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Home My WebLink About20103466.tiff PLANNED UNIT DEVELOPMENT (PUD) FINAL PLAT APPLICATION FOR PLANNING DEPARTMENT USE DATE RECEIVED: RECEIPT #/AMOUNT# /S CASE#ASSIGNED: APPLICATION RECEIVED BY PLANNER ASSIGNED: Parcel Number 0 Cp - o Co - i - O - C 1 0 (12 digit number-found on Tax I.D.information,obtainable at the Weld County Assessor's Office, or www.co.weld co us) (Include all lots being included in the application area. If additional space is required,attach an additional sheet.) park o 4 tlz N Yet— Legal Description Lo* o-c Vii` - 40 4Z , Section Co , Township 4- North, Range 6°O West Property Address(if Applicable) Existing Zone District: P V 17 Proposed Zone District: Total Acreage: 3 I -7 Proposed#/Lots 1 e (14,2adows Average Lot Size: . Minimum Lot Size: Z-9Z O.‹.. Proposed Subdivision Name: P,_,54*es Proposed Area(Acres)Open Space: Z . l o e-e. Are you applying for Conceptual or Specific Guide? Conceptual Specific X• FEE OWNER(S) OF THE PROPERTY(If additional space is required,attach an additional sheet) Name: ScL\U. v— sic Work Phone# Home I6 hone#'37c.-53Z- 3o tog Email Address Address: Z5o5 Cou��`� City/State/Zip Code L off/e \0.v`c1 , C D SOS 37 APPLICANT OR AUTHORIZED AGENT (See Below:Authorization must accompany applications signed by Authorized Agent) • Name: S C,��a e L v' \\v ._' c Work Phone# Home Phone#970--53Z -%,(4 Email Address Address: Z3 SO 5 oo-� 3 City/State/Zip Code \.--6v e\0.� ti C..0 80 5 3Z UTILITIES: Water: L irk e �-' o v S o ��o,'•�e\r �$ICY'i c-k Sewer: \v,a t 7.-3V1v`Q -. (. u o_k S e Pk\c Gas: Xc • Electric: ?CC e. Phone: Qt.,'e s Jr DISTRICTS: School: 02Z Post: 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 included indicating the signatory has the legal authority to sign for the corporation.I(we),the undersigned,hereby request the Department of Planning Services to review this PUD Final Plat or request hearings before the Weld County Planning Commission and the Board of County Commissioners concerning the PUD Final Plat fort crib d unincorporated area of Weld County,Colorado: "1-41—)1144/ , Sig ature: Owner or Authoriz gent Date gn ture: Owner or Authorize gent Date_ le-o ✓^ -10- PUD FINAL PLAN COMPLIANCE STATEMENT The Meadow Estates PUD final plan is in compliance with,and meets the criteria as set forth in the recorded Change of Zone plat. The Change of Zone provided for the change of use from Agriculture to Estate Lot Residential. The Final Plat and Construction Plans were prepared for a total of five (5) estates lots ranging in size from 2.92 acres to 5.13 acres,one of which incorporates existing improvements. The access for this development is designed to line up with Larimer County Road 11 per CDOT requirements,and provide for the abandonment of the existing access to the existing improvements and Oil and Gas facilities. Drainage improvements are designed per Weld County requirements and potable water will be provided by Little Thompson Water District's system. The culdesac road is designed per the Change of Zone plat and the road section has been designed per existing soil conditions on the site. QUITCLAIM DEED THIS DEED, dated this Z$ day of August, 2009, between THEODORE H. SHRAGE, TRUSTEE OF THE SCHRAGE LIVING TRUST, grantor; and THE MEADOWS ESTATES P.U.D., a Colorado nonprofit corporation, duly organized and existing under and by virtue of the laws of the State of Colorado, grantee, whose legal address is 23505 Weld County Road 3, Loveland, CO 80537. WITNESS, that the grantor, for the sum of Ten Dollars ($10.00) and other good and valuable consideration, has remised, released, sold and QUITCLAIMED, and by these presents does remise, release, sell and QUITCLAIM unto the grantee, its successors and assigns forever, all the right, title, interest, claim and demand which the grantor has in and to the real property, together with improvements, if any, situate, lying and being in the County of Weld and State of Colorado, described as follows: Outlots A,B and C; all identified on the map and plat identified as Final Plat The Meadows Estate P.U.D. recorded in the records of the Weld County Clerk and Recorder on at reception number County of Weld, State of Colorado. TO HAVE AND TO HOLD the same, together with all and singular the appurtenances and privileges thereunto belonging, or in anywise thereunto appertaining, and all the estate, right, title, interest and claim whatsoever of the grantor, either in law or equity, to the only proper use, benefit and behoof of the grantee, its successors and assigns forever. IN WITNESS WHEREOF, the grantor has caused its name to be hereunto subscribed by its Manager the day and year first above written. Signed this 28th day of August, 2009 Theodore H. Schrage as Trustee for the Schrage Living Trust � 1 eAC, By: eodore H. Schrage, Trustee STATE OF COLORADO ) ) ss. COUNTY OF WELD ) The foregoing instrument was acknowledged before me on August Zir009, by Theodore H. Schrage, Trustee of The Schrage Living Trust. WITNESS my hand and official seal. My commission expires: 7/j 6 I7o1 b Notary%Edblic v I KIMBERLY TREG®N1NG �� N e�� LEGAL DESCRIPTION: Drainage Easement for Outlot A of The Meadows Estates P.U.D. That portion of The Meadows Estates P.U.D. being a portion of the East One Half of the Northeast One Quarter of Section 6,Township 4 North,Range 68 West of the 6`1 P.M.Weld County,Colorado being more particularly described as follows: Considering the East line of Outlot A of said The Meadows Estates P.U.D as bearing S03°31'50"E and with all bearings contained herein being relative thereto. Beginning at the Southeast corner of said Outlot A thence N89°40'54"W 180.54 feet;thence S77°01'06"W 250.05 feet;thence S 70°21'52"W 90.12 feet to the Southwest corner of said Outlot A; thence NO2°37'28"W 806.56 feet to the point on a curve to left having a radius of 65.00 feet and partial central angle of 44°04'34";thence along the arc of said curve 50.00 feet;thence departing said curve$62°20'05"E 540.09 feet;thence S03°31'50"E 501.94 feet to the Point of Beginning. Said drainage easement contains 7.70 acres more or less subject to all easements,rights of way, reservations and restrictions of record or as they now exist. For and on Behalf of JL Walter Consulting Rodney A.Walters Colorado PLS 16847 ttkie ��:•�`of r,n fro � , ,s 687 a a te 1 oc1r-zsVee -O ,p tm'00 4�9 R�� COa- }� ms's ` LEGAL DESCRIPTION: Drainage Easement for Outlot B of The Meadows Estates P.U.D. That portion of The Meadows Estates P.U.D.being a portion of the East One Half of the Northeast One Quarter of Section 6,Township 4 North,Range 68 West of the 6th P.M.Weld County, Colorado being more particularly described as follows: Considering the East line of Outlot B of said The Meadows Estates P.U.D as bearing S01°0 1'06"W and with all bearings contained herein being relative thereto. Beginning at the Northeast corner of said Outlot B thence S01°01'06"W 865.68 feet;thence Si!°07'17"E 115.85';thence S20°56'17"E 163.12 feet;thence$69°03'43"W 51.38 feet;thence N27°18'24"W 26.69 feet;thence N18°30'46"W 174.52 feet;thence N65°13'01"W 159.66 feet;thence N25°46'15"E 203.40 feet to the beginning of a curve to the left having a radius 630.00 feet and a central angle of 25°46'27";thence along the arc of said curve 283.40 feet;thence departing said curve N00°00'12"W 436.67 feet;thence N89°59'48"E 44.28 feet to the Point of Beginning. Said drainage easement contains 1.74 acres more or less subject to all easements,rights of way, reservations and restrictions of record or as they now exist. For and Behalf of IL Walter Consulting Rodney A.Walters Colorado PLS 16847 ocaffirif -"4:9).%6 D rhyme I LEGAL DESCRIPTION: Drainage Easement for a portion of Lot 5 of The Meadows Estates P.U.D. That portion of The Meadows Estates P.U.D.being a portion of the East One Half of the Northeast One Quarter of Section 6,Township 4 North,Range 68 West of the 6th P.M.Weld County,Colorado being more particularly described as follows: Considering the most Southerly line of Lot 5 of said The Meadows Estates P.U.D as bearing$62°20'05"E and with all bearings contained herein being relative thereto. Beginning at the Southeast corner of said Lot 5 thence N03°31'50"W 84.15 feet;thence N09°42'43"W 135.05 feet;thence N 26°52'40"E 115.12 feet; thence N20°56'1T'W 126.95 feet; thence $69°03'43"W 51.38 feet;thence S08°06'24"W 178.18 feet;thence N90°00'00"W 210.00 feet;thence N85°21'22"W 69.99 fee thence S62°20'05"E 540.09 feet to the Point of Beginning. Said drainage easement contains 1.67 acres more or less subject to all easements,rights of way, reservations and restrictions of record or as they now exist. For and on Behalf of IL Walter Consulting Rodney A.Walters Colorado PLS 16847 , Ater -,_,.„,(v, 7 , I p,,,,,,t 1 O47 ilea %c/i-Z. .Ci74'x'QV ! � �?o�O Sit� s�,'� �' LEGAL DESCRIPTION: Drainage Easement for Outlot A of The Meadows Estates P.U.D. That portion of The Meadows Estates P.U.D.being a portion of the East One Half of the Northeast One Quarter of Section 6,Township 4 North,Range 68 West of the 6`h P.M.Weld County,Colorado being more particularly described as follows: Considering the East line of Outlot A of said The Meadows Estates P.U.D as bearing S03°31'50"E and with all bearings contained herein being relative thereto. Beginning at the Southeast corner of said Outlot A thence N89°40'54"W 180.54 feet;thence S77°01'06"W 250.05 feet;thence S 70°21'52"W 90.12 feet to the Southwest corner of said Outlot A; thence N02°37'28"W 806.56 feet to the point on a curve to left having a radius of 65.00 feet and partial central angle of 44°04'34";thence along the arc of said curve 50.00 feet;thence departing said curve$62°20'05"E 540.09 feet;thence S03°31'50"E 501.94 feet to the Point of Beginning. Said drainage easement contains 7.70 acres more or less subject to all easements,rights of way, reservations and restrictions of record or as they now exist. For and on Behalf of JL Walter Consulting Rodney A.Walters Colorado PLS 16847 . A. / 2 4i8117 2 . �aa«�w..$y�7i..V0FF�. 1.4 PUD FINAL PLAN COMPLIANCE STATEMENT The Meadow Estates PUD final plan is in compliance with, and meets the criteria as set forth in the recorded Change of Zone plat. The Change of Zone provided for the change of use from Agriculture to Estate Lot Residential. The Final Plat and Construction Plans were prepared for a total of five (5) estates lots ranging in size from 2.92 acres to 5.13 acres,one of which incorporates existing improvements. The access for this development is designed to line up with Larimer County Road 11 per CDOT requirements, and provide for the abandonment of the existing access to the existing improvements and Oil and Gas facilities. Drainage improvements are designed per Weld County requirements and potable water will be provided by Little Thompson Water District's system. The culdesac road is designed per the Change of Zone plat and the road section has been designed per existing soil conditions on the site. METHOUD OF FINANCING STATEMENT Schrage Living Trust will provide a letter of credit from its bait as collateral to Weld County for the proposed improvements of The Meadows Estates PUD. September 11, 2009 The Meadow Estates PUD ROAD CONSTRUCTION COST ESTIMATE 1. Strip and Stockpile 1689 C.Y. $ 0.75 $ 1,266.75 2. Cut/Fill 1608 C.Y. $ 1.00 $ 1,608.00 3. Subgrade Prep 5775 S.Y. $ 1.00 $ 5,775.00 4. 9"Base Course 500 Ton $ 12.00 $ 6,000.00 5. 7"Base Course 1482 Ton $ 12.00 $ 17,784.00 6. 4"Asphalt 4603 S.Y. $ 19.00 $ 87,457.00 Estimated Total $119,890.75 Declaration of Protective Covenants The Meadows Estates P.U.D. Theodore H. Schrage, being the declarant and owner of all the land in The Meadows Estates P.U.D. Lot B of recorded exemption NO. 1061-06-1 RE 4042. Located in Section 6 T4N, R68 W. 6th P.M. Weld County Colorado, as shown by a plot of the P.U.D. Dated Does make this declaration of protective covenants applicable to Lots 1 through 5 in The Meadows Estates P.U.D. Land Use I. No lot shall be used except for single family residential purposes. Placement of mobile homes shall be restricted. Preconstructed private garages, barns, storage sheds, hay sheds, R.V. sheds, garden storage sheds, and other outlot buildings may be permitted as approved by the Homeowners.;Association. No Quonset type buildings shall be constructed. II. No obnoxious or offensive activity shall be permitted on any lot and there shall be no discharging of firearms. III. No manufacturing, industrial or commercial enterprises shall be permitted, except for home occupations, conducted within the interior of the house, provided that deliveries and pickups do not exceed 5 per day. IV. No structure of a temporary nature (trailer, R.V. basemen t, etc. shall be P �'Y t, etc.) used as a temporary or permanent dwelling. V No signs or advertising of any kind shall be erected, placed,flung, etc or permitted except for Real Estate type signs, referring only to the lot on which it is displayed. VI. Landscaping for each lot shall be completed within one growing season after completion of residence. VII. Removal or replacement of existing trees along the ditch and open space is restricted by the Colorado Dept. Of Wildlife as this is wildlife habitat. VIII. Ditches and oil wells are private property also, any and all nearby properties, whether posted or not, are private property. IX. Overnight parking on the street will be limited to "guest occasions" and semi parking, large truck, etc parking will be permitted for 72 hours with no truck idling while parked. Animals I. No animals of any kind shall be raised, bred, trained or kept on any lot for commercial purposes, with exception of 4-H projects, rodeos, shows, etc. IL Small animals shall be allowed at the limits set forth by Weld County codes at the time. No aggressive animals of any type shall be allowed and dogs are to be kept under voice control or physical restraint at all fianes and shall not be allowed to chase domestic animals, livestock or wildlife. III. Large animals such as horses, cows, etc. shall be restricted to no more than 1 per acre, as per Weld County code. IV. All hay and animal feed must be inside a barn, shed or neatly stacked and covered. Each unit shall be maintained in a clean and sanitary manner, with water available to all animals at all times. Buildings and Improvements i. All dwellings shall have a minimum living space above ground of not less than 1800 sq ft for a single story, excluding porches and garages. A dwelling with 2 or more stories shall have a minimum of 280 ) sq ft of finished living space above ground. No more than 3 stories, excluding basement shall be allowed and the height is contingent on whether it obscures the view of any neighbor. II. All buildings and improvements shall be constructed of good and suitable materials and all workmanship shall result in first class consuction accomplished in a professional manner. All fences must meet set back regulations and not exceed Weld County code for height. Smooth wire for livestock enclosures is acceptable. III. Construction of buildings and improvements on any lot shallbe completed within 1 year and the builder having received the necessary state and county engineering and building permits applicable at the time of application. IV. No tanks for storage of gas, fael, oil or any material of a dangerous nature shall be erected. V. Septic tanks and leach fields shall be identified on the plot plan. Activities such as landscaping (LE., planting of trees and shrubs) and construction(I.E., auxiliary structures, dirt mounds, etc) are expressly prohibited in the designated absorption field site. All easements, ditches, utilities, shall show on the plot plan. All utilities shall be underground, with the exception of Lot #5 with the existing home. Maintenance I. Weeds must be kept cut, sprayed, mowed or removed at all times. All fences shall be kept in good repair. "Good fences make good neighbors." (Robert Frost) ii. All dwellings, accessory buildings, barns, garages, sheds, fences, etc., shall be maintained in a clean, orderly and attractive manner. No trash, litter, junk or building materials shall remain visible , except during period of construction. III. A corn on waste management agency will be encouraged to service all lots, IV. No junk cars, vehicles, equipment, or unlicensed vehicles of any kind shall be permitted, unless concealed from view. R.V.'s, travel trailers, boats, motorcycles, snow mobiles, stock trailers, farm machinery and farm equipment should be neatly parked and covered when possible or parked by out buildings. Pasturing of Lots. I The area around the residential building is not to be used as a feed pasture. The area outside the residential building is intended for animal exercise, riding area, and a minor supplement to the main food source of baled hay and commercially produced feed. II. Manure Handling The lot owner is responsible for maintaining the property as a healthy environment for both humans and animals. The owner is responsible for manure removal and shall not be allowed to create an excessively offensive odor to other lot owners, by manure composting. It shall be removed in a timely manner and screened from view. III. Regarding out lot and open space. The open space area is for exercise, riding and communal part time temporary grazing. It shall be kept sprayed and mowed and all fences shall be kept in good repair. IV. Open space maintenance shall be the responsibility of Theodore H. Schrage, owner, until 60% of the lots are sold (the 3rd lot) and it then becomes the responsibility of The Meadows Estates Homeowners Association. Rural Land Issues Lot owners should be aware that there may be a potential for nuisance conflicts from wildlife such as skunks, raccoons, foxes, coyotes, prairie dogs, and snakes. The Colorado Division of Wildlife can provide information about how to handle these situations, but lot owners are responsible for addressing these issues as they arise. IL During certain times of the year, mosquitoes may present a sgnifigent nuisance, as well as a West Nile threat. Precautions should be taken to protect you,your children and your animals. Using DEET, spraying, barn, lots and keeping areas free of standing water and puddles will help. Also present are aerial predators, eagles, hawks, falcons, owls, etc., that can be dangerous to small dogs, cats, chickens, etc. Weld County's Right to Farm Weld County is one of the most productive agricultural counties in the United States, ranking fifth in the total market value of agricultural products sold. The rural areas of Weld County maybe open and spacious, but they are intensively used for agriculture. Persons moving into a rural area must recognize and accept there are drawbacks, including conflicts with longstanding agricultural practices and a lower level of services than in town. Along with the drawbacks come the incentives which;attract urban dwellers to relocate to rural area: open views, spaciousness, wildlife, lack of city noise and congestion, and the rural atmosphere and way of life. Without neighboring farms, those features which attract urban dwellers to rural Weld County would quickly be gone forever. Agricultural users of the land should not be expected to change their long- established agricultural practices to accommodate the intrusions of urban users into a rural area. Well run agricultural activities will generate off-site impacts, including noise from tractors and equipment; slow-moving farm vehicles on rural roads; dust from animal pens, field work, harvest, and gravel roads; odor from animal confinement, silage, and manure; smoke from ditch burning; flies and mosquitoes; and the use of pesticides and fertilizers in the fields, including the use of aerial spraying. Ditches and reservoirs cannot simply be moved out of the way of residential development without threatening the efficient delivery of irrigation to fields which is essential to farm production. Section 35-3.5-102, C. R. S., provides that an agricultural operations shall not be found to be public or private nuisance if the agricultural operation alleged to be a nuisance employs methods or practices that are commonly or reasonably associated with agricultural production. Weld County covers a land area of over 4,000 square miles irn,size (twice the State of Delaware) with more than 3,700 miles of state and country roads outside the municipalities. The sheer magnitude of the area to be served stretches available resources. Law enforcement is based on responses to all complaints more than on patrols of the county and the distances which must be traveled may delay all emergency responses, including law enforcement, ambulance and fire. Fire protection is usually provided by volunteers who must leave their jobs and families to respond to emergencies. County gravel roads, no matter how often they are bladed, will not provide the same kind of surface expected from a paved road. Snow removal priorities mean that roads from subdivisions to arterials may not be cleared for several days after a major snowstorm. Snow removal for roads within subdivisions are of the lowest priority for public works or may be the private responsibility of the homeowners. Services in the rural areas, in many cases, may not be equivalent to municipal services. Rural dwellers must, by necessity, be more self-sufficient than urban dwellers. Children are exposed to different hazards in the country than in urban or suburban setting. Farm equipment and oil field equipment, ponds, and irrigation ditches, electrical power for pumps and center pivot operations, high speed traffic, sand burs, puncture vines, territorial farm dogs,and livestock present real threats to children. Controlling children's activities is important, not only for their safety, but also for the protection of the farmer's livelihood. Parents are responsible for their children. V. Irrigation ditch banks are not play grounds. Riding or playing on banks can be hazardous. Swimming or floating in ditches is unlawful as well as very dangerous. Children should be supervised at all times. Roads 1. Weld County (at this time) shall have no responsibility or obligation to construct, maintain or repair the Cul De Sac road known as Schrage Lane. The lot owners shall share equally the cost of maintaining said road, including but not limited to, grading, resurfacing, and snow removal as arranged by the homeowners. il. Non payment of homeowners fees to the Association for maintanence will result in a lien being placed on the defaulting property, enforceable by law with costs and attorneys fees so incurred, also being payable by the defaulting property owner. Provisions I. The expenses of functions imposed on the Association pursuant to this Declaration, together with the expenses of the administration'and its operations, shall be assessed uniformly against the lots owned by the purchasers, subject to the limitation on assessment set forth in paragraph below.An owner who is a purchaser shall be responsible for payment of the full share of any assessments for a lot whether or not the lot has improvements. Lot#5 and Outiot B which remains an Agricultural Zoning lot shall be exempt from these Covenants and shall be governed by Weld Count with respect to Agricultural Zoning laws. II. In no event shall the annual average common expense liability allocated to any lot in the property, exclusively of optional user fees, exceed the maximum amount allowable by then applicable Colorado law for exception of the property and the association from the general application of the Colorado Common Interest ownership ACT(CCIOA). The current Maximum Annual Assessment is $400.00 per lot, pursuant to Section 38- 33.3-116 C.R.S. and such amount may be periodically adjusted without requiring general application of CCIOA. In no event shall the Board adopt any budget which will result in assessment of more than pen iissible Maximum Annual Assessment. III. In the event the lot owners shall fail to maintain the open space areas in a reasonable order and condition in accordance with the original plan submitted with the final subdivision plat, the Board of County Commissioners for Weld County may exercise the power contained in CRS 24-67-105 as it now exists or as it may be amended. IV. These covenants shall operate as covenant running with the land for the benefit of any persons who now own or may hereafter own property in The Meadows Estates. This agreement is binding to all parties and may not be terminated or modified without the approval of all the members of The Meadows Estates P.U.D. and shall be filed accordingly with the State of Colorado. IN WITNESS WHEREOF, the Declarant has caused this Declaration to be executed as of the day and year first written above. 77c2:44 Theodore H. Schrage Owner of Scharge P.U.D;rknow as The Meadows Estates STAIN OF COLORADO COUNTY OF WELD Acknowledge before me this 1-39frk day of ytN. 2009, by Theodore H. Schrage. Witness my hand and official seal. My commission expires: t 3(2.017.- Notary he WRIGHT �; Address II‘ . dpi.®@doe *Comm Exp.01-03-2011 JUL-07-2010 WED 1136 AN FAX NO. P. 01/01 • Weld County Treasurer Statement of Taxes Due Account Number R4220406 Parcc1106106100010 Sites Address Legal D4scripti411 866 60 HWY WELD 00C IfIfH)00 PT E2NE4 6.4-68 LOT B RFC EXEMPT RE-4042(2O7RES) I. Account:R4229406 SCHRAGE LIVING TRUST 23505 CR 3 LOVELAND,CO 80537 ......,.. ...,4.. ..ana .....ears .aa.s ...Jc.0.an .u2vY....aa a.........v .aaun.gw.u.aurn.O.......................,a na.. a.nnnnOoa.. Billed Payments Reliance Year Charges 0.00 2009 Tx( 31,302,59 31,302.59 - $ Grand Total Due as of 07/07/20i0 $0.00 Tax Billed at 2009 Rates for Tax Arca 2385-2385 Authority Mill Levy Amount Values ACtu I Assessed WELD .16.8040000" $28197 AG-FLOOD 39,01 r $2,640 COUNTY IRRRIGATED LAND SCHOOL DIST R2J 412950000 $692.92 ACrGRAZ1NG LAND $1 0 330 NORTHERN COLORADO WATER 1.0000000 $16.78 AG-WASTE LAND d 310 (NC BERTHOUD FIRE 13,7740000 $231.13 FARMRESI /RAENCNCH E-IMPS MPS $168,7. 7 $13,430 DERTHOUD FIRE(BOND 2020) 1.5000000 825,17 $670 3.2550000 $5 62 MG OTHER BLS.- 52,3 k H . HIGH PLAINS LIBRARY AGRICULTURAL Taxes Billed 2009 77-6280000 $1,302.59 Total $180,2 5 $16,780 "Credit Levy ALL TAX LIEN SALE AMOUNTS ARE SUBJECT TO CHANGE DUE TO ENDORSEMENT OF CURRENT TAXES BY TIE LIENHOLDER OR TO ADVERTISING AND DISTRAINT WARRANT FEES. CHANGES MAY OCCUR AND THE TREASURERS OFFICE WILL NEED TO BE CONTACTED PRIOR TO REMITT, DICE AFTER THE FOLLOWING DATES: PERSONAL PROPERTY AND MOBILE HOMES-AUGUST 1,REAL PROPERTY-AUGUST . • WELD COUNTY TREASURER. Pursuant to the Weld County Subdivision Ordinance,the attached Statement(: )of Taxes Due, issued by the Weld County Treasurer,are evidence that; as of this date, all prop r,f taxes, special assessments and prior taxes liens currently due and payable connected with th I parcel(s) identified therein have been paid in full. •-.)Signed Date __.:7 7412_ te : • . I . : I Weld County Treasurer Statement of Taxes Due Account Number R4229406 Parcel 106106100010 Legal Description Situs Address PT E2NE4 6-4-68 LOT B REC EXEMPT RE-4042(2D7RES)SITUS:866 60 HWY WELD 866 60 HWY WELD 000000000 000000000 Account:R4229406 SCHRAGE LIVING TRUST 23505 CR 3 LOVELAND,CO 80537 Year Charges Billed Payments Balance 2008 Tax $793.99 $793.99 $0.00 Grand Total Due as of 09/09/2009 $0.00 Tax Billed at 2008 Rates for Tax Area 2385-2385 Authority Mill Levy Amount Values Actual Assessed WELD COUNTY 16.804000* $294.25 AG-FLOOD $7,977 $2,310 SCHOOL DIST R2J 40.974000 $717.48 IRRRIGATED LAND NORTHERN COLORADO WATER 1.000000 $17.51 AG-GRAZING LAND $105 $30 (NC AG-WASTELAND $4 $10 BERTHOUD FIRE 13.774000 $241.20 FARM/RANCH $181,929 $7,240 BERTHOUD FIRE(BOND 2014) 1.500000 $26.27 RESIDENCE-IMPS HIGH PLAINS LIBRARY 3.260000 $57.08 OTHER BLDGS.- $2,340 $680AGRICULTURAL Taxes Billed 2008 77.312000 $1,353.79 Total $192,355 $10,270 SenOrVet ($559.80) Net Taxes Billed for 2008 $793.99 *Credit Levy ALL TM LIEN SALE AMOUNTS ARE SUBJECT TO CHANGE DUE TO ENDORSEMENT OF CURRENT TAXES BY THE LIENHOLDER OR TO ADVERTISING AND DISTRAINT WARRANT FEES. CHANGES MAY OCCUR AND THE TREASURERS OFFICE WILL NEED TO BE CONTACTED PRIOR TO REMITTANCE AFTER THE FOLLOWING DATES: PERSONAL PROPERTY AND MOBILE HOMES-AUGUST 1,REAL PROPERTY-AUGUST 1. Weld County Tres WELD COUNTY TREASURER P.O. Box 458, Gre 1400 N 17th Ave, Pursuant to the Weld County Subdivision Ordinance, the attached Statement(s) of Taxes (970)353-3845 er Due, issued by the Weld County Treasurer, are evidence that, as of this date, all property taxes, special assessments and prior taxes liens currently due and payable connected with the parcel(s) identified therein have been paid in full. d Slgne ( Date • OFFICE OF THE SECRETARY OF STATE OF THE STATE OF COLORADO CERTIFICATE 1, Bernie Buescher, as the Secretary of State of the State of Colorado,hereby certify that,according to the records of this office, THE MEADOWS ESTATES HOMEOWNERS ASSOCIATION is a Cooperative Association formed or registered on 12/01/2009 under the law of Colorado,has complied with all applicable requirements of this office, and is in good standing with this office. This entity has been assigned entity identification number 20091629089. This certificate reflects facts established or disclosed by documents delivered to this office on paper through 12/01/2009 that have been posted, and by documents delivered to this office electronically through 12/05/2009 @ 20:58:31. 1 have affixed hereto the Great Seal of the State of Colorado and duly generated, executed, authenticated, issued, delivered and communicated this official certificate at Denver, Colorado on 12/05/2009 @ ------- 20:58:31 pursuant to and-in-accordance with-applicable-law. This certificate is assigned-Confirmation ---- Number 7519177. S ,yt��.jam,+ ,fib �ti�"" � rte--:` tea :.fir ;t. �,A .,i,.....-t-mt---::c,rtrTir:-....14K.7r*.16: 5Y +': '� iF:� 5 `.i �r i :itil 14 n (-----17. ,—. . .., ('----7/ - v�.P~ C----- -- Secretary of State of the State of Colorado *....,,...........—.....**.**.*.*..**,.*End of Certificate******************************************** Notice:A certificate issued electronically from the Colorado Secretary of State's Web site is fully and immediately valid and effective. However, as an option.the issuance and validity of certificate obtained electronically may be established by visiting the Certificate Confirmation Page of the Secretary of State's Web site. rip:;-v„•,:'.cos.sate.co.us-Zf_'CerrilicateSearchCriteria.do entering the certificate's confirmation number displayed on the certificate. and following the instructions displayed. Confirminz the issuance of a certificate is merely optional and is not necessary to the valid and effective issuance ofa certificate. For more information,visit our Web site, http://ww1r.sos.state.co_us,click Business Center and select"Freauenti;.Asked Questions." • CERT_GS D Revised 08/20/2008 Colorado Secretary of State Date and Time: 12./01/2009 09:29 PM Document must be filed electronically. ID Number: 20091629089 Paper documents will not be accepted. Document processing fee $50.00 Document number: 20091629089 Fees&forms/cover sheets Amount Paid: $50.00 are subject to change. To access other information or print copies of filed documents, visit www.sos.state.co.us and select Business. ABOVE SPACE FOR OFFICE USE ONLY • Articles of Incorporation for a Cooperative Association filed pursuant to§ 7-55-102 and of the Colorado Revised Statutes(C..R.S.) 1.The domestic entity name of the association is THE MEADOWS ESTATES HOMEOWNERS ASSOCIATION (The name of a cooperative association may,but need not contain the term or abbreviation"cooperative", "association", "incorporated", "company"; "limited", "coop", "ass'n" "assn" "assoc." "inc.", "co."or"ltd).) (Caution:The use of certain terms or abbreviations are restricted by law. Read instructions for more information.) association's principal office is 2. The principal office address of the p p Street address 23505 WCR 39 (Street number and name) LOVELAND CO 80537 (City) States(ZIP/Postal Code) United (Province—if applicable) (Country) Mailing address (leave blank if same as street address) (Street number and name or Post Office Box information) (City) (State) (ZIP/Postal Code) (Province—if applicable) (Country) 3.The registered agent name and registered agent address of the association's initial registered agent are Name SCHRAGE THEODORE HENRY (if an individual) (Last) (First) (Middle) (Suffix) OR (if an entity) (Caution: Do not provide both an individual and an entity name.) Street address 23505 WCR 39 (Street number and name) LOVELAND co . 80537 (City) (State) (ZIP Code) ARTINC_55 Pam 1 of 3 Rev. 12/0I/2009 Colorado Secretary of State Date and Time: 12108/2009 09:38 AM ID Number: 20091629089 Document must be filed electronically Document number: 20091638813 Paper documents will not be accepted. $10.00 Amount Paid: $10.00 Document processing fee Fees&forms/cover sheets are subject to change. To access other information or print copies of filed documents, visit m>vvw.sos_.state.cous and select Business Center- ABOVE SPACE FOR OFFICE USE ONLY Statement of Correction Correcting the Principal Office Address filed pursuant to § 7-90-305 of the Colorado Revised Statutes(C.R.S.) 1.The entity ID number and the entity name,or,if the entity does not have an entity name,the true name are Entity TD number 20091629089 (Colorado Secretary of State ID number) THE MEADOWS ESTATES HOMEOWNERS ASSOCIATION Entity name or True name 20091629089 2.The document number of the filed document that is corrected is 3.The principal office address as stated in the document identified above is incorrect. Such address,as corrected, is 23505 WCR 3 Street address (Street number and name) LOVELAND CO 80537 (City) ('State (ZIP/Postal Code) United States (Provtnce—fapplicable) (Country) Mne address (leave blank if same as street address) (Street member and name or Post Office Box information) (City,) tat (ZIP/Postal Code) Un etitStateS (Province—if applicable) (Country) 4. (rfapplicable,adopt the following statement by marking the box and include an attachment) ❑ This document contains additional information as provided by law. CORRECT_POA Page 1 oft Rev.10/7/2008 Notice: Causing this document to be delivered to the Secretary of State for filing shall constitute the affirmation or acknowledgment of each individual causing such delivery,under penalties of perjury,that such document is such individual's act and deed,or that such individual in good faith believes such document is the act and deed of the person on whose behalf such individual is causing such document to be delivered for filing,taken in conformity with the requirements of part 3 of article 90 of title 7,C.R.S.and,if applicable,the constituent documents and the organic statutes,and that such individual in good faith believes the facts stated in such document are true and such document complies with the requirements of that Part,the constituent documents, and the organic statutes. This perjury notice applies to each individual who causes this document to be delivered to the Secretary of State,whether or not such individual is identified in this document as one who has caused it to be delivered. 5. The true name and mailing address of the individual causing this document to be delivered for filing are Harris Rex 1417 297 .�t (First) (Middle) (s4 (Street number and name or Post Office Box information) Loveland CO 80538 'city) (State) States ��ostalCode) Unli@ (Province—i'applicable) (Country) (7f applicable,adopt the following statement by marldng the box and include an attachment) ❑ This document contains the true name and mailing address of one or more additional individuals causing the document to be delivered for filing. Disclaimer: This form/cover sheet,and any related instructions,are not intended to provide legal,business or tax advice, and are furnished without representation or warranty. While this form/cover sheet is believed to satisfy minimum legal requirements as of its revision date,compliance with applicable law,as the same may be amended from time to time,remains the responsibility of the user of this form/cover sheet. Questions should be addressed to the user's legal,business or tax advisor(s). CORR.ECT_POA Page 2 of 2 Rev.10/7/2008 ._...... . ............ .. • Mailing.address (leave blank if same as street address) (Street number and name or Post Office Box information) . CO . (City) (State) (ZIP Code) (The following statement is adopted by marking the box) p✓ The person appointed as registered agent above has consented to being so appointed. 4.The purposes for which the association was formed are GOVERN HOME OWNERS AND ANY OTHER LAWFUL PURPOSE 5.The attachment to this document contains information regarding the following: • the true name and mailing address of each incorporator; • the number and terms of directors,which number shall be not less than three; • the authorized capital stock,the number of shares into which said stock is divided,and the par value of each; and • the number of memberships authorized,the capital subscription of each,and the method of determining property-rights and interests of each member without capital stock. 6.(If the following statement applies,adopt the statement by marking the box and include an attachment) ❑✓ This document contains additional information as provided by law. 7.(Caution: Leave blank if the document does not have a delayed effective date. Stating a delayed effective date has sign f cant legal consequences. Read instructions before entering a date.) (If the following statement applies,adopt the statement by entering a date and,ifapplicable,time using the required format.) The delayed effective date and,if applicable,time of this document is/are (mmiddlyyyy hour:minute am/pm) Notice: Causing this document to be delivered to the Secretary of State for filing shall constitute the affirmation or acknowledgment of each individual causing such delivery,under penalties of perjury,that the document is the individual's act and deed,or that the individual in good faith believes the document is the act and deed of the person on whose behalf the individual is causing the document to be delivered for filing,taken in conformity with the requirements of part 3 of article 90 of title 7,C.R.S.,the constituent documents,and the organic ostatutes,and that the individual in good faith believes the facts stated in the document are true and the document complies with the requirements of that Part,the constituent documents,and the organic statutes. This perjury notice applies to each individual who causes this document to be delivered to the Secretary of State,whether or not such individual is named in the document as one who has caused it to be delivered. 8.The true name and mailing address of the individual causing the document to be delivered for filing are MARTIN MARY LILA (Last) (First) (Middle) (Suffix) 23505 WCR 39 (Street number and name or Post Office Box information) LOVELAND CO 80537 (City) (State) (ZIP/Postal Code) United States (Province—if applicable) (Country) ARTINC_55 Page 2 of 3 Rev.12/01/2009 of the following statement applies,adapt the statement by marking the box and include an attachment) ❑ This document contains the true name and mailing address of one or more additional individuals causing the document to be delivered for filing. Disclaimer: This form/cover sheet, and any related instructions, are not intended to provide legal, business or tax advice, and are furnished without representation or warranty. While this form/cover sheet is believed to satisfy minimum legal requirements as of its revision date, compliance with applicable law, as the same may be amended from time to time, remains the responsibility of the user of this form/cover sheet. Questions should be addressed to the user's legal,business or tax advisor(s). ARTINC_55 Page 3 of 3 Rev.12101/2009 Click the following links to view attachments Attachmen t 1 AK I IULLS OF INCORPORATION UNfl LUST POSTAL SEISE September 11, 2009 TO: JL Walter Consulting 114 E. 5th Street LOVELAND, COLORADO 80537 FROM: Gary Dill Growth Manager USPS 601 North Cleveland Ave. Loveland,Colorado 80537-9998 RE: The Meadows Estates PUD Dear JL Walter Consulting, I have reviewed your new development Meadows Estates and find only one requirement; the United States Postal Service will require that a centralized mail delivery system be placed at the entrance to this new development. There are a couple methods of delivery,the first; homeowners may place individual mailboxes, all located at the entrance at the same location,the second and the method I recommend is a centralized mailbox unit (CBU),this CBU is purchased by the owner-developer and placed on a concrete pad located at the entrance of this new development.The location of the developer provided concrete pad will be determined by me or an authorized employee of the USPS. This CBU offers the new homeowners with the security of locked mailboxes, parcel lockers and a secured drop for outgoing mail.Whichever method is chosen please have the developer contact me at 970-667-5303. I have recorded and entered the addressing into our data base.If addressing changes please contact me. nicer ly, ailg* / Vy • USPS Valentine Station 601 Cleveland Ave. Loveland,CO 80537-9998 970-667-5303 COLORADO DEPARTMENT OF TRANSPORTATION CD0T Permit No. 409069 SH/S/MP STATE HIGHWAY ACCESS CODE 60 A / 1.776 / R NOTICE Local Jurisdiction TO PROCEED Weld County Permittee(s): Applicant: Schrage Living Trust SAME Theodore H. Schrage, Trustee 23505 Weld County Road 3 Loveland, CO 80537 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 durin• construction as J appropriate. &x ati �q ;{1.2:::::1 ` hJ+k , ₹ 2 2 z 'tit �, r 1 ll r s7M ( r „ 4 rJi kv Jk ,z7r 'A �.4 k �, P Wk�d y f i,�,r,s *'+ .r r nr u r url�"Pt�' �' .v�xN�"�rk itq"a, s ri)ii � {a2 r.ez ' art , za.`"K aic �i �a Municipality or County Approval (When the approp , By (X) This Notice is not valid until signed by a duly authorized representative of the Department Colorado Department of Transportation By ` Title 1 �� Date (X) ()MIL' j j Lk I k f I l I all IM 1 T- \ / 11/4/2009 Copy istribution: Required: Make copies as necessary for: / Form 1265 8/98,6/99 �\\ Region(original) Local Authority Inspector Lee Ireton \ ' Applicant MTCE Patrol Traffic Engineer `.J Staff Access Section 5-Loveland • COLORADO DEPARTMENT OF .dANSPORTATION COOT Permit No. 4®9,t69 STATE HIGHWAY ACCESS PERMIT State Highway No/Mp/Side 60 A / 1.776 / R Permit fee - Date of transmittal Region/Section/Patrol Local Jurisdiction $100.00 10/19/2009 4/ 01 /5-Loveland Weld County The Permittee(s); Applicant: Ref No.: Schrage Living Trust SAME Theodore H. Schrage, Trustee 23505 Weld County Road 3 Loveland, CO 80537 970-532-9868 is hereby granted permission to have an access to the state highway at the location noted below.The access shall be constructed, maintained and 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:The access is to be located on State Highway 60,a distance of 4,098 feet east of Mile Post 1 on the south/right side. "SCHRAGE WAY"aligns with Larimer County Road 11 Access to Provide Service to: (Land Use Code:) (Size or Count) (Units) Single-Family Detached Housing-5 Each 50 ADT. OiUGas Well-2 Each 6 ADT Additional Information: 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 permittee agrees to the terms and conditions and referenced attachments contained herein. All construction shall be completed in an expeditious and safe manner and shall be 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 right-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. P rmittee Signature ) , ` gy �Parint Name 7 / -y---' Date C\t 5141 '6`.�!t SdR t4a-g L ,4 -Rigs; .114-(99 96�s 4.14? -2/. 1f�=oa)Ri .&GI c.nc Ary crag This permit is not valid until signedy5y a duly authorized representative of the Department. COLORADO DEP RTMENT OF TRANSPORTATION Signature $ 4 Pri t/Name Title ni (,� Date(of issue) 9 (ru ,et tl IC Otona �tce - W€ mi11tt t _cy- Ilfl� `D �j copy ist ibution: Required: Make copies as necessary for Previous editions aretobsolete afid may not be used 1.Region 3.Staff Access Section Local Authority Inspector Pagel of 3 CDOT Form#101 5/07 2.Applicant 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 Lode. I hese are provided tor 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 dot a fermi ee may request a Code. A copy of the State Highway Access Code is one year extension from the issuing authority. No more than available trom 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 of the permit, that conflict with concurrent of notice of denial or transmittal of the permit. highway construction or maintenance work, that endanger 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, u - conditions -the-pe init. Fail Ede 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 me UepaTtTPe i o issuing autnority to 'nitrate action to character bought 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 li 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 if a new access permit and improper De Department to determine construction element fails within two years due top construction or material specifications, the permittee shall be 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 dunng 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 S. 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 sunrm ry-is intende-d-to infu<<u entities external to CDOT1liat may-be eideririy the ' - - perform work related to their own facilities(such as Utility,Special Use or Access Permittees),about some of the more commonly encutmteied environmerrtal-permitsfcleararic.es tl lot nay apply to their activities. This listing is nut alt-iin..lusioe-"-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 CDOT Permit,Or Enforcement Actions By Other Agencies CLEARANCE CONTACTS-As indicated in the permit/clearance descriptions listed 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.cdohe.state.co.us/permits.ase. • CDOT Water Quality Program Manager;Rick Willard(303)757-9343 • CDOT Asbestos Project Manager;Julia Horn (303)512-5519 • 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.nwo.usace.arrimmil/html/od-ti/tri-lakes.html Sacramento Dist. (Western CO),Grand Junction Office(970)243-1199 http://www.sok.usace.armv.mil/cesok-co/requlatory/ Albuquerque District(SE Colorado),Pueblo Reg.Office(719)-543-6915 http://www.spa.usace.armv.mil/reg/ • CDOT Utilities,Special Use and Access Permitting:(303)757-9654 http://www.dot.state.co.us/Permits/ Ecological 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 CDOT 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 CDOT Regional Permitting Office and Regional 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 COOT website http://www.dot.state.co.us/environmental/Wildlife/Guidelines.aso,or the Colorado Division of Wildlife website http://wildlife.state.co.us/WildlifeSoecies/SpeciesOfConcern/. Additional guidance may be provided by the Regional Permitting Office in the Permit Special Provisions. 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 if 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 OAHP and/or COOT. If archaeological or historical artifacts are encountered during the progress of the permitted work,work in the subject area shall be halted and the CDOT Regional Permitting Office and Regional 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 OAHP at(303)866-3395. General Prohibition—Discharges-All discharges are subject to the provisions of the Colorado Water Quality Control Act and the Colorado Discharge Permit Regulations. Prohibited discharges include substances such as wash water,paint,automotive fluids, solvents,oils or soaps. Contact Information: Contact the CDOT Water Quality Program Manager at(303)757-9343,or the Colorado Department of Public Health and Environment,Water Quality Control Division (WQCD)at(303)692-3500. General Authorization-Allowable Non-Stormwater 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,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#'s listed above). 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(ISO)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 gasoline 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:Contact the CDOT/CDPHE Liaison at(303)757-9787. Environmental Clearances Information Summary Page 1 of 3 Colorado Department of Transportation November'07 Asbestos Containing Materials,Asbestos Contaminated Soil—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 son,must comply with the cDHPE Hazardous Materials and Waste Management tvision's(HMWMD)Solid --Waste-Regulations-.—The application-for~any-EBOT permit-must-specifically-identify dny ACM invoivdd it Iiie work-forwl authorization is being requested. Additional guidance or requirements may be specified in the permit special provisions. Contact Info:CDPHE AP-GO-and HMWMD Regulations can be accessed via the CDPHE Environmental Permitting Website-listed above. Additional information concerning clearance on CDOT projects is available from Julia Horn,CDOT Asbestos Project Manager(303) 512-5519,or Theresa Santangelo-Dreiling,Property Management Supervisor(303)512-5524. Construction Stormwater Permit;Stormwater Discharge From Industrial Facilities-Discharges of stormwater runoff from construction sites disturbing one acre or more-or certain types of industrial facilities-requires a CDPS Stormwater Permit. Contact Information:For Utility/Special Use activities being performed in conjunction and coordination with a CDOT highway construction contract,please contact the CDOT Water Quality Program Manager at(303)757-9343. Otherwise,contact the CDPHE Water Quality Control Division at(303)692-3500. Website: http://www.cdphe.state.co.us/wq/PermitsUnit/wgcdpmt.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. Website:http://www.cdphe.state.co.us/wo/PermitsUnit/wgcdpmt.html Minimal Industrial Discharge Permit—Discharges of small quantities of wastewater or wastewater requiring minimal treatment, such as that resulting from hydrostatic testing or certain wash waters, may require a Minimal Industrial Discharge Permit("MIND"). ( Contact Info:Contact the CDPHE WQCD at(303)692-3500. Website:ham://www. he.state.co.us/wq/PermitsUnit/wacdpmt.html Municipal Separate Storm Sewer System(MS4)Discharge Permit—Discharges from the storm sewer systems of larger municipalities,and from the CDOT highway drainage system that lies within those municipalities,are subject to MS4 Permits issued by the CDPHE WQCD. For facilities that lie within the boundaries of a municipality that is subject to a 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 COOT highway drainage system must comply with the applicable provisions of the Colorado Water Quality Control Act and the Colorado Discharge Permit Regulations,and are subject to inspection by the COOT and the CDHHE. Contact Information:Contact the CDPHE Water Quality Control Division at(303)692-3500 for a listing of municipalities required to obtain MS-4 Permits,or go to atp://www.cdphestate.co.us/wq/PermitsUnit/wgcdpmt.html#Municj!FormsGuidance. Discharge of Dredged or Fill Material—404 Permits Administered By the U.S.Army Corps of Engineers,and Section 401 Water Quality Certifications Issued by the CDPHE WQCD-Corps of Engineers 404 Permits are required for the discharge of dredged or fill 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 Information: Contact the appropriate Corps District Regulatory Office for information about what type of 404 permit may be required(information provided at top of ECIS). Contact the CDPHE Water Quality Control Division at(303)692-3500. Erosion and Sediment Control Practices-For activities requiring a Construction Stormwater 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. In either case,the CDOT Stormwater Quality and Erosion Control Guide(2002) should be used to design erosion controls.Contact Information:The CDOT Stormwater Quality and Erosion Control Guide may be obtained from the Bid Plans Office at 303 757-9313 or from:htt ://www.dot.state.co.us/environmental/envWaterQual/w ms4.as 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 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 proper 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 COOT/CDPHE Liaison or CDOT Water Qualit Pro ram Mana er. Concrete Washout-Waste generated from concrete activities shall NOT be allowed to flow into the drainage ways,inlets,receiving waters,or in the CDOT ROW. Concrete waste shall be placed in a temporary concrete washout facility. Concrete washout shall only be performed as specified by the COOT Environmental Program and shall be in accordance to CDOT specifications and guidelines. Contact Information: Contact the CDOT Water Quali Pro ram Mana er at 303 757-9343. 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 Permittin Office and Re ional Maintenance Su ervisor. S ills on hi hwa s,into waterwa s,or that ma otherwise resent an Environmental Clearances Information Summary Page 2 of 3 Colorado Department of Transportation November'07 • • immediate danger to the public shall be reported by calling 911,and shall also be reported to the CDPHE at 1-(877)-518-5608. 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 authaized`brapplicable requirem tsor n ez mption,approval or regis ra ion as een issue ehicles requiring a placaTd7rtfU11i obtain authorization�i1 and a State HAZMAT Permit from the Colorado Public Utilities Commission. Contact Information: For authors dtiuil dud rr rut e;lily(.411-the Fedeudl Mutur3dfety'Cdrlra;i Adnitribtidtiorr, US DOT for prier-and inird-blatt HAZMAT Registration(303)969-6748. Colorado Public Utilities Commission:(303)894-2868. Paleontology-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,all work in the subject area shall be halted and the CDOT Regional Permitting Office and Regional 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. Working on 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;andlor 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 www.dot.state.co.us/environmental/wild life/permitappl ication.asp. About This Form-Questions or comments about this Information Summary may be directed to Dahir Egal,CDOT Safety&Traffic En ineerin , Utilities Unit,at 303 757-9344,dahir.e al dot.state.co.us Environmental Clearances Information Summary Page 3 of 3 Colorado Department of Transportation November'07 g `v =e 3 — i'5k e"r t E o ' N E 1 �tq,t r g Ji r+� o E r m o ff `� �° v d 1 ili a , isi= T 3i C En U•I N o v m n m N SF P ''..,11.411'.(i (¢F' % ,O E° U m w m a a s `o �' Cu n j . ' co j-ig- 1 `-ft:µi - .. a = o E a, £o a a., v o" o�i t '+"a2� s1 S ,�F 55•'-ft: 'a LE E N H c o m o m 6 ,u'N o m E > o0 o_ . n •., t 4 � '^,=a yuai v 9✓ z E —`moo F- N -a .. :JET.- tw 'a m .ano . , r' i ,. y y Oa E2 m �,ni^ i - .nil ' s E ?. o ff t* s a � m E n o m m � 0 Y i x �trl�•n•.7.. O �< E o v 4-5- o. m a :ru o c7.> E 3t' •;: s ( v, m a 3 N R ii d L d Y O. N L O a Yd W -- = O. L 4}y 7' `2 t 5 'a:. V = Z O `v' H En u°fi o` 'a -= Yo E o a -a " c, ? 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If there are any questions regarding this permit, please contact Gloria Hice-Idler at(970) 350-2148. 2--T-he—Permittee—shall refer-to—all—additional standard—requirements included—with tfi permit and iy enclosed additional terms conditions, exhibits, and noted attachments. 3. Incorporated as part of this permit are the following: Application for Access Penult (CDOT Form No. 137) Permit (CDOT Form No. 101) and its two page attachment Exhibits: "A"- Access Plan "B"-Vicinity Map 4. 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. 5. Access construction methods and materials shall conform to the Colorado Department of Transportation Standard_Specifications for Road andBridge-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. 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. 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 danger of injury to feet, protective footwear that complies with the ANSI Z41-1999 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. 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 State Highway Access Permit 2 Attachment to Permit No. 409069-Additional Terms and Conditions 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 repairs. 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 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. 11. All other accesses to the property shall be removed immediately. Removal shall include, but not limited to,the return of the highway right-of-way side slopes,ditches, and fences to match existing adjacent conditions, INCLUDING REMOVAL OF ASPHALT APRONS. Any asphalt removed from the highway shall result in a smooth finished edge. -- Permittee is-responsible-for-obtaining-any necessary-additional-federalTstatei-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 installation 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. Two-way traffic shall be maintained throughout the work area at all times unless specific written authorization is obtained from the Department 17. No construction vehicles shall be parked, or construction materials/equipment stored, on the State Highway right-of-way overnight. 18. No work shall be performed near a Department electronic traffic control device without coordination with Cobie Garbiso at(970)350-2137. 19. The Department will not participate in any costs related to the design and installation of a traffic signal, should one be approved at this access in the future. 20. 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 State Highway Access Permit 3 Attachment to Permit No. 409069-Additional Terms and Conditions 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 Gloria Hice-Idler at the Greeley Traffic O ice, (970) 350-2148, to obtain the Lan scaping Permit. 21. 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. 22. 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. 23. 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. 24. 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. 25. 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. 26. 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. State Highway Access Permit 4 Attachment to Permit No. 409069 -Additional Terms and Conditions 27. If highway right-of-way fence exists or is proposed, the Permittee must contact Gloria Hice-Idler at the Greeley I raftic Office, (9/0) 350-2148, prior to removal or installation. 2.,—=Q. The-aeeess-shall-be cc>wstrueted-as-per Exhibit "A". 29. Construction traffic devices, when not in use, shall be removed or turned away from traffic. 30. 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. 31. The 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. 32. All required access improvements shall be installed prior to the herein authorized use of this access. 33. The access shall be surfaced immediately upon completion of earthwork construction and prior to use. 34. Surfacing of the access shall be completed as per Exhibit "A". 35.No-paved surface shall be-cut-unless--specified in this permit. Asphalt-removal-shall-be-saw-cuff to assure a straight edge for patching. 36. 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. 37. The Permittee shall install a new 30 inch corrugated metal pipe and shall provide for proper side slopes. Culverts over 18 inches in diameter shall have end sections. 38. The access shall be constructed 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. 39. 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. 40. The Permittee shall request final inspection by Lee Ireton at (970) 350-2147, within 10 days following completion of access construction, and prior to authorized use. The Permittee or their representative shall be present. 41. 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. 42. 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 resulting from damages shall be borne by the Permittee. State Highway Access Permit 5 Attachment to Permit No.409069-Additional Terms and Conditions 43. 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 require ec y or e appropriate agency prior to commencing work. Please refer to or request a copy of the "CDOT Environmental Clearance Inthrmation 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. 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. - r ,..- . — • F'COLORADO DEPARTMENT OF TRANS ZTATIOt4 — issuing authority application i ?STATE HIGHWAY ACCESS PERMIT APPLICATION acceptance date: ,0/1/0 J-l�aQ 9 t ! 9� p d Instructions: - Contact the Colorado Department of Transportation(CDOT)or your local government to determine your issuing authority. a 1 - Contact the issuing authority to determine what plans and other documents are required to be submitted with your application. I - Con rplctc this furrn(softie queati.ms rsroy--rrut epplTt-you)and atta,.li oil necesaauy Jluwuici16 dill}Sancta it k the-isa-rhng audio' y. i Please print - Submit an applirafinn fnr aactLarrasa affartpd I or type • - If you have any questions contact the issuing authority. -For additional information see CDOTs�s Access Managementwebsite,htta:Uwww.dot.state.c.o.us/AccessPerrnitts/index.htm 1)Pro Property owner —_-� p y (Permittee) `�,� }@� Z)Agentfcrpermiriee(ifdifferentfrom property oovnerl Sc\nr L uttn lvv- — t e ove_1 . Sc Y� e, Street addr s Mailing address 1. SOS L.leUUU C.Ibk&k.NSC1 . 3 City,state&zip Phone City,state&zip Phone#(required) t Lo c\av%& C0 $0531 970-- 63Z- 5b(O.1?)p E-mail address ~ E-mail address if available 3)Address of property to be served by permit(required) S ek.oro,1 e. t.....\,QM 4)Legal descriptilaln of property:If Within jurisdictional limits of Municipality,city and/or County,which one? county subttvision 11,,,e (yula.aouss,block lot section township range UJe\d I .ce.s euo I I I co i 4 N . i Cs 5)What State Highway are you requesting access from? 6)What side of the h" hway? I S•kA. (p0 EN S ❑ E ❑W R 7)How many feet is the proposed access from the nearest mile post? How many feet is the proposed access from the nearest cross street? $00 feet 0N❑S❑E®W)from:MP. Z. 0 • _feet pN❑S❑E❑W)from: L•C i . • Y\ A a• 8)What is the approximate date you intend to begin construction? .S (Av\2 t Z oto . 9)Check here if you are requesting a: 0 new access rltemporary access(duration anticipated: ) "Improvement to existing access ❑change in access use. ®removal of access relocation of an existing access(provide detail) I 10)Provide existing property use QeSa&N.N\al ) Pc gr1cw\k LA. Q. ? ) i (x y 11)Do you have knowledge of any State Highway ig access permits serving this property,or adjacent properties in which you have a property interest? ll ►.4 no 0 yes,if yes-what are the permit number(s)and provide copies: 4:2„. , t. C ` i and/sr, �rinit date: 0. t 43i • Tlnerre is of ex►s-ctfA-, gecess At $(p(, 5.k , (00 .Ltut c, 1 Co $os3) t 12)Does the properttowner own or have any interests in any adjacent property? II2 no yes,if yes-please describe: li i 13)Are there other existing or dedicated public streets,roads,highways or access easements bordering or within the property? Ono a yes,if yes-list them on your plans and indicate the proposed and existing access points. 14)If you are requesting agricultural field access-how many acres will the access serve? 15)If you are requesting commercial or industrial access please Indicate the types and number of businesses and provide the floor area square footage of each. business/land use square footage business square footage CDk1 4 60.5 hell (IS l I I I 16)If you are requesting residential developement access,what is the type(single family,apartment,townhouse)and number of units? type number of units type number of units SXV1142 Fa�N.\3 RA,Sat--.1c -\ i s I L I 17)Provide the following vehicle count estimates for vehicles that will use the access.Leaving the property then returning is two counts. In.'cate if your counts are a of oassena_ cars and light trucks at peak hour volumes C of multi unit trucks at peak hour volumes D leak hour volumes or 0 average daily volumes. 30 C of single unit vehicles in excess of 30 ft #o arm vehicles(field equipment) Total count of all vehicles Previous editions are obsolete and may not be u� Paae 1 of 2 CDOT Form#137 12/O4 , 18)Cheek with the issuing authority to determine yrh i the following documents are required to complete the re. .i of your application.. a) Property map indicating other access,bordering roads and streets. e) Subdivision,zoning.ordevelopment plan. 1 b) Highway and driveway plan profile. f) Proposed access design. c) Drainage plan showing impact to the highway right-of-way. g) Parcel and ownership maps including easements. d) Map and letters detailing utility locations before and after h) Traffic studies. geveloprnent In aria aconn rte light-or-way. i) i'roor of ownership. 1- It is the applicants 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 CDOT Utility/Special Use Permit offices or accessed via the CDOT Planning/Construction-Environmental-Guidance webpage htlp://www.dot.state.co.uslenvironmentai/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, ANSI/ISEA 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 1910.136, 1926.95, and 1926.96. 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.us/DesignSupportf>, then click 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's signature Print name Date e.o eov'e �- -��vo"V e C O/ � If he applicant is not the owner ctf 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. 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