2005-07-13_REVISION - M2000016 ‎(14)‎

• Permit No: M2000016
• IBM Index Class Name: Revision
• Doc Date: 7/13/2005
• Doc Name: weld county referral
• From: weld county
• To: lafarge
• Type & Sequence: AM1
• Media Type: D
• Archive: No

Weld County Use by Special Review Application
May 2, 2005
Page 2 of 3
Application Fee
USR Application (1 Original + 29 Copies)
o Application Fonn
o Project Overview
o Statements
o Use By Special Review Questionnaire
o Development Standards
o Approved Dust Abatement Plan
o APEN
o Approved Waste Handling Plan
o Approved Flood Hazard Development Permit (Application to amend is pending)
o Temporary Substitute Supply Plan
o NPDES
o Use By Special Review Map Set (Reduced to 8-1/2 x 11)
o Plant Site Layout(Peading)
o Individual Sewage Disposal System Permit (Pending)
• Weld County Road Access Information (1 Original + 29 Copies )
• Statement of Adequate Water Supply (12 Copies)
• Evidence of Adequate Sewage Disposal (12 Copies)
• Traffic Impact Study (5 Copies)
• Archaeological Historic Records Search Results (5 Copies)
• Applicant's Interest In The Property (In Process)
• Certificate Of Conveyance (In Process)
• Soils Report (In DMG Submittal)
• Legal Right To Enter And Mine Sand And Gravel (In DMG Submittal}
• Oil and Gas Agreements (1 Copy)
• Ditch and Irrigation Easements (Will Be Obtaining)
• Surface Owners Within 500 Feet (1 Copy)
• Mineral Owners (In Process)
• IGA Notice Of Inquiry (1 Copy)
• Maps (24 x 36) (30 Copies)
• Reduced Maps (8-1/2 x 11) (11 Copies)
• Electronic Digital Copy Of Maps
• Affidavit and Certified List of Names and Addresses of Surface Owners within 500'
of Property (In Process)
• Affidavit and Certified List of Names and Addresses of Mineral Owners and Lessees
of Minerals (In Process)
• $5,000 application fee
• $500 investigation fee
H:W 137_012_01\Weld Co USR\Cover [,etterMay2,2005.doc