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.,v gyn. v .... <br />' 121 lVCGt Victory Way'.Surt{ 100 <br />i <br />t'rnig.t't1R(b25 l/ 1 16 1~1~~ <br />f ti?741824-8148 <br />Pak 5'_;10.r1n- <br />Uutr 19ia1_ _ <br />nPP11CA'CION FQR ((1NDfl'IOhAL USF: <br />r\pplinn[: t~oPPat ~otutty rt~td Lepartaont ~I'hate_iQZoZa~_-9?4~- <br />Attdtets: l.i.. 6nx b67._.;raig, Cu ts1E26 _ _ _____. _- <br />irnduw<rer: ~~ith rianeho Land ~ LSveetook L.L.C. Plmnc:1.974). r324-2b31 <br />Addxas: 'r, u. Dox 215, CraiG, 4U 81625 _ ___ _ _ _ __ <br />AEenr,ifany hfd - 1°am:e:-- - - --- <br />Address _ - -- - - - - - _ - <br />40 acrarr tuned: h - --- <br />Acteage.___ __ - <br />LtpalDcserip[iao: 1~3~23Sl/4s,(1/4 ~ ,11/2.i.i1f1F.i1:1/k o1 seotian 2$,_TSSh, a97t; _- <br />... a. aun~CL: ---- <br />Pnpns~) Use (Describe in fXatil): u'rawl : Ss <br />Fmprased Starting Darr, SoDtenber i, 2005 Pn+lx+s+cd t'nnsplnion pate. acl?~!tser_ 1,. 201$ <br />ntrxh copies of trace aed 7 or fedetd pernot application... if applicabk, {,+ttnohed} <br />Attach copies of slme ®nd ! or tbdtral rCClirmmimt lands, if n~plietblc <br />lalicate type of water system: Public ( ) l'rivnte i ) Eiistin2 ( 7 td/x <br />Indicate typt of sewage system. Publi: t )Private ( ) t•eisting ( ) :`~A <br />Indicate any plans for building and sWCturer (pa7rnstxnt ~r ternprnm}1 to fx L,caivl,w Ptis tmd. Ina 6sJr anv <br />applicable ste plans and eka7lipr plarri. <br />h~S <br />Appliram 1 Agern $i>iaature: ~GCr,JS lhue: /_y -C~ 3 .- <br />Sea Nxhibit I. <br />I,undow'tret Sicpotarc; 1>::u: - _-- - <br />Orcopy of Icasr cnMtnct. <br />lltc above signing hereby aWhoriYES the Moffat Cuttnt} C'uasm-5.sintxra ur tltcir dc~+6mtn, tv enrtduct :as utT- , <br />site Inspection of the properly described hicin when nme.Q+ara to ron6-e an infunned ~~+lu:nian of the pngn+ed <br />coedhioxal rue. <br />Re+ioed I!S~CFt <br />• ~ <br />- - - ~ <br />