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