PERMFILE118052

• Permit No: M2005060
• IBM Index Class Name: Permit File
• Doc Date: 8/17/2005
• Doc Name: Reclamation Permit Application Form
• From: DMG
• To: Weld County
• Media Type: D
• Archive: No

DEPARTMENT OF PLANNING SERVICES
1555 N. 17th Avenue, Greeley, Colorado 80631
Phone [phone], Ext. 3540 Fax [phone]
USE BY SPECIAL REVIEW (MINING OPERATION) APPLICATION
FOR THE DEPARTMENT OF PLANNING SERVICES USE ONLY
Application Fee Receipt Number Case Number
Recording Fee Receipt Number Zoning District
Application Checked By: Planner Assigned to Case
To be completed by APPLICANT is accordance with procedural guide requirements:
I (we), the undersigned, hereby request a hearing before the Weld County Planning Commission
concerning a proposed gravel (gravel, coal, borrow pit, e1c.) mining operation for the
following described unincorporated area of Weld County:
LEGAL DESCRIPTION:
NW 1/4 of Sec 15, T7N, R59W, 6th PM
0 7 2 1 1 5 0 0 0 0 0 9
PARCEL NUMBER: ___~________(12digitnumber-found on Taxl.D.lnformationor
obtained at the Assessor's Office).
2. Surface owner(s) of area of land described
Name: Keith & Shirley Ashbaugh Address: 39434 WCR 115 Phone: [phone]
Name: Address: Phone:
3. Owner(s) of mineral rights or substance to be mined
Name:- K .i_th & Shi rl PX Ashhangh Address:~g6 na WCR 1 1 S Phone: q7n-4'i7-5471
Name: Address: Phone:
4. Source of applicant's legal right to enter and to mine on the land described:
copy or any
5. Applicant's address: 1111 H Street, P.0. Box 758 Greeley phone: [phone]
Address: Greeley, CO 80632 Phone:
6. Identify any prior permits for'mining held by applicant or affiliated person:
Weld County has several mining Hermits. This is the first Hermit for the
7. Description of Operation
A. Types and number of operating and processing equipment to be used rock crusher, conveyors ~
fyont-anted 1o~r,~n~er~ axravAtnr, 9 haul Yrnrkc Y, ranAPmc anA cpmic
B. Maximum number of employees: 20 ,and number of shifts:
C. Number of stages to be worked: 1, and periods of time each is to be worked 3 to 4
months at a time, depending on need for material.
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