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COLORADO <br /> Division of Reclamation, <br /> Mining and Safety <br /> By Submitting this form you are requesting an investigation of Department of Natural Resources <br /> compliance with DRMS rules. <br /> DRMS Internal Information <br /> Select Permit Type <br /> Minerals <br /> Permit No List <br /> M1985112 <br /> Date of Complaint <br /> 06/04/2020 <br /> COMPLAINANT INFORMATION <br /> *Indicates a Required Field <br /> Do you wish to remain anonymous? <br /> Yes No <br /> Connection to Incident* <br /> Select all that apply <br /> Land Owner Mineral Owner <br /> Nearby Res=den` Observed Incident <br /> Other <br /> DESCRIPTION OF COMPLAINT <br /> (Please be as specific as possible) <br /> Note: Please provide as much detail related to location and issue as possible.Without enough detail, DRMS will not be <br /> able to process or investigate the complaint and,therefore, DRMS will have no choice but to discard the complaint. <br /> Location of Concern* <br /> Please provide as much detail as possible. It is important to narrow down the location. If available,please include Township, Range <br /> and Section,physical address,or GPS location.You may also upload a pdf map below. <br /> The location of my property is the NE 1/4 of the SE 1/4 Sec 4 Twp 5 N Range 65 W 6th PM.Address 503 <br /> Cherry Ave. Greeley,CO 80631 <br /> Incident County <br /> Weld County <br /> Is this an ongoing issue(s)? <br /> Yes No <br />