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Moffat County Planning Department NO. C- <br />221 West Victory Way, Suite 110 Fee: $200.00 <br />Craig, CO 81625 Date Paid 2 -?-6 <br />(970) 824-9148 <br />APPLICATION FOR CONDITIONAL USE <br />Applicant: Jp?,?` AG.tJ i?2 Phone: Home-Business-Cell: 9?o-ggy-,27®9 <br />Address: cfC.1/00 4. 61u? !!JO Cv'4'!a 'CD. er107.5' <br />'Y L <br />Landowner:WA&&tele &cLeS Ud- Phone: Home-Business-Cell: -.,AK4. , <br />Address: <br />Agent, if any Phone: Home-Business-Cell: <br />Address <br />Acreage: Zoned: Z_'j / -f-'016r, q <br />a <br />Legal Description and Driving Directions: <br />517 oe fke. oVE/4 766/ R-4) 0) <br />S1 a L' ?L? e N'Gcl/ ?'CF?V ?j _ QdLA) . a rz c L <br />Y <br />Proposed Use (Describe in Detail): n G?.t`v °vv <br />vl y N? ° CS ? r ° t, <br />Proposed Starting Date: M (N/ Z000 Proposed Completion Date: C90 <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 ( W) Existing ( -A) <br />Indicate type of sewage system: Public ( ) Private (v ) Existing (d ) <br />Indicate any plans for buildings and structures (permanent or temporary) to be located on this land. Include any <br />ap licable site plans and elevation plans. <br />v Y' A00 7 - 96D® • Vii' Onomio-aeW <br />v fi'idG 6--w cl' 7'4 zm ' <br />Include a mat), drawn to scale, showing the general location of the property, the location of the proposed <br />use, the existing and proposed roads and easements, and the names and mailing addresses of adjacent <br />property owners. The map should include at least a 200 foot perimeter and show access to the property <br />from a public road. <br />Applicant / Agent Signature: Date: '-g -400 <br />Landowner Signature: Date: Or copy of lease contra <br />The above signing hereby authorizes the Moffat County Commissioners or their designate, to conduct an off- <br />site inspection of the property described herein when necessary to make an informed evaluation of the proposed <br />conditional use.