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Your First Name <br /> Jonathan <br /> Your Last Name* <br /> Cain <br /> Your Address <br /> 45 W. 1 rst Street <br /> Your Address 2 <br /> PO Box 96 <br /> Your City* <br /> Nederland <br /> Your State <br /> CO <br /> Your Zip Code <br /> Maximum of 10 digits. (Example)80202 <br /> 80466 <br /> Email Address* <br /> Enter a valid email address in this field to receive a confirmation e-mail. <br /> townadmin@nederlandco.org <br /> Your Phone Number* (') <br /> Used only to follow up. <br /> 3032583266 <br /> Extension <br /> Alternate Phone Number(?) <br /> Used only to follow up. <br /> 3037189596 <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 /> I,as the Town and Zoning Administrator for the Town of Nederland am submitting the attached objection and <br /> request Party Status on behalf of the Town. <br /> Permitting Action Comment/Objection is Regarding <br /> New Permit • Change to Existing Permit <br />