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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 />lr = klrs <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 />