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DIVISION OF RECLAMATION, MINING AND SAFETY <br />Completeness Notices Checklist <br />/ �0{�,n5 <br />l Operator Rack pit <br />�� 2ao�t- d53 <br />1V County Planning Department _ o t <br />Specify County: ( n 046 (d 5 <br />Ft 11-J dc�'�aer'6,2o1� <br />G/ County Commissioners <br />Specify County: a n rd S <br />♦ Soil Conservation District <br />SpecifySCD: ('on2rdS <br />❑ ♦ Municipalities (IfApplicable: Within 2 miles of Operation) <br />Specify: <br />❑ ♦ Army Corps of Engineers <br />Circle One: Colorado /Gunnison <br />Frisco <br />Durango <br />Denver <br />/ Southern Colorado <br />© ♦ Division of Wildlife <br />Circle One: NW NE SW SE <br />❑ ♦ Urban Drainage (IfApplicable: Within 100 year floodplain —Adams, Arapahoe, Boulder, <br />Denver, Douglas and Jefferson counties) EPS Circle One: Y N <br />C� ♦ Air Pollution (Health Department) <br />Q ♦ Historical Society <br />❑ State Land Board <br />Id ♦ Water Quality (Health Department) <br />❑ Water Resources <br />❑ A BLM (IfApplicable) EPS Circle One: Y N <br />❑ A Forest Service (IfApplicable) EPS Circle One: Y N <br />♦ - Receive one paper copy of Application form, Legal Description and Location Map <br />A - Receive CD of entire application <br />