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DIVISION OF RECLAMATION, MINING AND SAFETY <br />Completeness Notices Checklist <br />Operator: Weld County Public Works <br />Mine Name: Koskie Pit <br />Permit Number: M- 2014 -024 <br />Date: 5/9/14 <br />Specialist: PSH <br />❑ Operator: Clay Kimmi <br />Weld County Public Works <br />1111 H St <br />P.O. Box 758 <br />Greeley, CO 80632 <br />❑ County Planning Department <br />Specify County: Weld <br />❑ County Commissioners <br />Specify County: Weld <br />❑ ♦ Soil Conservation District <br />Specify SCD: West Greeley <br />❑ ♦ Municipalities (If Applicable: Within 2 miles of Operation) <br />Specify: None <br />❑ ♦ Army Corps of Engineers <br />Circle One: Colorado /Gunnison <br />Frisco <br />Duran o <br />Denver <br />Sou ern Colorado <br />❑ ♦ Division of Wildlife <br />Circle One: NW NE SW SE <br />❑ ♦ Urban Drainage (If Applicable: Within 100 year floodplain — Adams, Arapahoe, Boulder, Denver, Douglas <br />and Jefferson counties) EPS Circle One: Y N �liJ <br />❑ ♦ Air Pollution (Health Department) <br />❑ ♦ Historical Society <br />❑ State Land Board <br />❑ ♦ Water Quality (Health Department) <br />❑ Water Resources <br />❑ A BLM (If Applicable) EPS Circle One: Y N O <br />❑ P Forest Service (If Applicable) EPS Circle One: Y N O <br />♦ - Receive one paper copy of Application form, Legal Description and Location Map <br />fJ - Receive CD of entire application <br />