Kansaswater Pollution Control Permit Foragricultural Andrelated Wastes Permit Application Page 8
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10APPENDIX 2
Habitable Structure Owners List
(Habitable structures within the applicable separation distance)
Using the format provided, please record the name, address, city, state, zip code of the owner, distance from the facility,
and direction from the facility, of all habitable structures within the applicable separation distance as determined by
the number of animal units for the facility. Habitable structures means any of the following structures which is occupied
or maintained in a condition which may be occupied and which, in the case of a confined feeding facility for swine, is
owned by a person other than the operator of such facility: a dwelling, church, school, adult care home, medical care
service, child care facility, library, community center, public building, office building, or licensed food service, or lodging
establishment, parks, and wildlife refuge.
*
Name
Mailing Address
Distance
Direction
(address, city, state, zip)
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2.
3.
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* As measured from the currently planned maximum extent of the facility structures such as buildings or wastewater lagoons.
KDHE BOW LWMS Permit Application form rev 4/7/2015
Page 8 of 10
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