REV89976

• Permit No: M1981286
• IBM Index Class Name: Revision
• Doc Name: WELD CNTY COLO USE BY SPECIAL REVIEW APPLICATION FOR MINING PERMIT
• Type & Sequence: CN1
• Media Type: D
• Archive: No

• III IIIIIIIIIIIIIiII •
999
WELD COUNTY, COLORADO
USE BY SPECIAL REVIEW APPLICATION
for
MINING PERMIT
Weld County Department of Planning Services, 915 10th Street, Greeley,
Colorado, Phone [phone], Extension 4400
For Department of Planning Services Use Only Case Number:
Dale Application Received:
Section: Township:
PC Hearing Date:
North, Range: West
Zoning District:
Recording Fee:
Recording Fee Receipt d:
Permit Fee:
Receipt Number:
Application Reviewed By:
To be completed by APPLICANT in accordance with procedural guide
Requirements:
1. I (we), the undersigned, hereby request a hearing before the Weld
County Planning Commission concerning a proposed gravel
(gravel, coal, borrowpit, etc.) mining operation for the following
described unincorporated area of Weld County:
P,gar oF:
LEGAL bESCRIPTION NW4 of Section One (1), Township Eight (8) North,
Range Sixty-One (61) West of the Sixth Principal Meridian 6th P. M. ,
County of Weld. State of Colorado
TOTAL ACREAGE: y¢,1~
2. Surface owner(s) of area of land described
Name: Raymond W. Thomas Address: 3771 Road P Phone: [phone]
Name: Ronald W. Thomas Address: Wiggins, CO 80654 Phone:
3. Owner(s) of mineral rights to substance to be mined
Name: Same Address: Phone:
Name: Address: Phone:
4. Source of applicants` legal right to enter and to mine on the land
described: See report; pages (attached)
(Attached certified copy of any document noted to the back of this form)
5. Address of applicant and general office
Applicants address: P.O. Box 758 Phone: [phone] Ext. 475
General Office address: 933 N. 11th Avenue Phone:
Greeley, CO 80631
6. Identify any prior permits for mining held by applicant or affiliated
person: Weld County Road & Bridge Department, Mining Division