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Your City <br />Denver <br />Your State <br />CO <br />Your Zip Code * <br />Maximum of 10 digits. (Example) 80202 <br />80202 <br />Email Address * <br />Enter a valid email address in this field to receive a confirmation e-mail. <br />ddimauro@wsmtlaw.com <br />Your Phone Number* <br />Used only to follow up. <br />7203055811 <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 <br />Mineral Owner <br />✓ Adjacent Land Owner <br />Government Agency <br />✓ Structure Owner within 200' of affected land <br />Nearby Resident <br />Concerned Citizen <br />✓ Other Quasi -governmental agency <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 />Please see attached letter and exhibit. <br />Permit Number* <br />Enter valid letter and then numbers, for example M1977999, M1999777UG or C1981201. <br />M1990057 <br />Permitting Action Type <br />Permit Conversion <br />Select revision type or leave blank if comment pertains to a new permit application or NOI <br />Permitting Action Sequence* <br />3 <br />Permit Type <br />Designated Mining Regular Operations Permit <br />County <br />Lake <br />Enter one county only <br />