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Notification Request - Long List (New Apps, Amendment, or Conversion) <br />Permit Specialist: ECS Today's Date: 4/4/2014 <br />Permitting Action: > / mo't- <br />Permit Number: M1977 -522 ✓ <br />Site Name: Star Water Resource <br />Permittee: LG Everist <br />- Permittee Address 1: 7321 E 88th Ave, Suite 200 <br />Permittee Address 2: <br />City: Henderson <br />County Name: Weld <br />EN County Commissioners /County Planning Dept. <br />A Municipalities within 2 Miles of Site: <br />City of Greeley <br />1000 10th Street <br />Greeley CO, 80631 <br />A Soil Conservation District: West Greeley <br />Ik Colorado Division of Wildlife: Northeast <br />State: CO Zip: 80003 <br />❑ Urban Drainage - only needed if site is within 100 yr floodplain in Adams, Arapahoe, <br />Boulder, Denver, Douglas or Jefferson Counties <br />N US Army Corps of Engineers: Denver Office <br />❑ US Bureau of Land Management - with CD of complete application if site is on BLM land <br />❑ US Forest Service - with CD of complete application if site is on USFS land <br />Include: Application Form, Exhibit A (legal description of property) and Index Map <br />for all notices. <br />Notifications are always sent to: CDPHE Air and Water Quality, OSE Water Resource <br />Division, Colorado State Land Board, and Colorado Historical Society. <br />