HomeMy WebLinkAbout20120190.tiff EXHIBIT
1861 - 201 I MEMORANDUM us 2-
TO: Kim Ogle, Planning Services DATE: November 7, 2011
WELD€ 0 N T Y FROM: Heidi Hansen, P.E., Public Works Department
SUBJECT: USR11-0022, Homestead Grange
A Use by Special Review permit for administrative offices and meeting hall for an agricultural
organization (Homestead Grange).
The Weld County Public Works Department has reviewed this proposal. This project falls under the Use
by Special Review Standard, Weld County Code, Chapter 23, Article II, Division 4, Section 23. Staff
comments made during this phase of the Use by Special Review process may not be all-inclusive, as
other issues may arise during the remaining application process.
COMMENTS:
The Colorado Department of Transportation (CDOT) has jurisdiction over all accesses to the state
highways. Please contact Gloria Hice-Idler at the Greeley office (970-350-2148 or 970-350-2163) to
verify the access permit or for any additional requirements that may be needed to obtain or upgrade the
permit. (State Highway 52)
The business will utilize an existing access from State Highway 52. CDOT will specify any access
requirements.
Please show dimensions for parking spaces and drive isles on the plat.
Each parking space shall be equipped with wheel guards or curb blocks when necessary to prevent
vehicles from extending beyond the boundary of the space and from coming into contact with other
vehicles, walls, fences or plantings.
A water quality feature has been designed for the site. Please show the water quality area on the Plat
and label it as "Water Quality— No Build or Storage Area".
This area IS NOT in a Special Flood Hazard Area (SFHA) as determined by the Federal Emergency
Management Agency (FEMA).
REQUIREMENTS:
1. Contact CDOT to discuss any requirements for the access.
2. Show dimensions for parking spaces and drive isles on the Plat.
3. Show curb blocks for parking spaces along the building.
4. Show the water quality area on the Plat and label it as"Water Quality— No Build or Storage Area"
5. Add the following development standards to the plat:
a. Pursuant to Chapter 15, Articles I and II of the Weld County Code, if noxious weeds exist
on the property or become established as a result of the proposed development, the
applicant/landowner shall be responsible for controlling the noxious weeds. All
vegetation, other than grasses, needs to be maintained at a maximum height of 12
inches until the area is completely developed.
2012-0190
C:\Documents and Settings\kogle\Local Settings\Temporary Internet Files\ContenLll
b. The historical flow patterns and run-off amounts will be maintained on site in such a
manner that it will reasonably preserve the natural character of the area and prevent
property damage of the type generally attributed to run-off rate and velocity increases,
diversions, concentration and/or unplanned ponding of storm run-off.
c. Weld County is not responsible for the maintenance of onsite drainage related features.
C:\Documents and Settings\kogle\Local Settings\Temporary Internet Files\Content.IE5\BINAATA2\USR I 1-0022[1].docx
Water Quality Feature Calculations
Surface Area (SF) Area (acres) % Impervious i
Roof 7,500 0.17 90% 0.9
Pavement 456 0.01 100% 1.0
Gravel/Crushed Asphalt 17,670 0.41 40% 0.4
Grass/Dirt 105,054 2.41 2% 0.02
Total Site 3.00
Weighted Imperviousness(i)= 0.125
W'QCV'=aA(0.91i3-1.19:2+0 7&)
6-hr drain time a=0.7
l2-hr drain trine a =0.9
24-hr drain trine a =0 9
40-hr drain tine a = 1.0
WQCV= 0.0808
Cv
Rogan&''d.519rage _ (,4 '?t71
1 '
Required storage= 0.0202 acre*feet
880 cu ft
MEMORANDUM
TO: KIM OGLE, PLANNING SERVICES Wimp C. FROM: MARY EVETT, ENVIRONMENTAL
SUBJECT: USR11-0022 HUWA ENTERPRISES HEALTH
COLORADO DATE: NOVEMBER 4, 2011
Environmental Health Services has reviewed this proposal for the Homestead Grange
meeting hall. The hall will be used for 4-H meetings, dances, showers and other
community meetings. The maximum occupancy will be 300 persons.
Water will be provided by a commercial well (Permit No. 285128) and an individual
sewage disposal system (SP-1100070). Septic Permit SP-1100070 will require final
approval prior to occupancy.
Access driveway and parking areas will be covered with recycled asphalt and the
remaining area will be planted with native grasses to control dust. A waste handling plan
was submitted and a dumpster will be provided by Gray Brothers. The applicant needs
to provide the phone number and address of Gray Brothers and the name, address and
phone number of the disposal site.
We have no objections to the proposal; however, we do recommend that the following
conditions be part of any approval:
We recommend that the following requirements be met prior to allowing the plat to be
recorded:
1. The applicant shall submit a waste handling plan, for approval, to the
Environmental Health Services Division of the Weld County Department of Public
Health & Environment. The plan shall include at a minimum, the following:
1) A list of wastes which are expected to be generated on site (this should
include expected volumes and types of waste generated).
2) A list of the type and volume of chemicals expected to be stored on site.
3) The waste handler and facility where the waste will be disposed (including
the facility name, address, and phone number).
We recommend that the following requirements be incorporated into the permit as
conditions that must be met one month prior to construction activities:
1. A State stormwater discharge permit may be required for a development/
redevelopment/ construction site where a contiguous or non-contiguous land
disturbance is greater than or equal to one acre in area. Contact the Water Quality
Control Division of the Colorado Department of Public Health and Environment at
www.cdphe.state.co.us/wci/PermitsUnit for application more information.
We recommend that the following requirements be incorporated into the permit as
conditions that must be met prior to the issuance of the Certificate of Occupancy:
1. An individual sewage disposal system is required for the proposed facility and
shall be installed according to the Weld County Individual Sewage Disposal
Regulations. Septic Permit SP-1100070 must receive final approval from Weld
County Environmental Health Services.
2. The applicant shall submit evidence of an Underground Injection Control (UIC)
Class V Injection Well permit from the Environmental Protection Agency (EPA)
for any large-capacity septic system (a septic system with the capacity to serve
20 or more persons per day). Alternately, the applicant can provide evidence
from the EPA that they are not subject to the EPA Class V requirements.
We recommend that the following requirements be incorporated into the permit as
development standards:
1. All liquid and solid wastes (as defined in the Solid Wastes Disposal Sites and
Facilities Act, 30-20-100.5, C.R.S., as amended) shall be stored and removed
for final disposal in a manner that protects against surface and groundwater
contamination.
2. No permanent disposal of wastes shall be permitted at this site. This is not
meant to include those wastes specifically excluded from the definition of a
solid waste in the Solid Wastes Disposal Sites and Facilities Act, 30-20-100.5,
C.R.S., as amended.
3, Waste materials shall be handled, stored, and disposed in a manner that
controls fugitive dust, fugitive particulate emissions, blowing debris, and other
potential nuisance conditions.
4. The applicant shall operate in accordance with the approved "waste handling
plan", at all times.
5. Fugitive dust and fugitive particulate emissions shall be controlled on this site.
The facility shall be operated in accordance with the approved "dust abatement
2
plan", at all times.
6. This facility shall adhere to the maximum permissible noise levels allowed in
the Residential Zone as delineated in Section 14-9-30 of the Weld County
Code.
7. Adequate drinking, handwashing and toilet facilities shall be provided for
employees (volunteers) and patrons of the facility, at all times.
8. Any septic system located on the property must comply with all provisions of
the Weld County Code, pertaining to Individual Sewage Disposal Systems.
9. Adequate toilet facilities (portable toilets) and hand washing units shall be
provided during the construction of the facility.
10.In the event the facility's water system serves more 25 persons on a daily basis
the water system shall comply with the Colorado Primary Drinking Water
Regulations (5 CCR 1003-1). Evidence shall be provided to the Weld County
Department of Public Health and Environment that the system complies with
the Regulations. (25 people per day over a 60 day period)
11.Bottled water shall be utilized for drinking during construction of the project.
12.The applicant shall comply with Colorado Retail Food Establishment Rules and
Regulations governing the regulation of food service establishments.
13.The operation shall comply with all applicable rules and regulations of State
and Federal agencies and the Weld County Code.
Additionally, please note the following:
1. This application is proposing a well(s) as its source of water. The applicant
should be made aware that while they may be able to obtain a well permit from
the Office of the State Engineer, Division of Water Resources, the quantity of
water available for usage may be limited to specific uses, i.e. domestic use only,
etc. Also, the applicant should be made aware that groundwater may not meet all
drinking water standards as defined by the Colorado Department of Public Health
and Environment. We strongly encourage the applicant to test their drinking
water prior to consumption and periodically test it over time.
3
• Submit by Email•
Weld County Referral
October 7,2011
IIDc
(DORADO
The Weld County Department of Planning Services has received the following item for review:
Applicant: Huwa Enterprises,c/o Ann Christen Case Number: USR11-0022
Please Repay By: November 4,2011 Planner: Kim Ogle
Project: A SITE SPECIFIC DEVELOPMENT PLAN AND SPECIAL REVIEW PERMIT FOR A PUBLIC
AND QUASI-PUBLIC BUILDINGS INCLUDING: ADMINISTRATIVE OFFICES OR MEETING HALLS
FOR AGRICULTURAL ORGANIZATIONS(HOMESTEAD GRANGE, INC.] IN THE (A)
AGRICULTURAL ZONE DISTRICT
Location: NORTH OF AND ADJACENT TO HWY 52, 0.5 MILES EAST OF COUNTY ROAD 87
Parcel Number: 14810530001 Legal: Lot A RE-5103, being part of SW4 Section 5,Ti N,R61W of the
6th P.M.,Weld County,Colorado.
The application is submitted to you for review and recommendation. Any comments or
recommendation you consider relevant to this request would be appreciated. Please reply by the
above listed date so that we may give full consideration to your recommendation. Any response not
received before or on this date may be deemed to be a positive response to the Department of Planning
Services. If you have any further questions regarding the application, please call the Planner
associated with the request. Please note that new information may be added to applications
under review during the review process. if you desire to examine or obtain this additional
information, please call the Department of Planning Services.
flWe have reviewed the request and find that it does/does not comply with our Comprehensive
Alan because:
E
We have reviewed the request and find no conflicts with our interests.
See attached letter.
Comments. The applicant has already contact CDOT and obtained an access permit for their upcoming community hall style
building.CDOT has no additional issues with this proposal.Our right-of-way request for this stretch of Hwy 52 is
75 feet from the centerline of the highway, If you have any questions,i can be reached at 970-350-2163.
1
1 10/11/2011
Signature I Date
Colorado Department of Transportation
Agency
Weld County Planning Dept. 1555 N 17th Ave,Greeley,CO.80631 {970)353-6100 ext.3540 (970)304-6498 fax
COLORADO DEPARTMENT OF TRANSPORTATION CDOT Permit No. 411034
sHl 52
STATE HIGHWAY ACCESS CODE
52 B / 51.166 / L
NOTICE TO PROCEED Local Jurisdiction
Weld County
Permittee(s): Applicant:
Huwa Enterprises Ann Christen
Brent Huwa
5415 WCR 89 43550 Highway 52
Roggen,CO 80652 Roggen,CO 80652
The permittee is hereby authorized to proceed with access construction within state highway right-of-way in
accordance with the above referenced State Highway Access Permit and this Notice to Proceed.
This Notice to Proceed is valid only if the referenced Access Permit has not expired. Access Permits expire
one year from date of issue if not under construction, or completed. Access Permits may be extended in
accordance with Section 2.3(11)(d), of the Access Code.
Adequate advance warning is required at all times during access construction, in conformance with the Manual
on Uniform Traffic Control Devices for Streets and Highways.
All construction shall be completed in an expeditious and safe manner and shall be finished within 45 days
from initiation. The permittee or applicant shall notify the Department prior to commencing construction as
indicated on the Access Permit.
Both the Access Permit and this Notice To Proceed shall be available for review at the construction site.
This Notice to Proceed is conditional. The following items shall be addressed prior to or during construction as
appropriate.
Municipality or County Approval (When the appropriate local authority retains issuing authority)
By Title Date
(X)
This Notice is not valid until signed by a duly authorized representative of the Department
Colorado Department of Transportation
•
By I l' — Title L Date
(X) ,a TT l�CJ- - �'�'` PQ,}�YYI I T --ty 7/21/2011
Copy dEs button, Required: Make copies as necessary for: Form 1265 8198,6/99
Region(original) Local Authority Inspector Lee Ireton
Applicant MTCE Patrol Traffic Engineer
Staff Access Section 23-Hudson
COLORADO DEPARTMENT OF TRANSPORTATION - CDOT Permit No 411034
S TATE HIGHWAY ACCESS PERMIT State Highway No/Mp/Side
52 B / 51.166 / L
Perm t fee Date of transmittal Region/Section/Patrol Local Jurisdiction
$100.00 5/19/2011 4 / 01 /23-Hudson Weld County
The Permittee(s); Applicant: Ref No.:
Huwa Enterprises Ann Christen
Brent Huwa
5415 WCR 89 43550 Highway 52
Roggen,CO 80652 Roggen,CO 80652
970-381-0060 303-849-5231
is hereby granted permission to have an access to the state highway at the location noted below.The access shall be constructed, maintained end used in
accordance with this permit. including the State Highway Access Code and any attachments,terms,conditions and exhibits. This permit may be revoked
by the issuing authority if at any time the permitted access and its use violate any parts of this permit.The issuing authority,the Department and their duly
appointed agents and employees shall be held harmless against any action for personal injury or property damage sustained by reason of the exercise of
the permit. _
Location:This access is located on State Highway 52,a distance of 877 feet east of mile post 51 on the north/left side.
Access to Provide Service to: (Land Use Code.) (Size or Coun() (Units)
435 -Community Center 8 A17T
997-Agriculture 4 ADT
Additional Information:
I
L
MUNICIPALITY OR COUNTY APPROVAL
Required only when the appropriate local authority retains issuing authority.
Signature Print Name Title Date
Upon the signing of this permit the perrnittee agrees to the terms and conditions and referenced attachments contained
herein. All construction shall be completed in an expeditious and safe manner and shall he finished within 45 days from
Initiation. The permitted access shall be completed in accordance with the terms and conditions of the permit prior to
being used.
The permittee shall notify Lee Ireton with the Colorado Department of Transportation in
Greeley, Colorado at(970) 350-2147, at least 48 hours prior to commencing construction within the
State Highway r€ght-of-way.
The person signing as the permittee must be the owner or legal representative of the property served by the permitted access and have full authority to
accept the permit and its terms and conditions.
Permittee Signature Print Name Date
e7/1011r
- 13re,4/ 4 ' i— 2 - /1---,�f
This permit is not valid until signed by a duly authorized representative of the Department.
COLORADO DEPARTMENT OF TRANSPORTATION
S. nature ,, 11 Print Name Title ll Date(of issue)
t*tAA- �.C c — G t o r t'A N i Le. - d (�✓ f-ty rn i - t`c r 7/2.1/1/
Copy istributlon: Required: Make copies as necessary for Previous edit ns are obsoled may not be used
1.Regron 3.Staff Aces Section Local Authority Inspector age 1 of 3 CDOT Form#101 5/07
2.Appllcant 4.Central Files MTCE Patrol Traffic Engineer
State Highway Access Permit PERMIT EXPIRATION
Form 101, Page 2 1. A permit shall be considered expired if the access is not
under construction within one year of the permit issue date
The following paragraphs are excerpts of the State Highway or before the expiration of any authorized extension. When
Access Code. These are provided for your convenience but the permittee is unable to commence construction within one
do not alleviate compliance with all sections of the Access year after the permit issue date, the permittee may request a
Code. A copy of the State Highway Access Code is one year extension from the issuing authority. No more than
available from your local issuing authority(local government) two one-year extensions may be granted under any
or the Colorado Department of Transportation (Department). circumstances. If the access is not under construction within
When this permit was issued, the issuing authority made its three years from date of issue the permit will be considered
decision based in part on information submitted by the expired.Any request for an extension must be in writing and
applicant, on the access category which is assigned to the submitted to the issuing authority before the permit expires.
highway, what alternative access to other public roads and The request should state the reasons why the extension is
streets is available, and safety and design standards. necessary, when construction is anticipated, and include a
Changes in use or design not approved by the permit or the copy of page 1 (face of permit) of the access permit.
issuing authority may cause the revocation or suspension of Extension approvals shall be in writing. The local issuing
the permit. authority shall obtain the concurrence of the Department
prior to the approval of an extension, and shall notify the
APPEALS Department of all denied extensions within ten days. Any
1. Should the permittee or applicant object to the denial of person wishing to reestablish an access permit that has
a permit application by the Department or object to any of expired may begin again with the application procedures.An
the terms or conditions of a permit placed there by the approved Notice to Proceed, automatically renews the
Department, the applicant and permittee (appellant) have a access permit for the period of the Notice to Proceed.
right to appeal the decision to the [Transportation]
Commission [of Colorado). To appeal a decision, submit a CONSTRUCTION
request for administrative hearing to the Transportation 1. Construction may not begin until a Notice to Proceed is
Commission of Colorado within 60 days of transmittal of approved. (Code subsection 2.4]
notice of denial or transmittal of the permit for signature.
Submit the request to the Transportation Commission of 2. The construction of the access and its appurtenances
Colorado, 4201 East Arkansas Avenue, Denver, Colorado as required by the terms and conditions of the permit shall
80222-3400. The request shall include reasons for the be completed at the expense of the permittee except as
appeal and may include changes, revisions, or conditions provided in subsection 2.14. All materials used in the
that would be acceptable to the permittee or applicant. construction of the access within the highway right-of-way or
on permanent easements, become public property. Any
2. Any appeal by the applicant or permittee of action by a materials removed from the highway right-of-way will be
local issuing authority shall be filed with the local authority disposed of only as directed by the Department. All fencing,
and be consistent with the appeal procedures of the local guard rail, traffic control devices and other equipment and
authority. materials removed in the course of access construction shall
be given to the Department unless otherwise instructed by
3. In submitting the request for administrative hearing, the the permit or the Department inspector.
appellant has the option of including within the appeal a
request for a review by the Department's internal 3. The permittee shall notify the individual or the office
administrative review committee pursuant to [Code] specified on the permit or Notice to Proceed at least two
subsection 2.10. When such committee review is requested, working days prior to any construction within state highway
processing of the appeal for formal administrative hearing, right-of-way. Construction of the access shall not proceed
2.9(5) and (6),shall be suspended until the appellant notifies until both the access permit and the Notice to Proceed are
the Commission to proceed with the administrative hearing, issued.The access shall be completed in an expeditious and
or the appellant submits a request to the Commission or the safe manner and shall be finished within 45 days from
administrative law judge to withdraw the appeal. The two initiation of construction within the highway right-of-way. A
administrative processes, the internal administrative review construction time extension not to exceed 30 working days
committee, and the administrative hearing, may not run may be requested from the individual or office specified on
concurrently. the permit.
4. Regardless of any communications, meetings, 4. The issuing authority and the Department may inspect
administrative reviews or negotiations with the Department the access during construction and upon completion of the
or the internal administrative review Committee regarding access to ensure that all terms and conditions of the permit
revisions or objections to the permit or a denial, if the are met. Inspectors are authorized to enforce the conditions
permittee or applicant wishes to appeal the Department's of the permit during construction and to halt any activities
decision to the Commission for a hearing, the appeal must within state right-of-way that do not comply with the
be brought to the Commission within 60 days of transmittal provisions
permit,
or maintenance work, that endange ent
pt
of notice of denial or transmittal of the permit. highway construction
highway property, natural or cultural resources protected by right-of-way or any adopted municipal system and drainage
law, or the health and safety of workers or the public. plan.
5. Prior to using the access, the permittee is required to 11. By accepting the permit, permittee agrees to save,
complete the construction according to the terms and Indemnify, and hold harmless to the extent allowed by law,
conditions of the permit Failure by the permittee to abide by the issuing authority, the Department, its officers, and
all permit terms and conditions shall be sufficient cause for employees from suits, actions, claims of any type or
the Department or issuing authority to initiate action to character brought because of injuries or damage sustained
suspend or revoke the permit and close the access. If in the by any person resulting from the permittee's use of the
determination of the Department or issuing authority the access permit during the construction of the access.
failure to comply with or complete the construction
requirements of the permit create a highway safety hazard, CHANGES IN ACCESS USE AND PERMIT VIOLATIONS
such shall be sufficient cause for the summary suspension 1. It is the responsibility of the property owner and
of the permit. If the permittee wishes to use the access prior permittee to ensure that the use of the access to the
to completion, arrangements must be approved by the property is not in violation of the Code, permit terms and
issuing authority and Department and included in the permit. conditions or the Act. The terms and conditions of any permit
The Department or issuing authority may order a halt to any are binding upon all assigns, successors-in-interest, heirs
unauthorized use of the access pursuant to statutory and and occupants. If any significant changes are made or will
regulatory powers. Reconstruction or improvement of the be made in the use of the property which will affect access
access may be required when the permittee has failed to operation,traffic volume and or vehicle type, the permittee or
meet required specifications of design or materials. If any property owner shall contact the local Issuing authority or the
construction element fails within two years due to Improper Department to determine if a new access permit and
construction or material specifications, the permittee shall bo modifications to the access are required.
responsible for all repairs. Failure to make such repairs may
result in suspension of the permit and closure of the access. 2. When an access is constructed or used in violation of
the Code, section 43-2-147(5)(c), C.R.S., of the Act applies.
6. The permittee shall provide construction traffic control The Department or issuing authority may summarily
devices at all times during access construction, in suspend an access permit and immediately order closure of
conformance with the M.U.T.C.D. as required by section 42- the access when its continued use presents an immediate
4-104, C.R.S., as amended. threat to public health, welfare or safety. Summary
suspension shall comply with article 4 of title 24, C R.S.
7. A utility permit shall be obtained for any utility work
within highway right-of-way. Where necessary to remove, MAINTENANCE
relocate, or repair a traffic control device or public or private 1. The permittee, his or her heirs, successors-in-interest,
utilities for the construction of a permitted access, the assigns, and occupants of the property serviced by the
relocation, removal or repair shall be accomplished by the access shall be responsible for meeting the terms and
permittee without cost to the Department or issuing conditions of the permit, the repair and maintenance of the
authority, and at the direction of the Department or utility access beyond the edge of the roadway including any cattle
company. Any damage to the state highway or other public guard and gate, and the removal or clearance of snow or ice
right-of-way beyond that which is allowed In the permit shall upon the access even though deposited on the access in the
be repaired Immediately.The permittee Is responsible for the course of Department snow removal operations. Within
repair of any utility damaged in the course of access unincorporated areas the Department will keep access
construction,reconstruction or repair. culverts clean as part of maintenance of the highway
drainage system. However, the permittee is responsible for
8. In the event it becomes necessary to remove any right- the repair and replacement of any access-related culverts
of-way fence, the posts on either side of the access shall be within the right-of-way. Within incorporated areas, drainage
securely braced with an approved end post before the fence responsibilities for municipalities are determined by statute
is cut to prevent any slacking of the remaining fence. All and local ordinance. The Department will maintain the
posts and wire removed are Department property and shall roadway including auxiliary lanes and shoulders, except in
be turned over to a representative of the Department. those cases where the access installation has failed due to
improper access construction and/or failure to follow permit
9. The permittee shall ensure that a copy of the permit is requirements and specifications in which case the permittee
available for review at the construction site at all times. The shall be responsible for such repair. Any significant repairs
permit may require the contractor to notify the individual or such as culvert replacement, resurfacing, or changes in
office specified on the permit at any specified phases in design or specifications, requires authorization from the
construction to allow the field inspector to inspect various Department.
aspects of construction such as concrete forms, subbase,
base course compaction, and materials specifications. Minor
changes and additions may be ordered by the Department
or local authority field inspector to meet unanticipated site
conditions.
10. Each access shall be constructed in a manner that shall
not cause water to enter onto the roadway or shoulder, and
shall not interfere with the existing drainage system on the Form 101, Page 3
COLORADO DEPARTMENT OF TRANSPORTATION
Environmental Clearances Information Summary
PURPOSE-This summary is intended to inform entities external to CDOT that may be entering the state highway right-of-way to
perform work related to their own facilities(such as Utility, Special Use or Access Pennittees), about some of the more commonly
encountered environmental permits/clearances that may apply to their activities. This listing Is not all-inclusive-additional
environmental or cultural resource permits/clearances may be required in certain Instances. Appropriate local, state and federal
agencies should be contacted for additional information if there Is any uncertainty about what permits/clearances are required for a
specific activity. IMPORTANT—Please Review The Following Information Carefully—Failure to Comply With Regulatory
Requirements May Result in Suspension or Revocation of Your COOT Permit,Or Enforcement Actions By Other Agencies
CLEARANCE CONTACTS -As indicated in the permit/clearance descriptions fisted below, the following individuals or agencies
may be contacted for additional information:
• Colorado Department of Public Health and Environment(CDPHE): General Information—(303)692-2035
Water Quality Control Division(WQCD): (303)692-3500
Environmental Permitting Website http://www,cdphe,stale,co.u§leermits,aso.
• CDOT Water Quality Program Manager: Rick Willard (303)757-9343 http;//www.coloradodot.info/programs/environmental/water-
gvality
• CDOT Asbestos Project Manager. Theresa Santangelo-Drelling,(303)512-5524
• Colorado Office of Archaeology and Historic Preservation:(303)866-3395
• U.S.Army Corps of Engineers, District Regulatory Offices:
Omaha District(NE Colorado), Denver Office(303)979-4120 http://www.nwousacearmy.mil/htmi/oci-tlitri-lakes.html
Sacramento Dist, (Western CO), Grand Junction Office(970)243-1199 http://www.spk,usace,armv.mll/cespk-co/rectu''atory/
Albuquerque District(SE Colorado), Pueblo Reg.Office(719)-543-6915 htto://www.sDa.usace,armv.r►Jij/reoi
• COOT Utilities,Special Use and Access Permitting: (303)757-9654 bitegifiggiattiapiaajacaM
jcoloaical Resources—Disturbance of wildlife shall be avoided to the maximum extent practicable. Entry Into areas of known or
suspected threatened or endangered species habitat will require special authorization from the COOT permitting office. If any
threatened or endangered species are encountered during the progress of the permitted work,work in the subject area shall be halted
and the COOT Regional Permitting Office and Region Planning and Environmental Manager shall be contacted immediately.
Authorization must be provided by CDOT prior to the continuation of work. Information about threatened or endangered species may
be obtained from the CDOT website, http://coloradodot.info/programs/environmental/wildlif@/quldelinee, or the Colorado Division of
Wildlife website http;//wildlife.ltatec,o.usiWildiifeSpecies/SpeciesOfConcerrt/. Additional guidance may be provided by the appropriate
Region Planning and Environmental Manager(RPEM).
cultural Resources—The applicant must request a file search of the permit area through the Colorado Office of Archaeology and
Historic Preservation(OAHP), Denver, to ascertain ii historic or archaeological resources have previously been identified. inventory of
the permit area by a qualified cultural resources specialist may be necessary, per the recommendation of CDOT. If archaeological
sites/artifacts or historic resources are known to exist prior to the initiation of the permitted work or are encountered as the project
progresses, all work in the subject area shall be halted and the CDOT Regional Permitting Office and Region Planning and
Environmental Manager shall be contacted immediately. Authorization must be provided by COOT prior to the continuation of work.
Additional guidance may be provided by the Regional Permitting Office and RPEM. Contact information: Contact the OAHP for file
search at(303)866-3395.
Paleontoloalcat Resources-The applicant must request a fossil locality file search through the University of Colorado Museum,
Boulder, and the Denver Museum of Nature and Science to ascertain if paleontological resources have been previously identified.
Inventory of the permit area by a qualified paleontologist may be necessary, per the recommendation of CDOT. If fossils are
encountered during the permitted work, ail work In the subject area shall be halted and the COOT Regional Permitting Office and
Region Planning and Environmental Manager shall be contacted immediately. Authorization must be provided by CDOT prior to the
continuation of work. Additional guidance may be provided by the Regional Permitting Office in the Permit Special Provisions.
Contact Information: Contact the CDOT Paleontologist at(303)757-9632.
Hazardous Materials,Solid Waste-The Solid Wastes Disposal Sites and Facilities Act C.R.S. 30-20-100,et al,and Regulations
Pertaining to Solid Waste Disposal Sites and Facilities(6 CCR 1007-2), prohibit solid waste disposal without an approved Certificate
of Designation(a landfill permit). The Colorado Hazardous Waste Act C.R.S.25-15-301 et al, and the Colorado Hazardous Waste
Regulations(6 CCR 1007-3)prohibit the transfer,storage or disposal (TSD)of hazardous waste except at permitted TSD sites. There
are no permitted landfills or TSD sites within the State Highway Right of Way. Therefore, all solid or hazardous wastes that might be
generated by the activities of entities entering the State Highway Right of Way must be removed from the ROW and disposed of at a
permitted facility or designated collection point(e.g„for solid waste, a utility or construction company's own dumpster). If pre-existing
solid waste or hazardous materials contamination(Including oil or petroleum contaminated soil,asbestos, chemicals,mine tailings,
etc.)is encountered during the performance of work, the permittee shall halt work in the affected area and immediately contact the
CDOT Regional Permitting Office for direction as to how to proceed. Contact Info:Andy Flurkey, COOT Hazardous Materials Project
Manager, (303)512-5520.
Asbestos Containing Materials,Asbestos Contaminated Soli—All work on asbestos containing materials(ACM)must comply with
the applicable requirements of the CDPHE Air Pollution Control Division's(APCD)Regulation 8. Disposal of ACM,and work done in
asbestos-contaminated soil,must comply with the CDPHE Hazardous Materials and Waste Management Division's(HMWMD)Solid
Waste Regulations. The application for any CDOT permit must specifically Identify any ACM involved In the work for which
authorization is being requested. Additional guidance or requirements may be specified in the permit special provisions. Contact
Info:CDPHE APCD and HMWMD Regulations can be accessed via the CDPHE Environmental Permitting Website listed above.
Additional information cpmerninc clearance on COOT orolects is available from the COOT Asbestos Project Manager(303)512-
5519, or Theresa Santangelo-Dreiling,Property Management Supervisor(303)512-5524.
Environmental Clearances Information Summary Page 1 of 3 Colorado Department of Transportation December'10
Transportation of Hazardous Materials-No person may offer or accept a hazardous material for transportation in commerce unless
that person is registered in conformance with the United States Department of Transportation regulations at 49 CFR, Part 171. The
hazardous material must be properly classed,described, packaged, marked, labeled, and in condition for shipment as required or
authorized by applicable requirements,or an exemption, approval or registration has been issued. Vehicles requiring a placard, must
obtain authorization and a State HAZMAT Permit from the Colorado Public Utilities Commission. Contact Information: For
authorization and more info call the Federal Motor Safety Carrier Administration, US DOT for inter-and Intra-state HAZMAT
Registration(303)969-6748. Colorado Public Utilities Commission:(303)894-2868.
pischarge of Dredged or Fill Ma lal—404 Permits Administered Sy the U.S.,6rmv Corps of Engineers,and Section 401
pater Quality Certifications Issued by the CDPHF vac-Corps of Engineers 404 Permits are required for the discharge of
dredged or MI materials into waters of the United States, Including wetlands. There are various types of 404 Permits,including
Nationwide Permits,which are issued for activities with relatively minor impacts. For example,there is a Nationwide Permit for Utility
Line Activities(NWP#12). However,depending upon the specific circumstances,it is possible that either a"General" or"Individual"
404 permit would be required. If an Individual 404 Permit is required,Section 401 water quality certification from the CDPHE WQCD
is also required. Contact the appropriate Corps District Regulatory Office for information about what type of 404 permit may be
required(contact Information above, Contact the CDPHE Water Quality Control Division at(303)692-3500.
Workings)n or in any stream or Its bank-in order to protect and preserve the state's fish and wildlife resources from actions that
may obstruct,diminish, destroy,change, modify,or vary a natural existing stream or Its banks or tributaries,it may be necessary to
obtain a Senate Bill 40 certification from the Colorado Department of Natural Resources. A stream is defined as 1)represented by a
solid blue line on USGS 7.5'quadrangle maps; and/or 2)intermittent streams providing live water beneficial to fish and wildlife; and/or
3)segments of streams supporting 25%or more cover within 100 yards upstream or downstream of the project; and/or 4)segments of
streams having wetlands present within 200 yards upstream or downstream of the project. The Colorado Division of Wildlife (CDOW)
application,as per guidelines agreed upon by COOT and CDOW, can be accessed at
h a//www,coloradodot,info/programs/environmental/wildlifelquidelines.
Stormwater Construction Permit(SCP)and Stormwater Discharge From industrial Facilities-Discharges of stormwater runoff
from construction sites disturbing one acre or more-or certain types of industrial facilities,such as concrete batch plants-requires a
CDPS Stormwater Construction Permit. Contact information:For Utility/Special Use activities being performed in conjunction and
coordination with a CDOT highway construction contract,please contact the COOT Water Quality Program Manager at(303)757-
9343. Otherwise, contact the CDPHE Water Quality Control Division at(303)692-3500. Website:
�http://www.cciptie,state,co.us/Wa/Permitsynit/irdex,html.
construction Dewatering(Discharge or Infiltration)—Discharges of water encountered during excavation or work in wet areas
may require a Construction Dewatering Discharge Permit. Contact information: For Construction Dewatering Discharge Permits,
contact the CDPHE WQCD at(303)692-3500. For Dewatering Application and instructions,see Section 3 at the CDPHE website:
htte://www,cdphe,state.co.us/welPerrnitsU nit/FORMSandADDlications/Appsandformsnewpaeo.html
rMUniClpal Separate Storm Sewer System(MS4)Discharge Permit—Discharges from the storm sewer systems of larger
municipalities, and from the COOT highway drainage system that lies within those municipalities, are subject to MS4 Permits issued
by the CDPHE WQCD. For facilities that Ile within the boundaries of a municipality that is subject to an MS4 permit,the owner of such
facility should contact the municipality regarding stormwater related clearances that may have been established under that
municipality's MS4 permit. All discharges to the CDOT highway drainage system or within the Right of Way(ROW) must comply with
the applicable provisions of the Colorado Water Quality Control Act and the Colorado Discharge Permit Regulations Permit#COS-
000005(tittoJ/www.coloradodot,info/programs/environm_patal/water-ouality/docummnJs/CDOT%201y1S4%20Pefmlt,dociview)and
COR-030000(htto://www.odahestate.co.usiwa/PermitsUnIt/PERMITs/SWeerMitsratS/SWConStnAtiOn.PErmiLedf). Discharges are
subject to inspection by COOT and CDHPE. Contact the CDPHE Water Quality Control Division at(303)692-3500 for a fisting of
municipalities required to obtain MS4 Permits,or o to tto://www,cdohe.stake.co.us/wg/permltsuniUMS4/MS4Permittees.pdf.
General Prohibition—Discihargt:t-All discharges are subject to the provisions of the Colorado Water Quality Control Act and the
Colorado Discharge Permit Regulations. Prohibited discharges include,but are not limited to,substances such as wash water,paint,
automotive fluids, solvents,oils or soaps and sediment. Allowable non-stormwater discharges can be found at
http://www.coloradodotlnfo/programs/environmentaLlwater-quality/glossary.html#AllowableDlschargo. Contact information: Contact
the COOT Water Quality Program Manager at(303)757-9343,or the Colorado Department of Public Health and Environment, Water
Quality Control Division at(303)692-3500.
General Authorization -Allowable Non-pormwater Discharges -Unless otherwise identified by CDOT or the WQCD as significant
sources of pollutants to the waters of the State,the following discharges to stormwater systems are allowed without a Colorado
Discharge Permit System permit: landscape irrigation, diverted stream flows, uncontaminated ground water infiltration to separate
storm sewers, discharges from potable water sources, foundation drains,air conditioning condensation,irrigation water,
uncontaminated springs,footing drains;water line flushing,flows from riparian habitats and wetlands,and flow from fire fighting
activities. Contact Information: The CDOT Water Quality Program Manager or the CDPHE Water Quality Control Division
(telephone it's listed above),
erosion and Sediment Control Practices-For activities requiring a Stormwater Construction Permit,erosion control requirements
will be specified through that permit. In those situations where a stormwater permit is not required,all reasonable measures should be
taken in order to minimize erosion and sedimentation according to CDOT 208 specifications. In either case, tho CDOT Erosion
Control and Stormwater Quality Guide(most recent version)should be used to design erosion controls and to restore disturbed
vegetation.Contact Information:The CDOT Erosion Control and Stormwater Quality Guide may be obtained from the Bid Plans
Office at(303)757-9313 or from:,ttto://www.dot.state,co.us/environmental/envWaterQual/wgms4.asi
Disposal of Drilling Fluids-Drilling fluids used in operations such as Horizontal Directional Drilling may be classified as"discharges"
or"solid wastes",and in general, should be pumped or vacuumed from the construction area, removed from the State Highway Right
of Way,and disposed of at permitted facilities that specifically accept such wastes. Disposal of drilling fluids into storm drains, storm
sewers,roadside ditches or any other type of man-made or natural waterway is prohibited by Water Quality Control and/or Solid
Waste regulations. Small quantities of drilling fluid solids(less than 1 cubic yard of solids)may be left on-site after either being
Environmental Clearances Information Summery Page 2 of 3 Colorado Department of Transportation December'10
separated from fluids or after infiltration of the water. provided: 1)the drilling fluid consists of only water and bentonite clay,or,if
required for{roper drilling properties,small quantities of polymer additives that are approved for use in drinking water well drilling;2)
the solids are fully contained in a pit,and are not likely to pose a nuisance to future work In the area,3)the solids are covered and the
area restored as required by CDOT permit requirements(Utility,Special Use,or Access Permits,etc.). Contact Information:
Contact the CDOT/CDPHE Liaison or CDOT Water Quality Program Manager.
Concrete Washout-Waste generated from concrete activities shall NOT be allowed to flow into the drainage ways,inlets, receiving
waters, or in the COOT ROW. Concrete waste shall be placed in a temporary concrete washout facility and must be located a
minimum of 50 feet from state waters,dralnageways,and inlets. Concrete washout shall only be performed as specified by the CDOT
Environmental Program and shall be in accordance to CDOT specifications and guidelines. Contact Information: Contact the CDOT
Water Quality Program Manager at(303)757-9343. Website:http://www.coloradodot.Into/orogramslenvironmentaUwater-
auality/revised-m-standards;refer to the link Revision of Sections 101, 107, 208. 213 and 620 Water Quality Control One or More
Acres of Disturbance for additional guidance.
Spill Reporting-Spills shall be contained and cleaned up as soon as possible. Spills shall NOT be washed down into the storm
drain or buried. All spills shall be reported to the CDOT Illicit Discharge Hotline at(303)512-4446(4H20),as well as the Regional
Permitting Office and Regional Maintenance Supervisor. Spills on highways,into waterways,any spill in the highway right-of-way
exceeding 25 gallons,or that may otherwise present an Immediate danger to the public shall be reported by calling 911,and shall also
be reported to the CDPHE at 1.877-518-5608.
About This Form-Questions or comments about this Information Summary may be directed to Alex Karam',CDOT Safety&Traffic
Engineering,Utilities Unit,at(303)757-9841,alex.karamladot.state.co.us.
Environmental Clearances Information Summery Page 3 of 3 Colorado Department of Transportation December'10
. +
ft
" Industrial facilities program
CDOT issues Utility Permits to those utility companies,
industry, or others wishing to install, adjust, relocate, remove,
or maintain utilities in CDOT's right-of-way. CDOT issues
} a ` Access Permits for building access from private property
(driveways) to state highways(driveways). These two permits
^ are issued and inspections are conducted through CDOT's
six regional offices located throughout Colorado. CDOT's
Water Quality Program tracks and maintains a record of any
permittee that ties into CDOT's storm drain system.
CDOT hiss a program to identify and
eliminate any discharge to their storm CDOT's Industrial Facilities Program is focused on educating
drain system that is not composed entirely those industrial facilities that discharge stormwater into
ofstonnwarer- s.authorized by CDOT's storm drain system. Under this program, CDOT also
another permit fromom.CDPHE).Allowable educates industrial facilities on the proper management of
discharges into CDOT's storm drain
system include the following: potential pollutants that could enter the CDOT storm drain
■ Landscape irrigation system.
• Diverted stream flows Industrial facilities include a site that includes any of the
• Rising ground waters following activities for any of the following categories of
industries:
• Uncontaminated ground water
infiltration to separate storm sewers ■ Activities
• Manufacturing, processing, raw materials storage
• Uncontaminated pumped ground water • Industrial plant yards
• Discharges from potable water sources • Access roads/rail lines used to carry raw materials,
• Foundation drains manufactured products, waste materials, or byproducts
• Air conditioning condensation • Material handling
• Irrigation water • Refuse site
• Application or disposal of process waste waters
• Springs • Storage and maintenance of materials handling
• Water from crawl space pumps I equipment
• Footing drains I • Residual treatment, storage, or disposal
• Lawn watering • Shipping and receiving areas
• Manufacturing buildings
• Individual residential car washing • Storage areas used (including tank farms)for raw
• Individual residential swimming pool materials and immediate and final products
and hot tub discharges ■ Areas where,industrial activity has taken place in the
• Individual residential street washing past and significant materials remain and are exposed
to stormwater
• Water-line flushing ■ Categories of Industries
• Flows from riparian habitats and • Manufacturing
wetlands • Food and kindred products (SIC 20)
• Flows from emergency fire fighting • Tobacco products(SIC 21)
activities • Textile mill products (SIC 22)
• Water incidental to street sweeping • Apparel and other textile products (SIC 23)
(including associated side walks and • Lumber and wood products (SIC 24)
medians) and that is not associated • Furniture and fixtures (SIC 25)
with construction • Paper and allied products(SIC 26)
•
'. +r5 ,7°""n { E.. m•b• `r1aF,,rta ,t2ette:
• Printing and publishing(SIC 27)
• Chemicals and allied products (SIC 28)
• Petroleum and coal products (SIC 29)
• Rubber and miscellaneous plastics (SIC 30)
• Leather and leather products (SIC 31)
• Stone, clay, and glass products (SIC 32) _
• Primary metal industries (SIC 33)
• fabricated metal products (SIC 34) .
• Industrial machinery and equipment(SIC 35)
• Electronic and electric equipment (SIC 36) CDOT defines a utility or utility
• Transportation equipment (SIC 37) facility as any privately, publicly, or
• Instruments and related products (I.e., search/ cooperatively owned line,facility, or
navigation, measuring and controlling, medical, system producing, transmitting, or
photographic, watches) (SIC 38) distributing the following
• Miscellaneous manufacturing industries (i.e., jewelry, • Communications
silverware, musical instruments, toys, sporting goods, is Cable television
office/art supplies, caskets, brooms, floor coverings,
signs)(SIC 39) ■ Power
• Mining: metal,coal, oil and gas, nonmetallic minerals ■ Electricity
(SIC 10-14) 1 Light
• Oil and gas exploration, production, processing, or
treatment operations ■ Heat gas
• Transportation facilities which involve vehicle ■ Oil
maintenance, equipment cleaning, and airport deicing, is Crude products
including
• Railroad transportation (SIC 40) II Water steam
• Local and interurban passenger transit (SIC 41) ■ Waste
• Trucking and warehousing (except farm products and • Stormwater not connected with
refrigerated warehousing) (SIC 42) highway drainage
• Postal service (SIC 43) ■ Other similar commodity
• Water transportation(SIC 44)
• Air tralcpurtation (SIC 45)
• Petroleum bulk stations and terminals (SIC 5171) -•-- !
• Hazardous waste, treatment, storage or disposal
• Landfills, land application sites, and open dumps that :, ' i ,, �`
receive industrial wastes ` . s ' fly ).'
• Recycling facilities, metal scrap yards, battery I -.:.:"."7';'
t �, i , d
reclaimers, salvage yards, automobile junkyards for i. ' ?;, :.,_.t:
reclaimers,
used motor vehicle parts or scrap and waste materials �./, C - ;
• Steam electric power generating facilities including
f
coal handling sites -- -,.--,.t. r '^
• Wastewater treatment works for municipal and
domestic sewage or biosolids having a design flow , „-
of 1 MGD or more (except farm lands and domestic \ ,. ,,s- ._ .
gardens) ,1�
• Construction activity resulting in a disturbance of ^ ?
5 acres or more, including clearing, grading, and , �i:'r ; ' i
i
excavation
State Highway Access Permit 1
Attachment to Permit No.411034-Additional Terms and Conditions
1. If highway right-of-way fence exists or is proposed, the Permittee must contact Tim Bilobran at the
Greeley Traffic Office, (970) 350-2163,prior to removal or installation.
2. If there are any questions regarding this permit,please contact Tim Bilobran at(970) 350-2163.
3. The Permittee shall refer to all additional standard requirements included with this permit and any
enclosed additional terms,conditions, exhibits, and noted attachments.
4. Incorporated as part of this permit are the following:
Application for Access Permit(CDOT Form No. 137)
Permit(CDOT Form No. 101)and its two page attachment
Exhibits:
"A"- Access Plan
"B"-Vicinity Map
5. This permit is issued in accordance with the State Highway Access Code (2 CCR 601-1), and is based
upon the information submitted by the Permittee. This permit is only for the use and purpose stated in the
Application and Permit. Any changes in traffic volumes or type, drainage, or other operation aspects may
render this permit void, requiring a new permit to the be applied for based upon existing and anticipated
future conditions.
6. Access construction methods and materials shall conform to the Colorado Department of Transportation
Standard Specifications for Road and Bridge Construction(current edition).
7. If necessary, minor changes, corrections and/or additions to this permit may be ordered by the
Department inspector, other Department representative or local authority to meet unanticipated site
conditions. Changes may not be in violation of the State Highway Access Code. All major changes to the
plans must be approved in writing by the Department prior to commencement of any work on or within the
State Highway right-of-way.
All workers within the State Highway right-of-way shall comply with their employer's safety and health
policies/procedures, and applicable U.S. Occupational Safety and Health Administration (OSHA)
regulations - including, but not limited to the applicable sections of 29 CFR Part 1910 - Occupational
Safety and Health Standards and 29 CFR Part 1926- Safety and Health Regulations for Construction.
At a minimum, all workers in the State Highway right-of-way, except when in their vehicles,shall wear the
following personal protective equipment:
* Head protection that complies with the ANSI Z89-1-1997 standard;
* At all construction sites or whenever there is a danger of injury to feet, protective footwear that complies
with the ANSI 7A1-1999 standard will be worn;
* High visibility apparel as specified in the Traffic Control provisions of this permit (at a minimum,
ANSI/ISEA 107-1999, Class 2)..
Where any of the above-referenced ANSI standards have been revised, the most recent version of the
standard shall apply.
State Highway Access Permit 2
Attachment to Permit No. 411034-Additional Terms and Conditions
8. This permit is subject to revocation due to: 1) Noncompliance with the provisions of this permit; 2)
Abandonment; 3) Supersedure by new permit covering the same installation; or 4) Conflict with necessary
planned highway construction and/or improvements. The Permittee shall promptly terminate occupancy
upon notice of cancellation of the permit from the Department, unless a new permit is applied for and
granted.
9. Reconstruction and improvements to the access may be required when the Permittee has failed to meet
the required design and/or material specifications. If any construction element fails within two years due to
improper construction or material specifications,the Permittee is responsible for all such repairs.
10. The Department retains the right to perform any necessary maintenance work in this area.
11. Backing maneuvers within and into the State Highway right-of-way are strictly prohibited. All vehicles
shall enter and exit the highway right-of-way in forward movement. Backing into the right-of-way shall be
considered a violation of the terms and conditions of this access permit and may result in revocation of the
permit by the Department and/or the issuing authority.
12. The Permittee is responsible for obtaining any necessary additional federal, state, and/or City/County
permits or clearances required for construction of the access. Approval of this access permit does not
constitute verification of this action by the Permittee.
13. All costs associated with the reconstruction of this access are the responsibility of the Permittee. This
includes design, construction,signing and striping,utility relocation,testing of materials, and inspections.
14. No work will be allowed at night, or on Saturdays, Sundays, and legal holidays without prior
authorization from the Department. The Department may also restrict work within the State Highway
right-of-way during adverse weather conditions.
15. Traffic detours or lane closures will not be allowed, unless pre-approved by the Department.
16. No construction vehicles shall be parked, or construction materials/equipment stored, on the State
Highway right-of-way overnight.
17. No work shall be performed near a Department electronic traffic control device without coordination
with Cobie Garbiso at(970) 350-2137.
18. Landscaping and site construction shall not obstruct sight distance at any State Highway access point.
Landscaping within the State Highway right-of-way requires the Permittee to obtain a CDOT Landscaping
Permit from the Traffic/Access Section. The access permit does not authorize that activity. Irrigation of
features within the right-of-way may require the Permittee to install a subsurface drain in accordance with
CDOT Standard M-605-1 or other approved system. The Permittee shall contact Lee Ireton, at the Greeley
Traffic Office, (970) 350-2147 to obtain the Landscaping Permit.
19. Routine, periodic maintenance and emergency repairs may be performed within the State Highway
right-of-way, under the general terms and conditions of the permit. Any significant repairs such as culvert
replacement, resurfacing, or changes in design or specifications, will require written authorization from the
Department. The Department shall be given proper advance notice whenever maintenance work will affect
State Highway Access Permit 3
Attachment to Permit No. 411034-Additional Terms and Conditions
the movement or safety of traffic on the State Highway. In an emergency, the Department Region Office
and the State Patrol shall immediately be notified of possible hazards.
20. All work is to conform to the plans referenced by this permit on file with the Department or as modified
by this permit. (If discrepancies arise, this permit shall take precedence over the plans.) The Department
plan review is only for the general conformance with the Department's design and code requirements. The
Department is not responsible for the accuracy and adequacy of the design, dimensions,elevations, and any
other elements which shall be confirmed and correlated at the work site. The Department through the
approval of this document,assumes no responsibility for the completeness and/or accuracy of the plans.
21. Survey markers or monuments must be preserved in their original positions. Notify the Department at
(970) 350-2173 immediately upon damage to or discovery of any such markers or monuments at the work
site. Any survey markers or monuments disturbed during the permitted work shall be repaired and/or
replaced immediately at the expense of the Permittee.
22. Should any excavation encounter plant or animal fossils, the remains of historic or prehistoric
structures, artifacts, (pottery, stone tools, arrowheads, etc.), the work shall be stopped and the Permittee
shall notify the Department inspector.
23. The Permittee or the contractor shall notify Lee Ireton at (970) 350-2147 or(970) 590-7155 at least two
working days prior to beginning any access improvements or construction of any kind within the State
Highway right-of-way. Failure to comply with this requirement may result in revocation of this permit.
24. The Department inspector may suspend any work due to: 1)Noncompliance with the provisions of this
permit; 2) Adverse weather or traffic conditions; 3) Concurrent highway construction or maintenance in
conflict with permit work; 4) Any condition deemed unsafe for workers or the general public. The work
may be resumed upon notice from the Department inspector.
25. The access shall be reconstructed as per Exhibit "A".
26. Construction traffic devices,when not in use, shall be removed or turned away from traffic.
27. The access shall be completed in an expeditious and safe manner and shall be finished within 45 days
from initiation of construction within State Highway right-of-way.
28. All required access improvements shall be installed prior to the herein authorized use of this access.
29. The access shall be resurfaced immediately upon completion of earthwork construction and prior to use.
30. Resurfacing of the access shall be maintained as per Exhibit "A".
31. No paved surface shall be cut unless specified in this permit. Asphalt removal shalt be saw cut to
assure a straight edge for patching.
32. If frost, water or moisture is present in the subgrade, no surfacing materials shall be placed until all
frost, water or moisture is gone or removed.
State Highway Access Permit 4
Attachment to Permit No.411034-Additional Terms and Conditions
33. The access shall be reconstructed and maintained in a manner that will not cause water to enter onto the
roadway, and will not interfere with the existing drainage system within the State Highway right-of-way.
Drainage to the State Highway right-of-way shall not exceed historical rate of flow.
34. The Permittee shall request final inspection by Lee Ireton at (970) 350-2147 or (970) 590-7155 within
10 days following completion of access construction, and prior to authorized use. The Permittee or their
representative shall be present.
35. All existing drainage structures shall be extended, modified, or upgraded as necessary,to accommodate
all new construction and safety standards,in accordance to the Department's standard specifications.
36. A fully executed complete copy of this permit must be on the job site with the contractor at all times
during construction. Failure to comply with this or any other construction requirement may result in the
immediate suspension of work by order of the Department inspector or the issuing authority.
37. The design and reconstruction of access and/or development of this property shall not negatively impact
adjacent nearby properties. Correction of the problem and cost resulting from damages shall be borne by
the Permittee.
38. Two-way traffic shall be maintained throughout the work area at all times unless specific written
authorization is obtained from the Department.
39. The State requires a Certificate of Insurance prior to commencing any work on the State Highway right-
of-way. Policies shall name the State of Colorado as additional insured party. All vendors, contractors,
and utility companies shall procure, at their own expense, and maintain for the duration of the work period,
the following minimum insurance coverages:
A. Standard workman's compensation and employer's liability, including occupational disease, covering all
employees engaged in performance of the work at the site, in the amount required by State Statutes.
B. Comprehensive general liability in the amount of$1,000,000 combined single limit bodily injury and
property damage, each occurrence and$2,000,000 annual aggregate.
C. Automobile liability in the amount of $1,000,000 combined single limit bodily injury and property
damage, for each accident.
Certificates of insurance showing compliance with these provisions shall be attached to and made a part of
this permit and be available on the site during construction.
40. It is the responsibility of the Permittee to determine which environmental clearances
and/or regulations apply to the project, and to obtain any clearances that are required
directly for the appropriate agency prior to commencing work. Please refer to or
request a copy of the "CDOT Environmental Clearance Information Summary" (ECIS)
for details. The ECIS may be obtained CDOT Permitting Offices or may be accessed
via the CDOT Planning/Construction-Environmental Guidance webpage at
http://www.dot.state.co.us/environmental/Forms/asp. FAILURE TO COMPLY WITH
REGULATORY REQUIREMENTS MAY RESULT IN SUSPENSION OR REVOCATION Of YOUR
CDOT PERMIT, OR ENFORCEMENT ACTIONS BY OTHER AGENCIES.
State Highway Access Permit 5
Attachment to Permit No.411034-Additional Terms and Conditions
ALL discharges are subject to the provisions of the Colorado Water Quality Act and the
Colorado Discharge Permit Regulations. Prohibited discharges include substance
such as: wash water, paint, automotive fluids, solvents, oils or soaps.
Unless otherwise identified by CDOT or the Colorado Department of Public Health and
Environmental (CDPHE) Water Quality Control Division (WQCD) as significant
sources of pollutants to the waters of the State,the following discharges to storm
water systems are allowed without a Colorado Discharge Permit System Permit:
landscape irrigation, diverted stream flows, uncontaminated ground water infiltration to
separate storm sewers,discharges from potable water sources, foundation drains, air
condition condensation, irrigation water, springs, footing drains,waterline flushing,
flows from riparian habitats and wetlands, and flow from fire fighting activities.
ANY OTHER DISCHARGES, including storm water discharges from industrial facility or construction
sites,may require Colorado Discharge Permit System permits from
CDPHE before work begins. For additional information and forms, go to the CDPHE
website at: http://cdphe.state.co.us/wq/PermitsUnit/wqu.
41. The Permittee shall extend the current 18 inch corrugated metal pipe and shall provide for proper side
slopes. Culverts over 18 inches in diameter shall have end sections.
COLORADO DEPARTMENT OF TRANSPORTATION Issuing authority applcation 4
STATE HIGHWAY ACCESS PERMIT APPLICATION acceptance date: .5/1_1/ f�-
Instructions: • Contact the Colorado Department of Transportation(COOT)or your local government to determine your Issuing authority.
- Contact the issuing authority to determine what plans and other documents are required to be submitted with your application.
• Complete this form(some questions may not apply to you)and attach ail necessary documents and Submit it to the Issuing authority.
Please print - Submit en application for each access allotted.
or type • If you have any questions contact the Issuing authority.
•For additional Information see CDOT's Access Management webstteat)dtp (rff r.dot,etats,ge.u$/AscesePecm)tsfirtdmc.han
1)Prerty owner(Permlttee) p 2) t or Agent for permier*(ii different from property owner)
I-/u Wiz Er 4' re r',s-e [�re nt' f1'u i C hri.�4eri
Street address
n q3 sso y Sz)
Po'
eSdp CJF ! TftCi eazipPrte (riro�qstaleeft, 0 faits.).. 70--.3J1 y)lr'd A0 e9 Co ,�a 3u 8/ s)3 t
E-mress E-mail ssifavailable
j Oirtn,c 5. a)r/khb n -I
3)Address of property to be served by permit(required)
4)Legal description of property:if within lurtsdiotionai limits of Municipality,city and/or County,which one?
mine
i , subdreeon I Wad( l be C i o s 1 1 1 Mg. 1
5) hat State Highway are you requesting access from? 6)What side of the h
�a gIN s DE nW
ax ham`,
7)How feel is the opo.9ed access from the nearest more post? How many feet is the proposed access from the nattiest cross astreet'?eet .,!)
feet ON❑s'/E Ow)from: ...i.....210,..C.(2,._feet QN Qs®E Qyy)from f:_r! / f�"' _.
6)1 is the approximate date a ybu intend to begin construction?
we ({r8- 1i( live1. . '.ninF, 1iritr.i 1ei0lr,:�f'iOCI_s 7A' JAif �t�1'�.Cr("m,hg ,j 4,-I-
8)Check here if you are requesting a: �.J
®®new access [temporary access(duration antfrTlpated: ) improvement to existing access
f�lchange In access use nremovat of access relocation of an existing access(provide detai I)
10)
Provide existing property use
11)e• 'wheys knowledge of any State f-Rghway access permits serving this property,or adjacent properties in which you have a property interest?
o Dyes,if yes-what are the permit numbers)and provide copies: and/or,permit date:
12)Does the property owner own or have any intervals in any adjacent property?
Dno yes,if yes-please describe:
ttiY 4.. e 0 • r ^ /
13)Are there other existing or dedicated public streets,roe ,Fig ays or ass easements bordering or within the property?
Ono Oyes,if yes-Hsi them on your plans and indicate the proposed and existing are-ass points.
14)If you are requesting agricultural field access•how many acres will the access serve?
15)If you are requesting comrnerdal or industrial access please indicate the types arid number of businesses and provide the floor area square footage of each.
buafneserland use square footage business square footage
l
16)II you are requesting residential developement access,what is the typo(single family,apartment,townhouse)and number of units?
tYPe number of units type number of units 1
I I 1.
1 1
17)Provide the following vehicle count estimates for vehicles that will use the access.Leaving the property then returning is two counts. ii
Indicate If your counts are 9 d peaargar ten ero r5nr VnoJe et peak lour volumes Sol maSt we tWa Al puck her volume
apesic hour volumes or�average daily volumes.
C of alrg4 veil vahieha do moss o/30 It. I 01 farm VMk4a lt4014Nnift Total count of aS vehicles
f
Previous editions are obsolete and may not be used Pape f of 2 COOT Form 031 01/10 l
I
F
i
18)Check with the issuing authority to determine which of the following documents are required to complete the review of your application.
a' Property map fndlcaling other access,bordering roads and streets. e) Subdivision,zoning,or development plan.
bl Highway and driveway plan profile_ f) Proposed access design.
c) Drainage plan shaving impact to the highway right-of-way. g) Parcel and ownership maps including easements.
d) Map and letters detailing utility locations before and attar h) Traffic studies.
development In and along the right-of-way. i) Proof of ownership.
1- It is the applicant's responsibility to contact appropriate agencies and obtain all environmental clearances that apply
to their activities. Such clearances may Include Corps of Engineers 404 Permits or Colorado Discharge Permit System
permits, or ecological, archeological, historical or cultural resource clearances. The CDOT Environmental Clearances
Information Summary presents contact information for agencies administering certain clearances, Information about
prohibited discharges, and may be obtained from Regional COOT Ut lity/Special Use Permit offices or accessed via the
COOT Planning/Construction-Environmental-Guidance webpage http:l/www.dot-state.co.us/environmerttai/Forms.asp.
2- All workers within the State Highway right of way shall comply with their employer's safety and health policies/
procedures, and all applicable U.S. Occupational Safety and Health Administration (OSHA) regulations -including, but not
limited to the applicable sections of 29 CFR Part 1910-Occupational Safety and Health Standards and 29 CFR Part 1926
- Safety and Health Regulations for Construction.
Personal protective equipment(e.g. head protection, footwear, high visibility apparel, safety glasses, hearing protection,
respirators,gloves, etc.) shall be worn as appropriate for the work being performed, and as specified in regulation. At a
minimum, all workers in the State Highway right of way, except when in their vehicles, shall wear the following personal
protective equipment: High visibility apparel as specified In the Traffic Control provisions of the documentation
accompanying the Notice to Proceed related to this permit(at a minimum, ANSUISEA 107-1999, class 2); head protection
that complies with the ANSI Z89.1-1997 standard; and at all construction sites or whenever there is danger of injury to
feet, workers shall comply with OSHA's PPE requirements for foot protection per 29 CFR 1910.138, 1926.95, and
1928.96. If required, such footwear shall meet the requirements of ANSi Z41-1999.
Where any of the above-referenced ANSI standards have been revised, the most recent version of the standard shall
apply.
3- The Permittee is responsible for complying with the Revised Guidelines that have been adopted by the Access Board
under the American Disabilities Act(ADA). These guidelines define traversable slope requirements and prescribe the
use of a defined pattern of truncated domes as detectable warnings at street crossings. The new Standards Plans and
can be found on the Design and Construction Project Support web page at;
<http://www,dot,state,co.ua/DosignSupp0rt/>, then cock on Design Bulletins.
If an access permit is issued to you, it will state the terms and conditions for its use. Any changes in the use of the
permitted access not consistent with the terms and conditions listed on the permit may be considered a violation of the
permit.
The applicant declares under penalty of perjury in the second degree,and any other applicable state or federal
laws, that all information provided on this form and submitted attachments are to the best of their knowledge
true and complete.
I understand receipt of an access permit does not constitute permission to start access construction work.
Applicant or Agent for Permittee signature Print name Date
•
rha, 6 r{ -\ s-to ) I
If the applicant is not the owner of the property, we require this application also to be signed by the property owner or
•
their legally authorized representative (or other acceptable written evidence). This signature shall constitute agreement
with this application by all owners-of-Interest unless stated In writing. If a permit is issued, the property owner, In most
cases,will be listed as the permittee.
Property owner signature
Qs� Print name Data
Previous editions are obsolete and may not be used Pape 2 of 2 COOT Form 1137 01110
rvoccminillit
•
Ftv: —mom
WC .
CM c
•
L.!:Mill q:‘' I n . .
sco
Y
2
G
a!
V
b
as o )S
V
, ...,z4 C4
wogv a ,C • I-- _
e., ta, 0 P) a b p ---•u t F3 o ° ,. ).2
"-
rr hh
1-474 `13
1=1C/1 �" 6., H
W cip c " bi � � i-
W h 4 y •-•L` § K bQ
ato (j}
.2 (41
d "C 1.4 A O W 1I., 0
d ). aec � O4J I.,
get-
4 •a d
co
;4. Q q
A Dr L.OR ME Street Atlas USA®2006
Vicinity Map for Access Permit #411034
GPI EXHIBIT "B" Judson
OreeleyWel my
YS"tip
�. ...... I Sts Loceeon
-GirOdelCii Rona
��,]j
EaatmWaeey View/ aws:`v`a1�1 a; °FOR d34
'' „ Masters site
e114 CAA
RarorNdl�'�,' 62
IFF
.*3 eelns
e . I
A
esburg
•
Ste Leonean
tdson Prospect Valley
Rosner
Paselle&
., .. t •Hoyt
Denverite
J_-/--
Front Range
Ul •W agdns--'"".._.__�__.-...._.
nett
.,... 40 . • Strasburg 36
__.._—..
as
Aurore Akpark I -
297
40
rx Scale 1 :400,000
Data use subject to license. 'ss� - -es�
®2005 Malone.Street A9as USA®2008. ""a M1"n �_�.._ a �^
www,delorme.com 1"=6.31 mi Data Zoom 9-0
Hello