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•. ..a ~...• a .V <br />21 West Victory Way Fee .75.00 plus <br />Xaiy, CO 81625 ~ pos e <br />970) .eza-e~-r Dat~aid y~ECEIVED <br />~~oa <br />APPLICATION FOR CONDITIONAL USB APR 1 9 1999 <br />ppli.cant: JAy ~AVNr2 ~.1~Aenoa ~_'en~r. =NC.. Phone: 8.2~~27d9,;~„cMinPCaIsB,Geology <br />ddress:~fa'S/O0 E.'• .~/w.y. 5~0 ~i~,..a <br />andowner: ~aLe ,Q.;r~rud Phone:8zh~ G~G(o <br />ddress: 3S9.Z I~w~. 39~ Cr.gi4 <br />gent, if any: ~~e~i,.Q 7YI~Qie.~e Phone:_~~.5~-3.25 <br />_ddresa: SSS /_~~rrv /„~ <br />i <br />'lcreage: y. ~s~ Zoned: ~a~~~~`1.,r.e <br />~,egal Description: Tor..ws~~~ lo// ~.e.,6c '~D ji/ ~;o~~/ON /D .4/F ~~. <br />~ro/posed Uae (Describe in Detail) :~ /»°n°T.c ;s ~~,.../~~o.e .4 o/al ~u <br />~//f o ~SO.~/~ a r/rte -~~ A~a.c~ urF _ LY~./a~ariD Gnsys~i r/NA~ ~ Se.FI ,r/b ~~LsP~ <br />-ha o~ilent2 eY /es~t~/vVCl~iew/. ~.a B ~14a.4 S.~q~~t osCl~Inferril.~fvo~._ sNi .SifT <br />r.~~n ..~..,.~..'` ~//.) /!~~ pls.,,. ., nn/,.,i 1_'., ~~.. /ii.,.~..i <br />~ C~?A !/SG /ALL! 6e QQra LU/fU/;~ aH~ ~U~~/ Dom. <br />Proposed Starting Date:~~Propoaecl Completion Date: <br />Attach copies of state Nand/or federal permit: applications, if applicable. <br />Attach copies of state and/or federal reclamation bonds, if app,~l/icable. <br />Indicate type of water system: Public ( ) Private (N~~E' E~~ki,,~~e//ting <br />Indicate type e~f sewage system: Public ( ) Private ~/i~,yVC ES(is~ing <br />Indicate any plans for buildings and structu.rea (permanent or temporary) to be <br />located on this land. Include any applicable site plane and elevation plans. <br />... <br />n -. <br />r <br /> <br />Landowner Si nature: ~ z Date: <br />• <br />The above e~:~ning hereby authorizes the Ma Ent County Commissioners or their <br />designate, to conduct an of-site inspection of the property described,h~reir <br />when necessary to make an informed evaluation of the proposed conditional use. <br />n.... (11 /rl~ <br />d L/ /_ ~ •~ <br />~. <br />Applicant/Agent Signature: f/V, Date~~~~//-~ , <br />~. <br />