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Permit Number * <br />Enter valid letter and then numbers, for example M1977999, M1999777UG or C1981201. <br />M1990057 <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 />County <br />Lake <br />Enter one county only <br />Site Name <br />Perm ittee/ Operator Name <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 />