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Alternate Phone Number <br /> Used only to follow up. <br /> Alternate Phone Extension <br /> Connection to Operation <br /> Select all that apply <br /> Land Owner of affected land Structure Owner within 200' of affected land <br /> Mineral Owner V 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 /> Comment/Objection Narrative <br /> I'm in favor of the zephyr gold mine. I'm so happy there is gold in the ground to bring 90 new jobs to the area. <br /> What a wonderful opportunity. <br /> Permit Number* <br /> Enter valid letter and then numbers,for example M122112211 or C123456789. <br /> M1234 <br /> Permitting Action Type <br /> Acreage Release Request <br /> Select revision type or leave blank if comment pertains to a new permit application or NOI <br /> Permitting Action Sequence* <br /> Canon <br /> Permit Type <br /> Mining <br /> County <br /> Fremont <br /> Enter one county only <br /> Site Name <br /> Perm ittee/Operator Name <br /> Comment or Objection <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 />