Laserfiche WebLink
Your Address 2 <br /> Your City <br /> Broomfield <br /> Your State <br /> CO <br /> Your Zip Code <br /> Maximum of 10 digits. (Example)80202 <br /> 80023 <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 /> 303-586-14 <br /> Extension <br /> Alternate Phone Number <br /> Used only to follow up. <br /> Alternate Phone Extension <br /> 970-728-3729 <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 Concerned Citizen <br /> Government Agency Other Conservation organizations <br /> DESCRIPTION OF COMMENT OR OBJECTION <br /> You are providing a comment or objection to the public record of a permitting action currently under review by the Division of <br /> Reclamation, Mining and Safety.This form is not intended for reporting of possible violations or illegal activity. Please be as specific <br /> as possible. <br /> Comment/Objection Narrative* <br /> Our comments are uploaded as a PDF attachment. <br /> Permit Number <br /> Enter valid letter and then numbers,for example M1977999, M1999777UG or C1981201. <br /> P2022005 <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 /> Notice of Intent <br /> County* <br /> San Miguel <br /> Enter one county only <br />