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Extension <br /> 118 <br /> 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 Structure Owner within 200' of affected land <br /> Mineral Owner Nearby Resident <br /> Adjacent Land Owner Concerned Citizen <br /> ✓ Government Agency Other <br /> DESCRIPTION OF COMMENT OR OBJECTION <br /> (Please be as specific as possible! <br />