ADDITIONAL INFORMATION <br />Are there supporting photos, maps, or documents you wish to upload? * <br />Yes No <br />By submitting this form electronically you agree to receive any/all follow up correspondence from the Division of <br />Reclamation, Mining, and Safety at the email address you have provided. <br />I I <br />