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5 NAMES AND ADDRESSES OF ADJOINWG Pf ~R'IY OWNERS, LESSEES, ETC.. WHOSE PROPERTY A'~ ~ iADJOWS THE WATERWAY <br />MacPhee Family Trust Dula M. Fellin Martine & Nita r,ou Webb Allen J. & Cheryl Walz <br />i% Mary Salustro Box 543 1136 HWY 23 18473 Us xWY 550 <br />P.O. Box 431 Ouray, CO 81427 Ridgway, CO 81432 Ridgway, CO 81432 <br />Waltham, MA 02254 <br />John C. & Tracy Imhoff and Matthew Willard <br />33 Violet Court <br />Ridgway, CO 81432 <br />6. WATERBODY AND LOCATION ON WATERaODY WHERE ACTIVITY EXISTS OR IS PROPOSED <br />Uncompahgre River, East of CR 23, just North of Idlewild subdivision, app. 5 mi North of Ouray <br />1. LOCATION ON LAND WHERE ACTIVRY EXISTS OR IS PROPOSED <br />ADDRESS: County Road 23 <br />Ouray County, CO 81427 <br />STREET, ROAD. ROUTE OR OTHER DESCRIPTIVE LOCATION <br />~~ Ouray Colorado 81427 <br />COUNTY STATE ZIP CODE <br />Ouray County Commissioners <br />~ LOCAL GOVERNING BODY WRH JURISDICTION OVERSRE <br />I ,+~ <br />~ B. Is~eny portim of the ectiAry Iw which 9u1hwVBlian is sought now complele7 ^ YES L7 NO <br />It answer is 'yes' give reasons, month and year ale acliwry waz rampleted. Indirale the exrstina work on the tlrawinOS. <br />I <br />' 9 Lisl ell approvals or cerliliralions end den191s recarved Irom other lederel, rnlerslale, slate w local apennes for eny structures, COnstruclion, discharges or other <br />BCIIVIIIPS deSCllhBd in Ibis applicelion <br />ISSUING AGENCY TYPE APPROVAL IDENRFICNTION NO. DATE OF APPLICATION DATE OF APPROVAL DATE OF DENIAL <br />Ouray County Special Use Permit 12-16-91 <br />State of Colorado <br />Mined Land Reclamation Board <br />Limited Impact Permit 12-16-91 <br />10. Apptrrahm o hereby made Iw a pwmil a permits 10 euttwrue the aclwilies described herein. I rPrlity Itbl I em laminar with the inlormalion GOnlainetl in Iho <br />application, and 1ha1 1o the bazl of my Fnowledpe end belie) such rnloimalion is True, complete, and accurate 1 lurlher wrtily Ihal I possess the ealhwiN to <br />undwlaFe Ills proposed eGlivilies w I acct ectine as the tluly aNhwized agent of the applicant. <br />~w,./I,a.~~r ~~ ~LLlle ~'-/7- ~(I -Cr o~~--+e`- - IL-/7-9/ <br />SIGNATURE OF APPLI ~ DATE SIGNATURE OF AGENT GATE/~ <br />k ~T U, S c ~ ,QL,,. (tY <br />%- /q- Y~- /-/f-9z <br />The application must be signed by the person who tlesires to undertake the proposed activity (applicant) or it maybe signed by a duly <br />authorized agent if the statement in block 3 has been h71ed out and signed. <br />78 U.S.C. Section 7001 provides mat Whoever, in anY macular within the lurrsdtc9on of any department «agency of The Untied Slates <br />krlownngly and sviltlully falsifies, r»riceafs, « covers up by any trick. sch«ne, « device a material tact « makes any Wlse, bc6lious « haudulent <br />statements « representations « makes « uses any lake writing « document krowing same to contain any lake ficblious « <br />hautlulenl stattxlienl « envy, shall be Elrod rot more man SI0,000 « itllpdsened rot more elan five years, « both. <br />tReY1M W Ewe TORY ~]IS) 'U.S. Gmerrvrenl PrYnlrip GmG: 1931 - 52e235R0301 <br />