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PERMFILE117118
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PERMFILE117118
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Entry Properties
Last modified
8/24/2016 10:12:52 PM
Creation date
11/25/2007 3:16:38 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1985082
IBM Index Class Name
Permit File
Doc Date
5/23/1985
Doc Name
LIMITED IMPACT 110 & SPECIAL 10-DAY 111 PERMIT APPLICATION FORM
Media Type
D
Archive
No
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!r ~ Exhibit F ~ _ <br />• ------------------ <br />Moffat County Planning Department No. C - 8S- OS <br />Moffat County Courthouse Fee: $25.00 <br />221 West Victory Way Paid: ~/ ~ / $j <br />Craig, Colorado 81625 <br />(303) 824-8221 <br />APPLICATION FOR CONDITIONAL USE <br />Applicant: RAN L.EY ~C•..~~ e ~ f' ~.~/n /s ~nlE'7 Phone: B~S~- i~G 5cG b~c <br />Address: Qn. ~., v .O~SL~ .~.- I~ d . 72 ~ r /4 S Z e/'a c _ - <br />Landowner: <br />Address: 3`f3/ t <br />Agent, Sf any: Np/lJ ~ Phone: <br />Address <br />~sa5~- X75 <br />Acreage: /Zoone: <br />Legal Description: loved s ~t i o Co AJ R an c ~aW Se~'~-; o u <br />~ -7 <br />Proposed .Use (Describe iq Detail): <br />Proposed Starting Date: ~,U v 7L> M E u`'O O <br />Proposed Completion Dat <br />Attach Copies.of State and/or Federal Permit Applications, if Applicable. <br />Attach Copies of State and/or Federal Reclamation Bonds, if applicable. <br />Indicate Type of Water System: Public ( ) Private ( ) Existing ( ) N o,J E <br />Cndicate Type of Sewage System: Public ( 1 Private ( ) Existing ( ) N o N C <br />Cndicate any plans for buildings and structures (permanent or temporary) to be located <br />:n this land. Include any applicable site plans and elevation plans. NO~U t <br /> <br />elude a maw, drawn to scale, showing the general location of the property, the location <br />the proposed use, the existing and proposed roads and easements, and the names and <br />~111ng addresses of adjacent property owners. The map should include at least a 200 <br />~ot perimeter and show access to the property from a public road. <br />- - - - - ,~~~ z~« <br />te:~~1~ p,' / q,~G; Signature:~~j ~Q,~Q F~~.~ <br />~A plic t <br />above signed hereby authorizes the Moffat County Planning Director, or his designate, <br />conduct an on-site inspection of the property described herein when necessary to make <br />informed evaluation of the proposed conditional use. <br />Rev. 4/84 <br />.w-` - ~' <br />
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