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Your Address <br /> P.O. Box 332 <br /> Your Address 2 <br /> Your City <br /> Paradox <br /> Your State <br /> CO <br /> Your Zip Code <br /> Maximum of 10 digits. (Example)80202 <br /> 81429 <br /> Email Address* <br /> Enter a valid email address in this field to receive a confirmation e-mail. <br /> jennifer@informcolorado.org <br /> Your Phone Number* <br /> Used only to follow up. <br /> 3035861437 <br /> Extension <br /> 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 Nearby Resident <br /> Adjacent Land Owner U Concerned Citizen <br /> Government Agency Fv Other coalition of community and conservation <br /> organizations <br /> DESCRIPTION OF COMMENT OR OBJECTION <br /> (Please be as specific as possible) <br /> Comment/Objection Narrative* <br /> We are attaching an objection to the Dawson Gold Mine permit application, M-2021-046,on behalf of 19 <br /> organizations. Please see the letter from our organization with three attachments. <br /> Permit Number* <br /> Enter valid letter and then numbers,for example M122112211 or C123456789. <br /> M2021046 <br /> Permitting Action Type <br /> Select revision type or leave blank if comment pertains to a new permit application or NOI <br /> Permit Type <br /> 112d <br />