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DEPARTMENT OF PLANNING SERVICES <br />1555 N. 17`" 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 THE DEPARTMENT OF PLANNING USE DATE RECEIVED: <br />RECEIPT #/AMOUNT# /$ CASE # ASSIGNED: <br />APPLICATION RECEIVED BY PLANNER ASSIGNED: <br />To be completed by APPLICANT in accordance with procedural guide requirements: <br />I (we), the undersigned, hereby request a hearing before the Weld County Planning Commission concerning <br />a proposed raa vel (gravel, coal, borrow pit, etc.) mining operation for the following described <br />unincorporated area of Weld County: <br />Legal Description: Part of the SE'/, and part of the NE'/., Section 38• Township 1 North, Range 87 West <br />Flood Plain: Zone A Zone District: A ,Total Acreage: 52± .Overlay District: <br />Geological Hazard: .Airport Overlay District: <br />2. Surface owner(s) of area of land described: <br />Name: Lot Holding Investments, LLC Address: 301 Centennial Drive. Milliken, CO 80543 <br />Name: Valerie and Robert Parker Address: 634 Weld County Road 23.5. Brighton. CO 80501 <br />3. Owner(s) of mineral rights or substance to be mined: <br />Name: Same as above Address: Same as above Phone: <br />Name: Same as above Address: Same as above Phone: <br />4. Applicant's name: Hall-Irwin Corporation Email Address ieffgregg(rdhall-irwin.com <br />Address: 301 Centennial Drive. Milliken, CO 80543 Phone: 970-587-7200 <br />5. Identify any prior permits for mining held by applicant or affiliated person: <br />Firestien Resource MLRB Permit M-1995-060 and USR 7125; Herbst Resource MLRB Permit M-1985-031; <br />LaPoudre Resource MLRB Permit M-1983-090: USR 00571; Baseline MLRB Permit M-1997-058 &USR 1172 <br />I (We) request that the following described property be designated a Use BY Special Review by the Weld County <br />Board of County Commissioners. I (We) hereby depose and state under penalties of perjury that all statements, <br />proposals, and/or plans submitted with or contained within the application are true and correct to the best of my <br />(our) knowledge. Signatures of all fee owners of property must sign this application. If an Authorized Agent signs, <br />a letter of authorization from all fee owners must be included with the application. If a corporation is the fee owner, <br />notarized evidence must be included showing the signatory has to legal authority to sign for the corporation. <br />i <br />Signature: Owner or Autl on ed Agent Date <br />Signature: Owner or Authorized Agent Date <br />15 <br />