Laserfiche WebLink
DEPARTMENT OF PLANNING SERVICES <br />1555 N. 17th Avenue, Greeley, Colorado 80631 <br />Phone (970) 353-6100, Ext. 3540 Fax (970) 304-6498 <br />USE BY SPECIAL REVIEW (MINING OPERATION)APPLICATION <br />FOR PLANNING DEPARTMENT USE DATE RECEIVED: <br />j RECEIPT # /AMOUNT # I$ CASE # ASSIGNED: <br />APPLICATION RECEIVED BY PLANNER ASSIGNED: <br />To be completed by APPLICANT is accordance with procedural guide requirements: <br />1. I (we), the undersgned, hereby request a hearng before the Weld County Planning Commission concerning <br />a proposed gavel (gravel, coal, borrow pit, etc.) mining operation for the following described <br />unincorporated area of W eld County: <br />Legal Descriptbn NW 1/4 ,Section 15 ,Township 7 North, Range SQWest <br />Flood Plain: Zone District: ,Total Acreage: 9.9 ,Overlay District <br />Geological Hazard: ,Airport Overlay~District <br />2. Surface owner(s) of area of land described <br />Name: Keith & Shirley Ashbaugh Address:39434 WCR 115 Phone: (970)437-5331 <br />Name: Address: Phone: <br />3. Owner(s) of mineral rights or substance to be mined <br />Name: Keith & Shirley Ashbaugh Address: 39 434 WCR 115 Phone: ~g7D1447-5'i31 <br />Name: Address: Phone: <br /> eg elson <br />4. Applicant's name: Weld County Public Works EmailAtldress gnelson!sco.weld.co.ue <br />Address: 1111 H Street Greeley C O 80639 Phone: !r}~)3p/~_y~q~ <br />5. Identify any prior permits for mining held by applicant or affiliated person: <br />several 1r141iA^p ~,18}'at}66 -- Wpl A (nnnt~ Pnhl i r ilnrLc <br />I (We) request that the following described property be designated a Recorded Exemption by the W eid County <br />Board of County Commissioners. I (We) hereby depose and state under penalties of perjury that a~ statements, <br />proposals, and/or plans submitted with or contained within the application are true and correct to the best of my <br />(our)knowle e. Signatures of all fee owners of property must sign this application. If an Authorized Agent signs, <br />a letter of thodzation from all fee owners must be included wdh the application. If a corporation is the fee owner, <br />notari evidence m included showing the signamry has to legal aufhorityto sign for the corporation. <br />/ D <br />Signatur .OwnerorAuthorizedAgent Date Signature: Owner orAuthorizedAgent Date <br />15 <br />