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For Local Government Use Only <br />The following section must be completed by a planning official from each county and city listed unless the project will be <br />located en~irely within the city limits. In thnt case, only the city plnnning agency must complete this form. <br />This deals only with the local land-use p/an. Do not inc[ude ~pproval for activilies such as building or gradingpermils. <br />Please check the appropriate box helow and provide the requested information <br />^ Land uses to be served by proposed water uses (inclading proposed conshucrion) are atlowed outright or are not <br />regulated by your comprehensive plan. Cite applicable ordinance secflon(s): <br />0 Land uses to be served by proposed water uses (including proposed construction) involve discretionary land-use <br />approvais as listed in the table below. (Please attach documentation of applicable land-use approvals which have <br />already been obtained. Record of Action/land-use decision and accompanying frndings are sufficient.) <br />If approvals have been obtained but all appeal periods have not ended, ehecki°Being pursued". <br />Type of Land-Use Approval Needed Cite Most Significant, Applicable Plan <br />(e.g. plan amendments, rezones, Policies & Ordinance Secfion References Land-Use Appmval: <br />condidonai-use rmits e[c. <br /> <br />'~ 0 Obtained 6 Being pursued <br />DSUCOE removaUfill application L1I16 COU11ty COIICU1TCriC0 ^ Denied ~ Not being pursued <br />F1 <br />d l <br />i <br />it 244 <br />Lan <br />eode 16 80htained ~Beingpursued <br />n erm <br />oo <br />a . <br />e ^ Denied ^ Not bein u~ued <br /> 0 Obtained 0 Being pursued <br /> 0 Denied ^ Not bein ursued <br /> ^ Obtained 0 Being pursued <br /> ^ Denied ^ Not bein ursued <br />• ^ Obtained ^ Being pwsued <br /> 0 Denied ^ Not bein uisued <br />Local governments are invited to express special land-use concerns or make recommendations to the Water Resources <br />Department regarding this proposed use of water below, or on a separate sheet. , <br />*thr rA,,,.. ~a) fill nertnit ic in »rnrPee thr T anr f nnnfir cnnrnrrrnrP,~f that ~Prmit hac hPen ~htainPd <br />T <br />' _ ,0~3 a~ --S ~-1~~ ~ ~pc~o~/-fi~- ~4 Psr~e. ~ii ~ ~6r~~ti~'o . <br />Name: ~~~ ~ ~ !~~ f~~~ 2~~ Title: ~-' S ~i c • ~ ~' //.v~~ `~- <br />Signature: ,~ • /~.~-~/~~ _ Phone: _fv ~ ~ -^ ~QS ~ Date: y--~ r 6 ~ <br />Government Endty:. L/^~ +~/% Gl~/` ~ ~ <br />Note to local government representative: Please comp[ete thrs fo»n or sign the receipt be[ow and return it to the applicant. <br />If you sign the receipt, you will have 30 days from the Water Resources Department's notice date to relurn the completed <br />Land Use Information Form or WRD may presume the land use associated with the proposed use of water is compatibfe with <br />local comprehensive plans. <br />Receipt for Reauest for Land Use Information <br />Applicant name: <br />City or County: <br />Signature: _ <br />( <br />Staff contact: <br />Phone: <br />Date: <br />Lastupdated 12/22/06 WR <br />