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ALMA WATERSHED PROTECTION DISTRICT <br />PERMIT APPLICATION <br />1. Owner of Property: <br />P <br />Name: CA (AZ r e t Ce-- <br />• / <br />Mailing Address: f 17 <br />Phone: 720--2-5-2 " 2 " <br />2. Applicant (if other than property owner): <br />Name : / i ?d G??" /1 e ?- CL _ Gf1 t'_ { r'7 f f? L <br />M ?- <br />ailing Address: <br />L e- vi V B //C-- <br />Phone: 720 :2 a-Qi?20 --- 1 7!::(N- 243` 0%1-3 <br />3. Applicants interest in property (if other than owner): <br />4. Legal description <br />5. General description of proposed activity: I t G 1. 5 1, , & h V 7 ?t % j <br />,4-T-?2 ,( J- s-;- '7 ?"Pf-eq' 5r- Ail)" <br /> <br />i <br />n <br />/let <br />//,e C, C, L <br />L - i <br /> <br />7. Duration of rmit requestedU t<e. l c 1© C• f -d eel <br />1 m5/ <br />/ <br />l+?tv w? rf q.'G?ue5?AnG o a'li?%?j V 54- r.??-fowo 0 <br />8. Attach two sets of plans and specifica ons collecti ely showing the following. <br />a. Vicinity map or sketch showing the site of the proposed activity within the watershed. <br />b. Map of site plan showing the boundary lines of permit area. <br />c. Site plan showing the location of buildings or structures within fifty (50) feet of the proposed activity. <br />d. Contour map showing the existing topography of the permit area and its drainage down to Buckskin Creek or surface <br />tributaries. <br />e. Contour map showing the topography of the permit area and its drainage into Buckskin Creek upon completion of the <br />proposed activity. <br />(attach copy of relevant documents) <br />t/' 1 (be 5;' k/Ct let- ; n e- / 1 v c <br />c4,7-e-m ryt? 5Aa d w,`1 6e- bcd Ovz>^ Cow' ,^cs??;- 20 :30 <br />6. Identify any possible risks of pollution to the Alma water supply which may be created or ce <br />Describe measures. which will be used to eliminate or reduce such risks: