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Notification Request - Long List (New Apps Amendment r Conversion) <br />Permit Specialist: ECS Today's Date: oZ�2 �2-� <br />Permitting Action: Sy4fa--t— 14A arl <br />Permit Number: //P /qqg'— 071 <br />Site Name: <br />Permittee: �c �-� C jya.— <br />Permittee Address 1: 0606,<— C, R 13 <br />Permittee Address 2: <br />City: /1(a, X t� State: CO <br />Count Name: yctmex <br />County Commissioners /County Planning Dept. <br />El Municipalities within 2 Miles of Site: <br />/' <br />Soil Conservation District: �AqrA <br />Colorado Division of Wildlife: 1109ig6a A5 <br />Zip: 15V73/ <br />❑ Urban Drainage - only needed if site is within 100 yr floodplain in Adams, Arapahoe, <br />Boulder, Denver, Douglas or Jefferson Counties <br />W US Army Corps of Engineers: Denver Office <br />❑ US Bureau of Land Management - with CD of complete application if site is on BLM land <br />❑ US Forest Service - with CD of complete application if site is on USFS land <br />Include: Application Form, Exhibit A (legal description of property) and Index Map <br />for all notices. <br />Notifications are always sent to: CDPHE Air and Water Quality, OSE Water Resource <br />Division, Colorado State Land Board, and Colorado Historical Society. <br />E..» "x`n�, d. _:;:�asa`r rtt:3'm,�.=. >.:.._ .,. ..__:"s..x.&'it.T?c��.. ^e..a.`• �.,,,'s`i,., _.;z. .,., .c..'�'.i;�r..,..m= a'a- .Ez?','. :r. ;31 <br />