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Your City <br /> Platteville <br /> Your State <br /> CO <br /> Your Zip Code <br /> Maximum of 10 digits. (Example)80202 <br /> 80651 <br /> Email Address <br /> Enter a valid email address in this field to receive a confirmation e-mail. <br /> cclark@clarktaxpros.com <br /> Your Phone Number* (') <br /> Used only to follow up. <br /> 3033044864 <br /> Extension <br /> Alternate Phone Number M <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 ✓ Concerned Citizen <br /> Government Agency Other <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 /> Land ownership in project is contested, please see attached letter for explanation and maps of contested area. <br /> Permitting Action Comment/Objection is Regarding <br /> • New Permit Change to Existing Permit <br /> Permit Number*(') <br /> Enter a valid permit number <br /> M2024057 <br /> County* <br /> Colorado County where the proposed operation is located <br /> WELD <br /> Enter one county only <br /> Site Name <br />