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Home My WebLink About20110398.tiff SITE SPECIFIC DEVELOPMENT PLAN AND USE BY SPECIAL DR,( PAC REVIEW (USR) APPLICATION FOR PLANNING DEPARTMENT USE DATE RECEIVED: RECEIPT#/AMOUNT# /$ CASE#ASSIGNED: • APPLICATION RECEIVED BY PLANNER ASSIGNED: Parcel Number i Li t _ O ;-1 -0- (`) (--) - ( ) , : ,V (12 digit number-found on Tax I.D. information,obtainable at the Weld County Assessor's Office,or www.co.wetd.co.us) Legal Description pc i W nr WE `1 , Section ,;.( , Township j_._North, Ranger '7 West Zone District: , Total Acreage: 13..l , Flood Plain: , Geological Hazard: , Airport Overlay District: FEE OWNER(S) OF THE PROPERTY: Name: r. ra. ',,, .. e„ (r) r iti '<I rerr Work Phone IQ,c),))9/£- yJ BD Home Phone If( o3'857-`ja93Email S CnT r a mt1ti f, Cow\ Address: ) n-7 I I i-\ A )q ;", .i Address: City/State/Zip Code &-1 , 1.—kt -1-n i,4 , C.n e O . I Name: Work Phone# Home Phone# Email Address: Address: City/State/Zip Code Name: Work Phone# Home Phone# Email • Address: Address: City/State/Zip Code APPLICANT OR AUTHORIZED AGENT (See Below:Authorization must accompany applications signed by Authorized Agent) Name: TO—vv..-e_, rO. v—C Le_ r'r v ) Work Phone f4'I3o) G l I S1oPhone/Ca Home Email p GT F0.rm r ` j'.eo , CC,.o ,o.. Address: /n-7 I I I-y u, '. ,5 Address: (� City/State/Zip Code F-E, I—,r-I-n i; m '°0/n.3 I PROPOSED USE: e I (We) hereby depose and state under penalties of perjury that all statements, proposals, and/or plans submitted with or contained within the application are true and correct to the best of my(our)knowledge. Signatures of all fee owners of property must sign this application. If an Authorized Agent signs, a letter of authorization from all fee owners must be included with the application. If a corporation is the fee owner, notarized evidence must be luded indicating th the signa ry has to legal authority to sign for the corporation. ce.p.. • Sig re: Owner or Authorize Agent Date Signature: Owner or Authorized Agent Date ff�\JJII -6- EXHIBIT a 2011-0398 Ubt2-f'7Wo --3P1)L _ '/t/,! 1 f �/ A 5c6/ • / 4 OL ' �� l6 5C �/ :✓ S - : e 5 7) 7—A k /� S � � Y� l EL , , i1/r 41y L 1 c,9 /-1-7) AJ le gE.,,,/a J / - _ a // JL I J SITE SPECIFIC DEVELOPMENT PLAN AND USE BY SPECIAL REVIEW(USR) PROCEDURAL GUIDE SUBMITTAL CHECKLIST APPLICATION REQUIREMENTS: • One original application form (additional copies may be required,on request of the Department of Planning Services) LO One copy of the Special Review plat map (24"X 36")-see attached page eight for map requirements c LAS-\ n cn+<Si ✓ One 8-1/2"x 11" reduced copy of the (24"X 36") Special Review plat f-a'5 C 2S ea 1 1 \ NI r 1 kb e-lckfa One digital or electronic copy of completed application materials, if required / One original Special Review Use questionnaire ,---#../One original Weld County Access Permit Application Form, if required. Clearly indicate all existing and proposed accesses (residential, agricultural, oil and gas, ditch, etc). One copy of document showing evidence of adequate water supply (e.g. well permit or letter from water district). If using a well, please complete the attached Water Supply Information Summary. - 1pplicc r- Qx t -n1q� '}n q ✓ I Y. D� W 0.`W gubvrUS -OIZ One copy of document showing evidence of adequate sewage disposal (e.g. septic permit or letter from the sanitary %. sewer district) r 1�c,.a c,s C on One copy of deed or legal instrument identifying applicant's interest in the property ✓ One original Certificate of Conveyances form and any attachments, completed within thirty days of the application submission date ✓ One copy of affidavit and certified list of the names, addresses and the corresponding parcel identification number assigned by the Weld County Assessor of the owners' of property(the surface estate)within five hundred feet of property being considered. This list shall be compiled from the records of the Weld County Assessor, the Weld County Website,www.co.weld.co.us.,or a person qualified to do the task, and shall be current as of a date no more than thirty days prior to the date the application is submitted to the Department of Planning Services. Ic4C✓One original Emergency Information Sheet(for Commercial only) -beot-w- • II/A Notice of Inquiry if located within an Intergovernmental Agreement(IGA) boundary Application fee NIA Investigation fee, if required (fifty percent of permit fee) QPreliminary Drainage Report _ Loc•-7-e.c.�' p W T't._ ' (,Jc,-\-ts- r w11 __ �Zc 2 c),)-- N I 19 Preliminary Traffic Study— es- cp , 41OIles cap, VARr\. ?G`1 r 5rt.\ 47 Waste Handling Plan J/ Dust Abatement Plan Flood Hazard Development Permit(FHDP) Geologic Hazard Development Permit(GHDP) Special Review plat recording fee($11.00 first page + $10.00 each additional page) Packets shall be bound with either paper clips or binder clips (no substitutes). Applications bound in any other fashion may be returned to the applicant without review. The applicant shall submit 4 packets for a 7 day completeness review in the order listed below. Packet 1 will contain one original of all of the above Packets 2—4 will contain one copy of all of the above updated 07-15-10 • SITE SPECIFIC DEVELOPMENT PLAN AND USE BY SPECIAL • REVIEW (USR) QUESTIONNAIRE The following questions are to be answered and submitted as part of the USR application. If a question does not pertain to your use, please respond with "not applicable", with an explanation as to why the question is not applicable. 1. Explain, in detail, the proposed use of the property. 2. Explain how this proposal is consistent with the intent of the Weld County Code, Chapter 22 of the Comprehensive Plan. 3. Explain how this proposal is consistent with the intent of the Weld County Code, Chapter 23 (Zoning) and the zone district in which it is located. 4. What type of uses surround the site (explain how the proposed use is consistent and compatible with surrounding land uses). 5. Describe, in detail, the following: a. Number of people who will use this site b. Number of employees proposed to be employed at this site c. Hours of operation d. Type and number of structures to be erected (built) on this site • e. Type and number of animals, if any, to be on this site f. Kind of vehicles (type, size, weight)that will access this site and how often g. Who will provide fire protection to the site h. Water source on the property (both domestic and irrigation) Sewage disposal system on the property(existing and proposed) j. If storage or warehousing is proposed, what type of items will be stored 6. Explain the proposed landscaping for the site. The landscaping shall be separately submitted as a landscape plan map as part of the application submittal. 7. Explain any proposed reclamation procedures when termination of the Use by Special Review activity occurs.— /J(A- 8. Explain how the storm water drainage will be handled on the site. 9. Explain how long it will take to construct this site and when construction and landscaping is scheduled to begin. 10. Explain where storage and/or stockpile of wastes will occur on this site. • -7- • Site Specific Development Plan James Terry 10711 Hwy 52, Ft. Lupton, Co 80621 Legal Description PTW2NE4 Section 2, Township 1 North, Range 67 West 1. We propose to build a Dog Breeding Kennel on the existing property. We plan to build a 12'X112' kennel with heating to house approximately 99 dogs. We intend to breed top quality AKC dogs for sale. We plan to ship purchased dogs to their new owners and have minimal sales from our location. 2. This is consistent with Weld County Code, Chapter 22 as the kennel will maintain an agriculture aspect to the existing farm. The present farm will remain the same in size and operations while only adding a dog breeding facility. This is a rural based small business and it will maintain the high quality rural character. There are existing trees and • bushes surrounding the proposed kennel and provide a visual rural landscape. The farm has one share of water from the Brantner Ditch which will be used for the landscape as well as the farm land. The well on the property uses a non tributary aquifer the Larimer-Fox hill aquifer. This well will provide the water for the kennel. 3. This farm is zoned agricultural. This proposed Special Use Permit is consistent with that zoning. Breeding dogs is an agricultural type operation. There will be little impact on neighbors as the closest residential neighbor is about 1000 feet away. This is a family business and run by family members. There will be little additional traffic into the farm. 4. The farm is surrounded on the south by farmland, no residences. On the east there is farmland with a residence located 1760' from kennel location. To the north about 900' there is a business, Nelson Pipeline, which has operation hours 8am to 5pm. Their offices and shop area are located in the middle of farmland. To the west is a residence approximately 1000' and surrounding farmland. Our proposed kennel is compatible with the surroundings as it is very similar to any livestock operation and is therefore consistence with the surrounding farmlands. The dogs will be brought into the building and confined at • night for their safety and noise reduction. 5. a. When dogs are for sale there may be one car per week approximately 2 people per week visiting our location b. This is a father daughter business and they will take care of the day to day operations. There may be one employee hired on a part time bases. c. Proposed hours will be 12:00 to 4:00pm. Monday through Friday d. One kennel 12'X112' will be built. Concrete floor, wood siding, asphalt roofing. e. 99 dogs will be the maximum number at the kennel f. Family vehicles of prospective dog buyers may visit the site once a week. g. Ft. Lupton Fire Department h. One share of the Brantner Ditch will provide water for the surrounding landscape. The existing well on the property will be used to provide water for the kennel. The well is a non tributary aquifer, the Larmier-Fax Hill aquifer. • i. The existing septic will be used. It is used by 2 people daily and a projected possible additional 2 people once a week. j. N/A 6. The landscaping will remain the same. It consists of several large trees and shrubs and wild grasses. 7. N/A 8. The water running off the roof of the proposed building will run to the north and north east sides of the building. In to the existing trees and shrubs and be absorbed into the ground. 9. Construction will take approximately one month and we hope to begin as soon as our Special Use Permit is approved in 90 days. 10. There will be no stockpiling of waste. Dog waste will be placed into a dumpster. The dumpster is picked up weekly. S U ! ro1/4.: 4;:kzt a... , _i__ , , .4 : 0 He._,,, ___4.-1 • \.„) 0 s. __, ___, ` `alIl F 12 'c.,, --.. e+1\ I t,1- 1 e : • x &---x J o S ) ....-21 _ �' ` (; , r 1.2° rfri j li <X`-E≥ _j • 4 , J1 • L } Ji ff � I r)• iti ;I. -� ; ---0 r ,( 1L go OS, al 400 41, �.. w. . z i t 40 c. 3 2 -I-- IfQ. /vr- - 1 - 1'--+- --., -., _ -- - ..... _ - a r .r / , i /.' i: 'Ns /7_4 10 i .-%-____, ' `y' 1. -- Z , , i I • • i - .-..- ei. - I 1 , �` • I• i ic/e% / • Number of People Visiting Site We estimate an average of one car with 2 people per week will come to purchase a puppy at the kennel. We also expect to ship and deliver puppies to their new owners and there by reducing the number of people coming to the kennel. • Waste Handling Plan Dog waste will be removed from the dog runs daily and placed into a dumpster. The dumpster is emptied once a week. 4 COMMERCIAL AND RESIDENTIAL DISPOSAL INVOICE/STATEMENT YOIjR-WAY PLEASE REMIT PAYMENT TO'.YOUR-WAY DISPOSAL, INC. P.O. BOX 29773 SPOSAL, INC. THORNTON, CO 80229-0773 P.O. BOX 29773 IIIITIORNTON, CO 80229-0773 (�,� (303) 289-2595 :.;He Ys CUSTOMER PO.NUMBER A BILLING DATE CUSTOMER ACCOUNT L.ME 3 '. O H .. n' AMOUNT BILLED Total to Pay . 6 . , , ;-?T';,,m Cr _. AMOUNT ENCLOSED SERVICE _ SERVICE - PAYMENTS BY CREDIT CARD ARE NOW ACCE LOCATION ` li ' . ` ''L Y")�( PERIOD AUr�;)'p� , ;%HICJ PLEASE DETACH TOP PORTION AND RETURN WITH PAYMENT SATE TICKET NUMEE sE wce SIZE SERVICE •IS••SAL AMOUNT E i t Aar ..;a - A /D o V irY 5 am--` ,� Period I,,,U ' r � ._ payment , Sa -, , n-\ 11 . 9,11 i ?;m:_,ur,", Due A-ADDITIONAL REFUSE B.BULK C-CREDIT&ADJUSTMENTS E-EXTRASERVICE L-LUGGER MMISCELLANEOUS 0-OPEN TOP PPACKER BOX 0 EQUIPMENT CHARGE H-RECYCLE CHARGE 5SLUDGE 'OUR-WAY DISPOSAL,INC. TERMS: NET 10 DAYS. LATE FEE ADDED FOR ALL PAYMENTS RECEIVED AFTER 30 DAYS. P.O.BOX 29773 $30.00 FEE FOR ALL RETURNED CHECKS. THORNTON.co 00229 0773A FUEL SURCHARGE MAY APPLY. (303)289-2595 82-26/)070 1609 JAMES TERRY 0922004462 10711 HIGHWAY 52 FORT LUPTON,CO 80621-8427 DATE g‘—0? 303-857-7293 yD � ct � LU I $ PAY TO THE ORDER OF q DOLLARS LJ P 50 CHECKING PLUS First National Bank MOO)482 TM Mctio � - - Dust Abatement The kennel will be built in an area surrounded by trees and natural grass. Dog runs 3'X8' will exit the kennel. The runs will have pea gravel covering. The surrounding landscape will remain the same with trees and natural grass. This is irrigated with one share of water from the Brantner Irrigation Ditch 204 COLORADO DEPARTMENT OF AGRICULTURE 1 �j- r ' / .I c"-ii -.- 7 't ANIMAL INDUSTRY DIVISION 700 KIPLING ST..SUITE 4000 LAKEWOOD, CO 80215 TELE: 303-239-4161 PET ANIMAL CARE FACILITIES LICENSE APPLICATION 1111 New Application Renewal Application PERSON'S FULL LEGAL NAME: LAST (_', Y I I FIRST i LS (l vv, 42 M.1. BUSINESS NAME(S): I , i I , , I II MAILING ADDRESS: CITY: { 1 , ' STATE: [ z ,, ZIP: I i� ,r,. . I FACILITY ADDRESS: I , I c" - -IZIP: f CITY: COUNTY: STATE: ' ; ( .1 APPLICANTS PHONE NO I n R) Iee[,'';-'f I I,)' Y FACILITY PHONE NO.: I -' -, ' v ' EMAIL ADDRESS: I y • ( LICENSE CATEGORIES WITH FEE SCHEDULE:PLEASE CHECK AS MANY CATEGORIES AS APPLY BELOW: (See second page for further information about each category) CATEGORY FEE CATEGORY FEE F RETAIUWHOLESALE (live animal sales only) $350 (- DOG BREEDER (Large Scale Operation) $350 RETAIL AQUARIUM ONLY $320 I- CAT BREEDER $320 Sr BOARDING/TRAINING $350 1." COMMON BIRD BREEDER $175 "- PET HANDLER $175 f- UNCOMMON BIRD BREEDER $275 I" NETWORK BOARDING ,,- ,.Na ' P.,. , ,i.,}t ' cia -- PET GROOMING � " 1794 FERENGI ENTERPRISES, LW. 23-7/1020 IC 1 DOG BREEDER Small s 8a5a 84TH CIRCLE303-91a-7406 nit. '� ( ARVADA,CO 80006-2340 Explanation of fee schedule: If more than C J 61 O highest fee. Example:A pet facility selects I DATE ($345.00). The fee amount due with this appl /i indicated on this application. This example al PAY TO THE C"f� I $& -3 ' I' "I am aware that your agency does not nullify of ORDER OF U� ' to find out what if any,local laws orordinances i ��(f LA� /'� - Dou.Aus 8 r, ST Please initial you have read and agree u o of Has the applicant or applicants principals,pai n,.,,,,, rib r 9akNA federal law pertaining to cruelty,neglect or ab I vrcii,ra„acem _ �j l Has the applicant or applicants principals, specifics. Pon 06 aIJi f1�-S(d, ' I wish to be notified by PT mail or r- elect Facility times of operation:Days: r M ( Tu ;> W I - Th II F Times: r 8am I 9 10 r 11 X 12pm r 1 r 2 3 4 r 5 NOTE: IN ORDER TO PROESS THIS APPLICATION FULL PAYMENT,CITIZENSHIP OR CORPORATION INFORMATION,AND FACILITY PLANS(FOR N TIES ONLY)MUST ACC PANY THE OMPLETED APPLICATION FOR VALIDATION. Please make checks or money orders payable to CDA. Sign ure of pplicant Date Enclose Full Amount 0co� Ex .,�� A-CCe5S �V _ y� Weld County Public Works Dept. s -4, 1111HStreet ACCES ERMIT ` ? P.O. Box 758 s 1 rn -,�Q� Greeley,CO 80632 APPLICATION FORM Z/C 44O Phone: (970)304-6496 Fax: (970)304-6497 Applicant Property Owner(If different than Applicant) Name �O-y".`0`, rn_Kt 'erf.1 Name Company I Address Address 10- I I 1"l i..h� v i-)_,, City State Zip City rt. 1... , .4A (Dv.- State C00 Zip 8'0 6 -I Phone Business Phone c x fl 18- -1 ti Ott, Fax Fax E-mail E-mail v g¶ (0.If r, ® Y0.-y..ea , C.t r.-.. ♦=Existing Access A=Proposed Access Parcel Location &Sketch The access is on WeR- C.2 I-1 .i 3-✓ n i Nearest Intersection: 6a- &WCR Nt?Lor- Rd wew6t1 52 ir Distance from Intersection DO - e.ar Parcel Number :FE I tI IQ 9 0 eck 000 O 76 k\e Section/Township/Range a / 0 1 / &"7 t - • Is there an existing access to the property? 0 NO N Number of Existing Accesses 2 iii Road Surface Type &Construction Information Z Asphalt )( Gravel_ Treated _ Other WCR Culvert Size &Type Materials used to construct Access !"/n y S to_1-sc Construction Start Date C/o?/ /oajnish Date Proposed Use o Temporary (Tracking Pad Required)/$75 o Single Residential/$75 o Industrial/$150 o Small Commercial or Oil&Gas/$75 o Large Commercial/$150 ❑ Subdivision/$150 o Field (Agriculture Only)/Exempt Is this access associated with a Planning Process? o No o USR 0 RE 0 PUD 0 Other Required Attached Documents -Traffic Control Plan -Certificate of Insurance -Access Pictures(From the Left, Right,&into the access) By accepting this permit,the undersigned Applicant,under penalty of perjury,verifies that they have received all pages of the permit application;they have read and understand all of the permit requirements and provisions set forth on all pages;that they have the authority to sign for and bind the Applicant,if the Applicant is a corporation or other entity;and that by virtue of their signature the iipplicant is bound by and agrees to comply with all said permit requirements and provisions,all Weld County ordinances,and state laws egardin; cilities construction. Signature t r /a Printed Name .1/174e3 l 12110ZYDate?-a 0 - aow Approval or le ial will be issued in minimum of 5 days. Approved by Revised Date 6 /10 07/30/2010 08:30 970-350-2207 CDOT UTL SAFETY PAGE 02/09 COLORADO DEPARTMENT OF TRANSPORTATION Coon Penns No. 402042 STATE HIGHWAY ACCESS CODE SH/S/MR • 5214/0113.170/LNOTICE TO PROCEED j"'' `"°" Weld County Permittee(s): Applicant; James Grant Terry Nelson Pipeline Constructors 10711 Highway 52 6215 Colorado Boulevard Fort Lupton,CO 80621 Commerce City,CO 80022 303-857-4293 303-289-5971 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 hes 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 construotion, 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 Pernik. 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. None Municipality or County Approval (When the appropriate local authority retains issuing authority) ay Title Date (X) This Notice is not valid until signed by a duly authorized representative of the Department Colorado Department of Transportation 6y rata _ Date (x) gala HetCt A AC Ce�S�4' (0/Z(vr0)_ fay DI :Required 1.Region Perron see 2.Stan Amens Seddon. As needed:Loos! TCE Patrol, I 1288 W98 07/30/2010 08:30 970-350-2207 CDOT UTL SAFETY PAGE 03/09 CO WRADO DEPARTMENT OF TRANSPORTATION COOT Permit No. STATE HIGHWAY ACCESS PERMIT 402062 illState Highway NonApF9lde 52A/018.170/L Permit tee Pate of tranendltal Regb&SectlorvPamol Local JWdediotlon 100.00 06/26/2002 04/01/14 Weld County The Permittee(s); Applicant; Ref No.2002 James Grant Terry Nelson Pipeline Constructors 10711 Highway 52 6215 Colorado Boulevard Fort Lupton,CO 80621 Commerce City,CO 80022 303-8574293 303-289-5971 is hereby granted permiselon to have en aeceaa to the slate hlgrarey at the location noted below.The access ands be constructed,malntabbd and used in accordance with this petmk,Including the State Highway Access Code and any attachments,temps,conditions and exhibits.This permit may be revoked by the issuing authority a at any time the permitted access and Its use violate any parts of this permit The Issuing authorlly,the Department and their duly appointed agents and employees shat be held harmless against any action for personal Injury or property damage sustained by reason of the exercise of the permit Location: The access is located on State Highway 52,a distance of 898 fiat east from Mile Post 18 on the nortlfieft side. Access to Provide Service to: Maintenance Facility/Shed for Pipeline Company......_..___...,,.„, 20,000 Sq Ft 100.00 % Other terms and conditions: *See Attached Pages 2 and 3 and Other Enclosures for Additional Terms and Conditions. ' 0 MUNICIPALITY OR COUNTY APPROVAL Required only when the appropriate local authority retains issuing authority. By Date Tice (x) Upon the signing of this permit the permittee agrees to the terms and conditions and referenced attachments contained herein.All Construction shall be completed in an expeditious and sate manner and shall be finished within 46 days from initiation.The permitted access shall be completed In accordance with the terms and conditions of the permit prior to being used. The pennittee shall notify Troy Sparks with the Colorado Department of Transportation in Fort Lupton at 970-500- 49.53 at least 48 hours prior to commencing construction within the State Highway right-of-way. The person signing as the pemnatee must be the owner or legal repree latve of the property served by the permitted access and have hi authority to accept the permit and Its tams end Date (x> /kW-ft -----1.---/24--r1 (9/91-(2/0 01. This permit is not valid until signed by a duly authorized representative of the Department. COLORADO DEPARTMENT OF TRANSPORTATION Ry Oats(of issue) Title (x) tilt- I 19L2_69 10;-- Assistant Access Manager Capy'�N utQA� � MaeLaps Aept$rllya inept*,t necessary Prams rates as obsoleteCOOT Peer Ina ass (\ tappemrt MTCE Patrol Trees Engthrr . S.auff After Seism 07/30/2010 08:30 970-350-2207 CDOT UTL SAFETY PAGE 04/09 g ft d !Wei 8 f � 8i Ihi;jjtl!Iti Ala - li .+tic o a `th§ ib gis ""g a a li p 1 ail !gl magi ulfi lip] p " st •p . 9 l G o a S 4qpIi c :fig gsm o8 �3 a Pg 8Na I bk£ tqp(�' ;5. e 4 A214 12i tilaiiii iAll :i Iiiiinrilifill i 11 itIlla hilt` i 101;1 114ligitil/Aldi i • IN115111 fh :1188 iftrui Ati Viti2Ar .a ; l�illi ti k iIii ,ii:E 11 zap g!Illithilifillil OP 111'211151 141 la /nil Q. ! i ' • j ii ' ail2 11 eli !ill iiiiii 1:1 '4 q .-.1 m C 1 'Si €g1 qt1 " 24['811 e2/ Y PLrt 5y+ $41 -mpO5 r� Int b I Ih R t _ $ I! innt4ttil 3.1 E. S11111mm : y Wg 8q.-. �FU._ i0 p iW W: 1 Ii a gl 2. is r s;� &s� .� a .ail; ii i'!rrI ti i gg is ii iln1th9 22g<z2 t0 [2 Sill! iiii!iiifl g W � R H I2 of iig11' ! litill 1 LI tt{"I n' tfl ilt)- iant ! 1 4 jflJ1H. � IJ!IdijIIl• ] 111111 iIiII 07/30/2010 08:30 970-350-2207 CDOT UTL SAFETY PAGE 05/09 jg pil 41 n # . 151 Ili II .s E Lti g NM ti ieni_� ! Aa: fl Ri$ 11111 diljliji !pi ' il 12 1111101_hit ;HO I �. I ° al kg. 5 Ii. IIIIJI l 1g� a1 III 1�' a. IIS ill ion a7.2 .e!iit boill hi : 12: i III ., ill " I gillithi it il frill;111111211 c,„.1 Ili' gib plig Oil ; P ililrilti i gim g VIII ! la ubisel i mgt •1. i . . z t r . mc4li dill g � bgsi � .t� o . A. W2 a s i i;m qt g3 P � .. _ �°11• Y 6op CC 4� •+ g cccc q m ij � mle .t - �1 = m i gEf0 ! i ggit m iigilli tl g am 41 I$1i 'WA/ a 81 1191 s1 C s 8 . U .E st gif; $i is m 311k1 nitride! � gym � • i ;211111 v I k iii i 21 kflaseiga.;41 s iii! f f 5 ii YS6 . t $ i a$ I gEu 5 JjjijIPn1us f$ iti 8rhs !4ts!tjtiJ4J.{ g.` 1 Sei Es fA � _ flljlji _ Qbs lit ; t ¢ t o .� ¢ $ C o Ch 11111 u ftgt AjW .! � m1II( SS662SS • at a al i5 (uli o 0o a61 . �: n1 07/30/2010 08:30 970-350-2207 CDOT UTL SAFETY PAGE 06/09 State Highway Access Permit Page 1 Attachment to Permit No. 402062-Additional Terms and Conditions • 1. If there are any questions regarding this permit,please contact Gloria like-Idler at(970)350-2148. 2. The Permittee shall refer to all additional standard requirements included with this permit and any enclosed additional terms,conditions,exhibits,and noted attachments. 3. 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 with Vicinity Map 4. This pennit 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 exisiting and anticipated future conditions. 5. Access construction methods and materials shall conform to the Colorado Department of Transportation Standard Specifications for Road and Bridge Construction(current edition). 6. 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. • 7. 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. 8. 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 reperis. 9. The Department retains the right to perform any necessary maintenance work in this area. 10. Backing maneuvers within and into the State Highway right-of-way are strictly prohibited. All vehicles shall enter and exist 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. 11. The Pennittee 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 Pennittee. 12. 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. 13. No work will be allowed at nigh;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. • 07/30/2010 08:30 970-350-2207 CDOT UTL SAFETY PAGE 07/09 State Highway Access Permit Page 2 • Attachment to Permit No. 402062-Additional Terms and Conditions 14. Traffic detours or lane closures will not be allowed,unless pre-approved by the Department. 15, Two-way traffic shall be maintained throughout the work area at all times unless specific written authorization is obtained from the Department. 16. No construction vehicles shall be parked,or construction materials/equipment stored,on the State Highway right-of-way overnight. 17. Landscaping and site construction shall not obstruct sight distance at any State Highway access point. Landscaping within the State Highway right-of-way requies the Permittee to obtain a CDOT Landscaping Permit from the Maintenance Section. The access permit does not authorize that activity,although a proposed landscaping plan shall be included in the access permitting document. 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 Denny Volz at the Evans Maintenance Office, (970)506-4971 to obtain the Landscaping Permit. I S. 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 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. 19, 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. 20. Survey markers or monuments must be preserved in their original positions. Notify the Department at(970) 350-2 t 73 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. 21. Should any excavation encounter plant ot animal fossils,the remains of historic or prehistoric structures, artifacts,(pottery,stone tools,arrowheads,etc.),the work shall be stopped and the Perini tree shall notify the Department inspector. 22. The Permittee or the contractor shall nosily Troy Sparks at(970)506-4972 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 23. Whenever the work will affect the movement or safety of traffic,the Permittee shall develop and implement a construction traffic control plan,and utilitze traffic control devices as necessary to ensure the safe and expeditious movement of traffic around and through the work site and the safety of the work force. The traffic control plan shall be prepared by an American Traffic Safety Services Associaton(ATSSA)certified individual,a Colorado Contractors Association(CCA)certified individual,or a professional traffic engineer hi conformance with the Manual on Uniform Traffic Control Devices,and other applicable standards, A copy of the approved traffic control plan must be on site until the work is completed. • 07/30/2010 08:30 970-350-2207 CDOT UTL SAFETY PAGE 08/09 State Highway Access Permit Page 3 Attachment to Permit No. 402062-Additional Terms and Conditions • 24. The Department inspector may suspend any work due to: I)Noncompliance with the provisions of this permit;2)Adverse weather or traffic conditions;3)Concur art 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. If highway fight-of-way fence exists or is proposed,the Permittee must contact at the Maintenance office, ,prior to any removal or installation. 26. The access shall be constructed feet wide with foot radii. 27. Construction traffic control devices,when not in use,shall be removed or turned away from traffic. 28. The access shall be reconstructed perpendicular to the travel lanes of the State Highway for a minimum distance of 40 feet,and shall slope down and away from the adjacent pavement edge attune of 2%grade for a minimum of 20 feet. 29. 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. 30. Any access gate shall be set back so that the longest vehicle using the access can completely clear the traveled way when the gate is closed. 31. All required access improvements shall be installed prior to the herein authorized use of this access. 32. The access shall be resurfaced immediately upon completion of earthwork construction and prior to use. • 33. No paved surface shall be cut unless specified in this permit. Asphalt removal shall be saw cut to assure a straight edge for patching. 34. 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. 35, The Pennittee shall install a new 18 inch reinforced concrete pipe and shall provide for proper side slopes. Culverts over 18 inches in diameter shall have end sections. 36. 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. 37. 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. 38. The Permittee shall request final inspection by Troy Sparks at(970)506.4972 within 10 days following completion of across construction,and prior to authorized use. The Permittee or their representative shall be present. 39. 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 resuh in the immediate suspension of work by order of the Department inspector or the issuing authority. 40. The design and construction of access and/or development of this property shall not negatively impact adjacent nearby properties. Correction of the problem and cost resuhing from damages shall be borne by the Permittee. • n/raorznio nn:an 1/tl-eoa-zL / cLJI ult. ain't!? rOUt VW'CU 9703 CDOT TRAFFIC 166 P02 APR 19 'rc4 10:03 . COLORADO DIMRTWNT OF TRAN6llRTATION . tuba sett epplrtlr STATE HIGHWAY ACCESS PERMIT APPLICATION ma.m widaw.wv1dv/oZ Inwnions: . contactthe Detriment of ltangfertadon Of your goal government to determine yow Issuing authority. - contact the issuing authority to detemine what piens and otherdtoumsms are required to be submitted • with your applioatIon. - complete dfe form(some questions may in appy o you)and Salt all necessary documents and wbntk it to the Ruing atanity.9ubma Si eppgagbn for each access tasted. - I you have any questions oohed the Sing Shorty Plait prim or type I)Preps,en Nieman's)'^ gat Ton 40N PIPBLINE CONSTRUCTOFS tent a ss10711 Hiphwa9 52; Ft. Lupton CO 62y15 Colorado Elva Commerce City (0 suteSS , plume Fria aaap e, Colorado 80621 03.857.4293 Colorado 80022 1303.289.5971 a)Para d laesl'M a sorbed by peace rap 10711 Hwy. 52; Ft. Lupton & a new business Ceti oaw+ee.Sews p- I.awme bank r awem . 1 was Sr mvartawshldway wyaunpns*i rasa � mw -2765 ) Lot wnawe" 1 North ) 67 _ H o Paw N 4 8 q 8 O W - l'itShway 52 mmylathe*pgwdeawumli�rmMneedmkr pawl IewergMam teeprepaidawestram Mw ns tSewabet MUSS a e ww)ham;MP Ia 1120 pea(art N e E©l honas.2d C.R. 23 It ataeeayewreeeaaga a new access O temporary ants Ii hnprovenent to existing access XX flange In arses use 0 removal el swiss i Wiadut essmaticawtomSimmsear ossASsolont June 1 2002 ten a.yeu rem Fie tags al wa awe Npo.a soma pay aware its prosry.w agwm wavwew(n which rm new• hMmat. Oro ID yes,e Yes-valet yebw Fermi numbega)7:400093 enter,pemeoae:9/18/2000 fl)Doss eslgwyaww own r swains h lws swai al.MoMapegryt M■ r Be m no O yes,I yes-plebe desalt: na)MMemocisecormw welaaaseses.rows,tits,noun eamtew Savoy aw$*this nowt a no 0 MS,Kra-110 them on your pis and bkRotle the proposed end SOS awes poses 14)Ilyeu w Awe*aatmrndd et Pants' anus skim Sea its one end manbardhaajwwr ad p..01.Se by ow ruwkewpa&ntA. — sr Usage taalAns cementAcsw. Total Facility ko.000 Office Solace 17.000 I N 1.ntenance Shoo 113.000 1A)PM AS tsetrwe salarasd at a aver-haw a.te writswainamyl • N/A Symms ma4L&l development is.showe.Ypslimithnrk.*not ewmtwem end number clunks? tee numbs.Oen we N/A Awdwdrr I I I I tat Pans.en blowing M a muntssthalssbwddw that wews the wawa,Laving Is prpwythen iswmrq Is aarumr Indeaakycurccwww AM/Pill peak haw vohmts or O averaq dady volumes. I MP.W]�wWZwa opts simsans -pods kwawri nine haawww ewe awwa.dndw awww want d se was. 2Indndhd/ir W�bleweryrmy tew dew Shying e rrn nm md apirsdm tat**twwsafyaurrppliselan2 4 . t)a Was.should benoinceaan WS eel ®(a� mglwgadeaewyPlanWO s. CT Prwwgdneeln d Onlrepplansh ttaawwama.,hadwlrgmaawaw.w. W whq Nita Fishtails," (�pgJP rd wmwaromeroududhs wrmww. ��71 Msprtdmwm allig MbheMomhahomwdeM al egdhewdssisks30 m. arwapmsrehand Wye_tRwaayt p hats art pea. (lrylut Mwa7aalmaro wMlawmpYn S Phial areeweh Iiranas. II an OWNS permit Is Issued to you a wet slew ma Why and°MOUS,s for Is use.Any changes In the use of the permitted axes not cenehbnt Mt the tens and condition listed on the permit may be considered a violation of the permit The applies declares let penalty of per(ury in the second degree,and any other applicable stets or federal laws,that an Information provided on We form and submitted adashmohW are to the beat of their knowledge tone and complete. Applrnh a 6 Set. PrrsJdjwi' r c //o/oe-- II the tippets is not the trent of the worst we require ides appgadon also to be signed by Ira properly owner ortheir legs eutlndsad representative(or diner acceptable written evident).This signature nee constitute agreement with this application by ell ownareof4rnrnt unless aped In wrlire.If a permit le authorised.the Properly owner ben be lewd as the penal... aawrbtrrer Simi a-n's ‘ ..5-P•AO ^Os7., • wwbwwwe epplam..rw.r.d awT1400 amt wee FOR COMMERCIAL SITES, PLEASE COMPLETE THE FOLLOWING INFORMATION BUSINESS EMERGENCY INFORMATION: • Business '1 Name: 2 v �1 �(�_Y r�S e %,\t.¢ ' Phone: C3 03 f 18— 7 'T D �P Address: J Business O ) I I N �tAia Ca--A City, ST, Zip: 1+. �- ieO#o es. r��'Q Owner c \cL � \ l9Mt.+_ `-P Vr Phone: c ? O3 Gov 7— "td1 jj Home Address: ) O —) ) ) Awl- City, ST, Zip: rif,. H040 h c C Zv o2 List three persons in the order to be called in the event of an emergency: NAME TITLE ADDRESS PHONE lam- ' Pcss-4--k c r X.C73 w l ((3 Oa)9 ids 1.1,s2 ci c uct`—`C'&- (363) 90K-3 a45- Business �� Hours: / a boo -An q do Days: / lor\clo..Q � krw Fri, A tAAAll Type of Alarm: (lone)Burglar Holdup Fire Silent Audible 0 Name and address of Alarm Company: • Location of Safe: Ad 4 lffflf#ffN4f4f1f1f4f44Mfffiffi11fi44444#f4f444144Mfe4ff4Hff4fff4f44444k444Mf#444fi44441MMM MISCELLANEOUS INFORMATION: 11 `` ff Number of entry/exit doors in this building: 02_ Location(s): 6 ( 11,,"1,. E NO r TL 6; d -eS Is alcohol stored in building? Location(s): Location(s): WOAre drugs stored in building? I D Location(s): Are weapons stored in building? ("o Location(s): The following programs are offered as a public service of the Weld County Sheriffs Office. Please indicate the programs of interest. Physical Security Check Crime Prevention Presentation UTILITY SHUT OFF LOCATIONS: Main Electrical: Gas Shut Off: Exterior Water Shutoff: Interior Water Shutoff: • -12- Hello