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PERMFILE100233
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PERMFILE100233
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Entry Properties
Last modified
8/24/2016 9:55:02 PM
Creation date
11/24/2007 6:54:09 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M2005065
IBM Index Class Name
Permit File
Doc Date
9/6/2005
Doc Name
Reclamation Permit Application Form
From
Jack Clark Jr.
To
DMG
Media Type
D
Archive
No
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~:;;~: . <br />x. ;. <br />1 <br />i <br />LAND USE PERMIT <br />San Juan County, Colorado <br />icanc:. ~, --- - <br />eae:.3BLS V ~ Z <br />and State: Tel hone: <br />S.lvp~e ~.~ Co . 8/¢3~ <br />xx+xxrrxxx <br />r xfxfxx}fr <br />0 of Concern: (Appiicaat should provide attachments for each relevant area) <br />(Land Uae Administrator will initial approval if appropriate) <br />:rty Ownership ~' Permission of Property Owner <br />city Map / Plane and Drawings ~ <br />:al Hazards. Zoning Compatibility ~ <br />ration Eaviroamental'ImpacGs <br />ling Permit ~ ~ Pederal and/or State Permits _~ <br />-ity Emergency Services <br />.ag ~ insurance Coverage <br />~ OP County Road Impact ........ / <br />• ....... ..~ ... ~ Other .......... ........ <br />- ~~oa= ~s~~~e w : ~~~°J;~~,~on) rpm <br />Application Submitted: <br />¢ ~ Q~ ey; (Si tur ) <br />Permit Issued; ~~ <br />^, 'H Signatu <br />c <br />C10 B: ., ~ ' <br /> <br />ranee of CUndit..ion9: ~ ~ Bv: f.^iar:a [u r:vow . , . ~V ~ -_ "'"" <br />y • ... <br />"'. <br /> <br />rrxrerxxxx ... <br />
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