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HomeMy WebLinkAbout20091651.tiffSITE SPECIFIC DEVELOPMENT PLAN AND USE BY SPECIAL REVIEW (USR) APPLICATION • • FOR PLANNING DEPARTMENT USE RECEIPT # /AMOUNT # /$ APPLICATION RECEIVED BY DATE RECEIVED: CASE # ASSIGNED: PLANNER ASSIGNED: Parcel Number 1 3 0 9- 3 0 - 1- 0 0 - 0 3 4 (12 digit number - found on Tax I.D. information, obtainable at the Weld County Assessor's Office, or www.co.weld.co.us.) Legal Description PTE 2 NE 4 (Let A ff.2t` 12), Section 30 , Township 2 North, Range66 West Flood Plain: Zone District: Ag , Total Acreage: 3. 5 , Overlay District: Geological Hazard: , Airport Overlay District: FEE OWNER(S) OF THE PROPERTY: Name: Manuel and Anita Balderas Work Phone # 303 8 7 9770 Home Phone # 303 589 Address: 5 2i s L (,2 )-1 Address: City/State/Zip Code 6023 Email anita0mbtowing. c in Name: Work Phone # Address: Address: City/State/Zip Code Fort Lupton. CO 80621 Home Phone # Email Name: Work Phone # Address: Address: City/State/Zip Code APPLICANT OR AUTHORIZED AGENT (See Below: Authorization must accompany applications signed by Authorized Agent) Name: Manuel or Anita Balderas and Manuel Jr. Work Phone # 303-857-9770 Home Phone # 303-589-6023 Email anita@mbtowing. com Address: 7.8_5_3_447-8.3 a'17). L2 fU Address: City/State/Zip Code Fort Lupton. CO 80621 Home Phone # Email PROPOSED USE: Commercial site for the use of Auto Sales. Auto Salvage, Auto Towing Auto Service & repairs, Auto Body repairs 0 paint Services. Vehicle impound yard Coloradp State Patrol impound yard, Fort Lupton Police Impound, yard and Weld County Sheriff impound yard. 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 owner must be inded with the application. If a corporation is the fee owner, notarized evidence must be ed ind' a ing atsignatory has to legal authority to sign for the corps-tion 7-072n ` Afi�i a Balderas Si. nature: Owner or Authorized Agent Date EXHIBIT MaiYirel Balderas (-02-5102 Signature: Owner or Authorized Agent Date 2009-1651 3 6- Page 1 of l Jacqueline Hatch From: Jacqueline Hatch Sent: Monday, March 30, 2009 1:43 PM To: 'anita@mbtowing.com' Cc: 'freese_engineering@yahoo.com' Subject: returned letter Attachments: USR-1696 Balderas.rtf Anita, Attached is a copy of a letter we send out when we set up your case USR-1696. The letter came back as unable to deliver. Can you please verify your mailing address? We have 7853 Hwy 85 Ft. Lupton CO 80621. Thank you and please let me know if you have any questions. Jacqueline 3/30/2009 Page 1 of 1 Jacqueline Hatch From: Jasper Freese [freese_engineering@yahoo.com] Sent: Monday, March 30, 2009 4:59 PM To: Jacqueline Hatch Subject: Re: returned letter Jacqueline, We talked to Anita and verified her mailing address as being: 2732 Weld County Road No. 27, Ft. Lupton CO 80621. Thank you and please let me know if you have any questions. Scott Freese Engineering 217 East 18th Street Greeley, Colorado 80631 (970) 352-0100 3/31/2009 • • • FOR COMMERCIAL SITES, PLEASE COMPLETE THE FOLLOWING INFORMATION BUSINESS EMERGENCY INFORMATION: Business Name: M. B. Auto Service Phone: 303-857-9770 Address: 7853 Hwy 85 City, ST, Zip: Fort Lupton, Co 80621 Business Owner: Manuel Anita Balderas Phone: 303-857-9770 Home Address: 7853 Hwy 85 City, ST, Zip: For Lupton, Co 80621 List three persons in the order to be called in the event of an emergency: NAME TITLE Manuel Balderas OMner Anita Balderas Owner ADDRESS PHONE 7853 Hwy 85 Ft. Lupton, CO Cell# 303-589-6023 7853 Hwy 85 Ft. Lupton, CO Celli/ 303-589-0128 Manuel Balderas, Jr (son) 29700 Wcr 18 Keenesburg, C0303-732-4451 Business Hours: 8:00 A.M-5:00 P.M Days: Monday thru Friday Closed Sunday Type of Alarm: None Burglar Holdup Fire Silent Audible Name and address of Alarm Company: non Location of Safe: **************************************************************************iii****************************************************** MISCELLANEOUS INFORMATION: Number of entry/exit doors in this building: j Location(s): west si rip of hui 1 rti rig Is alcohol stored in building? N/A Location(s): Are drugs stored in building? N/A Location(s): Are weapons stored in building? N/A Location(s): The following programs are offered as a public service of the Weld County Sheriff's Office. Please indicate the programs of interest. X Physical Security Check Crime Prevention Presentation UTILITY SHUT OFF LOCATIONS: Main Electrical: West side Gas Shut Off: East side Exterior Water Shutoff: South • Interior Water Shutoff: Fast side -12- • • • • • March 6,2009 Prepared by Manuel & Anita Balderas DBA MB Auto sales & salvage we are requesting approval for a (USR) on our property located at 7853 Hwy 85 in Fort lupton, CO. The proposed use is as followed: 1. The proposed use of the property will consist of the following three categories: a. Towing Service & vehicle Impound Yard Colorado State Patrol Impound Yard Fort Lupton Police Impound Yard weld County Sheriff Impound Yard Property will NOT be used for public storage Property will NOT be used for recreational vehicle or boat storage b. Internet Used Auto Parts Sales & Auto Recycling/Dismantling used auto parts sold by internet Over the counter sales Monday -Friday 9-5, Saturday 8-2, closed Sundays & Holidays Recycling/Dismantling area will not be open to the public c. Auto Service & Repairs Auto Body Repairs Auto Body Paint Service Mechanical Repairs & Maintenance 2. This property is not big enough for agriculture use, this site has been in its present use since 1928 and has not been farmed for 79 years. We under strand the interest of the county to conserve agriculture land for future use, but we will be providing a service to the community, and we will be careful of the environment and it surround area. 3. The proposal is consistent with the intent of the weld County Code 23 zoning -zone District. The property is not located in a subdivision, it does not have a Pup it is rural; With enough property to locate the new building and parking areas for customers. use is allowed under special review. 4. The type of land use surrounding the site is commercial, agriculture and undeveloped land. On the North side of the property there is unimproved land. The south side is agriculture. On the west side there is a large oil tank and unimproved land. On the east side there is a gas station, agriculture, and undeveloped land. The reason we think it would be consistent with the area is because we can assist vehicle that stop at the gas station and along highway 85 with vehicle problems. the site will be in close proximity to The Colorado State Patrol, the weld county sheriffs and the Fort Lupton Police department. 5. a. The new site will be used by the state and local officials and be open to the public for car part sales and out repairs. b. The new site will have ten employees. c. Hours of operation are Monday -Friday 9-5, Saturday 8-2, closed Sundays & Holidays. Towing service is a 24 hours operation. d. There will be one new building erected approximately 60x120 e. There will small domestic animals such as dogs, cats, chickens. Page 1 • • • • • f. The type of vehicles that will have access to the site will include tow trucks, personal vehicles, and law enforcement vehicles Call vehicles on the property or having access will be under 26,500 GVW) g. Fort Lupton Fire District will provide fire protection service. h. Water source is domestic well water. We have approval for a commercial Well. Permit#3624965 (for new building) i. Sewage disposal is an existing septic. We are applying for a new septic permit for the proposed building. Used auto parts for repairs and internet sales will be stored. 6. Proposed landscaping will include trees, shrubs, sod, and xeroscaping. As indicate on the plot plan the front of the building will have trees every four feet. The front of the property does have 6'ft chain link fence, the rear of the property has 7'ft sold metal fence. Around the house we will have sod, native grass and flowered shrubs, xeroscaping will be used to conserve on water. 7. It is our option that retaining ponds are not require do to the fact that the property is sandy gravel. But if they are see item # 8 8. Storm water drainage will be directed to roadside ditch building roof will be directed to landscaped areas and roadside ditch. Also their will be 2 retaining ponds on the property one on the East NE front of property and the second pond on center of the North side approximately 40ft from the NW corner of the property. 9. Construction of the new site will possibly begin as soon as possible or in the Springtime. Landscaping around the perimeter of the property is about 85% complete. landscaping around the new build will be complete after the construction of the new building. 10. Traffic Study: The number of employes is 10 and the number of the number of customers per day is approximately 3-4 per day. The tow trucks is 2 per week and delivery trucks 2 per every other day. This is the closes estimate we can make. 11. We will use the center building for an office for the time it will take to build the new proposed building and have one or two port-o-potie. Only during contruction of the new building. MB Auto Sales & salvage has been in business since 1985. We currently have two facilities located in southeast Weld County. Our businesses have always complied with all local, state, and federal regulations regarding our types of businesses and therefore no actions have been taken against our company. Please be certain that our business will continue to meet and exceed the expectations set forth by our government and venders. Manuel -Bald Owner Page 2 An tab fderas ` Cr' Owner • • • • • WELD COUNTY ROAD ACCESS INFORMATION SHEET Weld County Department of Public Works 111 H St PO Box 758 Greeley CO 80632 Phone: (970 )356-4000 x3750 Fax: (970) 304-6497 Road File #: Date: RE #: Other Case #: 1. Applicant Name t7Z-,nu / r- An .1/6- &Peras Phone 303 P5 -7-i770 Address .27 3 2 cc, C R 2 7 City 4,2 L -02(c., State ce Zip sckzi 2. Address or Location of Access 7A 6 3 /y4 y ?' A ff /„.pfc n , ('C" 8O42/ Section 3cc Township Z Range 6,4, Subdivision Block Lot Weld County Road #: Side of Road Distance from nearest intersection 7C 7E 3. Is there an existing access(es) to the property? Yes No See, C n'( RRcce5c Pe fm.f 4. Proposed Use: O Permanent i Residential/Agricultural O Industrial O Temporary O Subdivision 4 Commercial O Other # of Accesses ******************************************************************************************************************************* 5. Site Sketch Legend for Access Description: AG = Agricultural RES = Residential 08G = Oil & Gas D.R. = Ditch Road O = House = Shed = Proposed Access A = Existing Access OFFICE USE ONLY: Road Date Road Drainage Requirement Special Conditions ADT Accidents ADT Date Date Culvert Accidents Size 0) Date Length Jae CTS Or." (Aid, 0 Installation Authorized Reviewed By: 0 Information Insufficient Title: • • COLORADO DEPARTMENT OF TRANSPORTATION STATE HIGHWAY ACCESS CODE NOTICE TO PROCEED CDOT Permit No. 408035 swsMP 85 C / 244.090 / L 85 Local Jurisdiction Weld County Permittee(s): Applicant: Manuel Balderas Manuel Balderas 7853 State Highwway 85 7853 State Highway 85 Fort Lupton, CO 80621 Fort Lupton, CO 80621 The permittee is hereby authorized to proceed with access construction within state highway right-of-way in accordance with the above referenced State Highway Access Permit and this Notice to Proceed. This Notice to Proceed is valid only if the referenced Access Permit has not expired. Access Permits expire one year from date of issue if not under construction, or completed. Access Permits may be extended in accordance with Section 2.3(11)(d), of the Access Code. Adequate advance warning is required at all times during access construction, in conformance with the Manual on Uniform Traffic Control Devices for Streets and Highways. All construction shall be completed in an expeditious and safe manner and shall be finished within 45 days from initiation. The permittee or applicant shall notify the Department prior to commencing construction as indicated on the Access Permit. Both the Access Permit and this Notice To Proceed shall be available for review at the construction site. This Notice to Proceed is conditional. The following items shall be addressed prior to or during construction as appropriate. Municipality or County Approval (When the appropriate local authority retains issuing authority) By (X) Title Date This Notice is not valid until signed by a duly authorized representative of the Department Colorado Department of Transportation By I t Title «r, , I ����� Date y �.�� �0 b liena c/cc 00 LO-. - _ a1 Copy d butio Required: 1. Region (original) 2. Applicant 3. Staff Access Section Make copies as necessary for. Local Authority Inspector Linda McWilliams MTCE Patrol Traffic Engineer 14 -Fort Lupton • • COLORADO DEPARTMENT OF TRANSPORTATION STATE HIGHWAY ACCESS PERMIT COOT Permit No. 408035 State Highway No/kip/Side 85C / 244.090 / L Permit fee $100.00 Date of transmittal 4/14/2008 Region/SectionIPabol 4 / 01 /14 -Fort Lupton Local Jurisdiction Weld County The Permittee(s); Manuel Balderas 7853 State Highwway 85 Fort Lupton, CO 80621 303-857-9770 is hereby granted permission to have accordance with this permit. Including by the Issuing authority if at any time appointed agents and employees shaN the permit. Applicant: an access to the state highway at the location the State Highway Access Code and any the permitted weans and Its use violate Ref No.: Manuel Balderas 7853 State Highway 85 Fort Lupton, CO 80621 303-857-9770 noted below. The access shall be constructed, maintained and used in attachments, terms, conditions and exhibits. This permit may be revoked any parts of this permit The issuing authority, the Department and their duly personal injury or property damage sustained by reason of the exercise of be held harmless against any action for Location: This access is located on State Highway 85, a distance of 475 feet north of mile post 244 on the west/left side. Access to Provide Service to: (Land Use Code:) (Size or Count) (Units) 210 - Single -Family Detached Housing 10 ADT 840 - Impound Yard 1 ADT Additional Information: a 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 herein. All construction shall be completed in an expeditious and safe manner Initiation. The permitted access shall be completed in accordance with the being used. The permittee shall notify Linda McWilliams with the Colorado Department Greeley, Colorado at (970) 350-2147, at least 48 hours prior In commencing State Highway right-of-way. The person signing as the permittee must be the owner or legal representative of the property accept the permit and its terms and conditions. and referenced attachments and shall be finished within terms and conditions of the permit of Transportation in construction within the served by the permitted access and contained 45 days from prior to have full authority to P r ittae Signature n •' Ln‘04.1 tD _ 1/,;L Print Name /11 PI rid Ur ( l) 4/ d /2.-tr. Date te /_3'I -C1 F - L This permit is not valid until signed by a duly authorized representative of the Department. COLORADO DEPARTMENT OF TRANSPORTATION Sig e i.LO-- I 1 (� -` /Print Name 1 I + G`La., I,rCE - IDCJL kd Tide --7) ,/� I6IZt,t IT SUN Date ( itsu)5� u{/a.i/ol Cohry Oi4tributlon: Required f.Region 2.Appkpnl Make copies as necessary for 3.Staff Arras Section Local Authority Inspector 4.Central Fibs MTCE Patrol Traffic Engineer Previous editions are obsolete and may not be used Paget of COOT Form Mel 3107 State Highway Access Permit Form 101, Page 2 The following paragraphs are excerpts of the State Highway •Access Code. These are provided for your convenience but do not alleviate compliance with all sections of the Access Code. A copy of the State Highway Access Code is available from your local issuing authority (local government) or the Colorado Department of Transportation (Department). When this permit was issued, the issuing authority made its decision based in part on information submitted by the applicant, on the arrecc category which is assigned to the highway, what alternative access to other public roads and streets is available, and safety and design standards. Changes in use or design not approved by the permit or the issuing authority may cause the revocation or suspension of the permit. APPEALS 1. Should the permittee or applicant object to the denial of a permit application by the Department or object to any of the terms or conditions of a permit placed there by the Department, the applicant and permittee (appellant) have a right to appeal the decision to the [Transportation] Commission [of Colorado]. To appeal a decision, submit a request for administrative hearing to the Transportation Commission of Colorado within 60 days of transmittal of notice of denial or transmittal of the permit for signature. Submit the request to the Transportation Commission of Colorado, 4201 East Arkansas Avenue, Denver, Colorado 80222-3400. The request shall include masons for the appeal and may include changes, revisions, or conditions that would be acceptable to the permittee or applicant. • 2. Any appeal by the applicant or permittee of action by a local issuing authority shall be filed with the local authority and be consistent with the appeal procedures of the local authority. 3. In submitting the request for administrative hearing, the appellant has the option of including within the appeal a request for a review by the Department's internal administrative review committee pursuant to [Code] subsection 2.10. When such committee review is requested, processing of the appeal for formal administrative hearing, 2.9(5) and (6), shall be suspended until the appellant notifies the Commission to proceed with the administrative hearing, or the appellant submits a request to the Commission or the administrative law judge to withdraw the appeal. The two administrative processes, the internal administrative review committee, and the administrative hearing, may not run concurrently. 4. Regardless of any communications, meetings, administrative reviews or negotiations with the Department or the internal administrative review Committee regarding revisions or objections to the permit or a denial, if the permittee or applicant wishes to appeal the Department's decision to the Commission for a hearing, the appeal must be brought to the Commission within 60 days of transmittal of notice of denial or transmittal of the permit. PERMIT EXPIRATION 1. A permit shall be considered expired if the access is not under construction within one year of the permit issue date or before the expiration of any authorized extension. When the permittee is unable to commence construction within one year after the permit issue date, the permittee may request a one year extension from the issuing authority. No more than two one-year extensions may be granted under any circumstances. If the access is not under construction within three years from date of issue the permit will be considered expired. Any request for an extension must be in writing and submitted to the issuing authority before the permit expires. The request should state the reasons why the extension is necessary, when construction is anticipated, and include a copy of page 1 (face of permit) of the across permit Extension approvals shall be in writing. The local issuing authority shall obtain the concurrence of the Department prior to the approval of an extension, and shall notify the Department of all denied extensions within ten days. Any person wishing to reestablish an access permit that has expired may begin again with the application procedures. An approved Notice to Proceed, automatically renews the access permit for the period of the Notice to Proceed. CONSTRUCTION 1. Construction may not begin until a Notice to Proceed is approved. (Code subsection 2.4] 2. The construction of the access and its appurtenances as required by the terms and conditions of the permit shall be completed at the expense of the permittee except as provided in subsection 2.14. All materials used in the construction of the access within the highway right-of-way or on permanent easements, become public property. Any materials removed from the highway right-of-way will be disposed of only as directed by the Department. All fencing, guard rail, traffic control devices and other equipment and materials removed in the course of access construction shall be given to the Department unless otherwise instructed by the permit or the Department inspector. 3. The permittee shall notify the individual or the office specified on the permit or Notice to Proceed at least two working days prior to any construction within state highway right-of-way. Construction of the access shall not proceed until both the access permit and the Notice to Proceed are issued. The access shall be completed in an expeditious and safe manner and shall be finished within 45 days from initiation of construction within the highway right-of-way. A construction time extension not to exceed 30 working days may be requested from the individual or office specified on the permit 4. The issuing authority and the Department may inspect the access during construction and upon completion of the access to ensure that all terms and conditions of the permit are met. Inspectors are authorized to enforce the conditions of the permit during construction and to halt any activities within state right-of-way that do not comply with the provisions of the permit, that conflict with concurrent highway construction or maintenance work, that endanger • • highway property, natural or cultural resources protected by law, or the health and safety of workers or the public. 5. Prior to using the access, the permittee is required to complete the construction according to the terms and conditions of the permit. Failure by the permittee to abide by all permit terms and conditions shall be sufficient cause for the Department or issuing authority to initiate action to suspend or revoke the permit and close the access. If in the determination of the Department or issuing authority the failure to comply with or complete the construction requirements of the permit create a highway safety hazard, such shall be sufficient cause for the summary suspension of the permit. If the permittee wishes to use the arracs prior to completion, arrangements must be approved by the issuing authority and Department and included in the permit. The Department or issuing authority may order a halt to any unauthorized use of the access pursuant to statutory and regulatory powers. Reconstruction or improvement of the access may be required when the permittee has failed to meet required specifications of design or materials. If any construction element falls within two years due to Improper construction or material specifications, the permittee shall be responsible for all repairs. Failure to make such repairs may result in suspension of the permit and closure of the access. 6. The permittee shall provide construction traffic control devices at all times during access construction, in conformance with the M.U.T.C.D. as required by section 42- 4-104, C.R.S., as amended. 7. A utility permit shall be obtained for any utility work within highway right-of-way. Where necessary to remove, relocate, or repair a traffic control device or public or private utilities for the construction of a permitted access, the relocation, removal or repair shall be accomplished by the permittee without cost to the Department or issuing authority, and at the direction of the Department or utility company. Any damage to the state highway or other public right-of-way beyond that which is allowed in the permit shall be repaired immediately. The permittee is responsible for the repair of any utility damaged in the course of access construction, reconstruction or repair. 8. In the event it becomes necessary to remove any right- of-way fence, the posts on either side of the access shall be securely braced with an approved end post before the fence is cut to prevent any slacking of the remaining fence. All posts and wire removed are Department property and shall be turned over to a representative of the Department. 9. The permittee shall ensure that a copy of the permit is available for review at the construction site at all times. The permit may require the contractor to notify the individual or office specified on the permit at any specified phases in construction to allow the field inspector to inspect various 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 right-of-way or any adopted municipal system and drainage plan. 11. By accepting the permit, permittee agrees to save, indemnify, and hold harmless to the extent allowed by law, the issuing authority, the Department, its officers, and employees from suits, actions, claims of any type or character brought because of injuries or damage sustained by any person resulting from the permittee's use of the access permit during the construction of the access. CHANGES IN ACCESS USE AND PERMIT VIOLATIONS 1. It is the responsibility of the property owner and permittee to ensure that the use of the access to the property is not in violation of the Code, permit terms and conditions or the Act. The terms and conditions of any permit are binding upon all assigns, successors -in -interest, heirs and occupants. If any significant changes are made or will be made in the use of the property which will affect access operation, traffic volume and or vehicle type, the permittee or property owner shall contact the local Issuing authority or the Department to determine if a new access permit and modifications to the access are required. 2. When an access is constructed or used in violation of the Code, section 43-2-147(5Xc), C.R.S., of the Act applies. The Department or issuing authority may summarily suspend an access permit and immediately order closure of the access when its continued use presents an immediate threat to public health, welfare or safety. Summary suspension shall comply with article 4 of title 24, C.R.S. MAINTENANCE 1. The permittee, his or her heirs, successors -in -interest, assigns, and occupants of the property serviced by the access shall be responsible for meeting the terms and conditions of the permit, the repair and maintenance of the access beyond the edge of the roadway including any cattle guard and gate, and the removal or clearance of snow or ice upon the access even though deposited on the access in the course of Department snow removal operations. Within unincorporated areas the Department will keep access culverts clean as part of maintenance of the highway drainage system. However, the permittee is responsible for the repair and replacement of any access -related culverts within the right-of-way. Within incorporated areas, drainage responsibilities for municipalities are determined by statute and local ordinance. The Department will maintain the roadway including auxiliary lanes and shoulders, except in those cases where the aces installation has failed due to improper access construction and/or failure to follow permit requirements and specifications in which case the permittee shall be responsible for such repair. Any significant repairs such as culvert replacement, resurfacing, or changes in design or specifications, requires authorization from the Department. Form 101, Page 3 • COLORADO DEPARTMENT OF TRANSPORTATION Environmental Clearances Information Summary PURPOSE - This summary is intended to inform entities external to CDOT that may be entering the state highway right-of-way to perform work related to their own facilities (such as Utility, Special Use or Access Permittees), about some of the more commonly encountered environmental pernits/dearances that may apply to their activities. This listing is not all-inclusive - additional environmental or cultural resource permits/dearances 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 httwJ/www.cdohe.state.co.us/oermits.aso. • CDOT Water Quality Program Manager; Rick Willard (303) 757-9343 • COOT 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 httoJJlwww nwo usace.armv.mil/htmUod-tladdgies.html Sacramento Dist. (Western CO), Grand Junction Office (970) 243-1199 htto:/hvvnv.sok usace.armv mil/cesok-co/reaulatorv/ Albuquerque District (SE Colorado), Pueblo Reg. Office (719)-543-6915 httrz/hwnv.soa.usace.army,miUred • CDOT Utilities, Special Use and Access Permitting (303) 757-9654 http;[hvww.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 COOT permitting office. If any threatened or endangered species are encountered during the progress of the permitted work, work in the subject area shall be halted and the CDOT Regional Permitting Office and Regional Planning and Environmental Manager shall be contacted immediately. Authorization must be provided by COOT prior to the continuation of work. Information about threatened or endangered species may be obtained from the COOT website htto://www.dotstate co.us/environmental/Wildlife/Guidelines aso or the Colorado Division of Wildlife website fitto:/Avildlifestate,co.us/WildlifeS0ecies/SoeciesOfConcem/. Additional guidance may be provided by the Regional Permitting Office in the Permit Special Provisions. Cultural Resource — 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 CDOT. If archaeological or historical artifacts are encountered during the progress of the permitted work, work in the subject area shall be halted and the COOT 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-Stonnwater Discharges - Unless otherwise identified by COOT 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 (TSD) of hazardous waste except at permitted TSD sites. There are no permitted landfills or TSD sites within the State Highway Right of Way. Therefore, all solid or hazardous wastes that night 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 • • • Environmental Clearances information Summary 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 soil, must comply with the CDHPE Hazardous Materials and Waste Management Division's (HMWMD) Solid Waste Regulations. The application for any CDOT permit must specifically identify any ACM involved in the work for which authorization is being requested. Additional guidance or requirements may be specified in the permit special provisions. Contact Info: CDPHE APCD and HMWMD Regulations can be accessed via the CDPHE Environmental Permitting Website listed above. Additional information 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 Stonnwater 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 COPS Stormwater Permit. Contact Information: For Utility/Special Use activities being performed in conjunction and coordination with a COOT 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://wenv.cdphe.state.co.ushvo/PermitsUnithvqWomt.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:httirl/www.cdohe.stateco.usAva/PemibUnitAvacdomt.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 ("MINDI'). Contact Info: Contact the CDPHE WQCD at (303)692-3500. Website: http://wonv.cdohe.state.co.ushwilPermitsUnithvocdomt.htrnl Municipal Separate Storm Sewer System (MS41 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 CDOT 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 CDOT and the CDHPE. 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 http://www.cdphe.sate.co.usAvc#PermhsUnittwocdpmt.html#MunicipalFormsGuidance. 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 'Generar or idividual' 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 COOT 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: jytpJ/www.dol.state.co.us/environmentaVenvWaterQuat/woms4.asp Disposal of Drilling Fields - Drilling fluids used in operations such as Horizontal Directional Oriling 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 cywrifically 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 CDOT / CDPHE Liaison or CDOT Water Quality Program Manager. Concrete Washout - Waste generated from concrete activities shall NOT be allowed to flow into the drainage ways, inlets, receiving waters, or in the CDOT ROW. Concrete waste shall be placed in a temporary concrete washout facility. Concrete washout shall only be performed as specified by the CDOT Environmental Program and shall be in accordance to CDOT specifications and guidelines. Contact Information: Contact the COOT Water Quality Program Manager 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 burled. All spills shall be reported to the COOT Illicit Discharge Hotline at (303) 512-4446 (4H20), as well as the Regional Permitting Office and Regional Maintenance Supervisor. Spills on highways, into waterways, or that may otherwise present an Page 2 of 3 Colorado Department of Transportation ovemeer • • • 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 authorized by applicable requirements, or an exemption, approval or registration has been issued. Vehicles requiring a placard, must obtain authorization and a State HAZMAT Permit from the Colorado Public Utilities Commission. Contact Information: For authorization and more info call the Federal Motor Safety Cartier Administration, US DOT for inter- and infra -state HAZMAT Registration (303) 969-6748. Colorado Public Utilities Commission: (303) 894-2868. Paleontoloav - The applicant must request a fossil beaky 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 COOT 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. Woridna on or In any abeam or its bank - In order to protect and preserve the state's fish and wildlife resources from actions that may obstruct, diminish, destroy, change, modify, or vary a natural existing stream or its banks or tributaries, it may be necessary to obtain a Senate Bill 40 certification from the Colorado Department of Natural Resources. A stream is defined as 1) represented by a solid blue line on USGS 7.5' quadrangle maps; and/or 2) intermittent streams providing live water beneficial to fish and wildlife; and/or 3) segments of streams supporting 25% or more cover within 100 yards upstream or downstream of the project and/or 4) segments of streams having wetlands present within 200 yards upstream or downstream of the project. The Colorado Division of Wildlife (CDOW) application, as per guidelines agreed upon by CDOT and CDOW, can be accessed at www.dot state co us/environmentalhirildlife/oemtlagolicatiOn.aso. About This Form - Questions or comments about this Information Summary may be directed to Dahir Egal, COOT Safety & Traffic Engineering, Utilities Unit, at (303) 757-9344, dahir.ec1a_Ifadpt.state.co.us Environmental Clearances Information Summary Page 3 of 3 Colorado Department of Transportation November'07 • • State Highway Access Permit 1 Attachment to Permit No. 408035 - Additional Terms and Conditions • • 1. If there are any questions regarding this permit, please contact Tim Bilobran at (970) 350-2163. 2. The Permittee shall refer to all additional standard requirements included with this permit and any enclosed additional terms, conditions, exhibits, and noted attachments. 3. Incorporated as part of this permit are the following: Application for Acrns Permit (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 and Bridge Construction (current edition). 6. If necessary, minor changes, corrections and/or additions to this permit may be ordered by the Department inspector, other Department representative or local authority to meet unanticipated site conditions. Changes may not be in violation of the State Highway Access Code. All major changes to the plans must be approved in writing by the Department prior to commencement of any work on or within the State Highway right-of-way. All workers within the State Highway right-of-way shall comply with their employer's safety and health policies/procedures, and applicable U.S. Occupational Safety and Health Administration (OSHA) regulations - including, but not limited to the applicable sections of 29 CFR Part 1910 - Occupational Safety and Health Standards and 29 CFR Part 1926 - Safety and Health Regulations for Construction. At a minimum, all workers in the State Highway right-of-way, except when in their vehicles, shall wear the following personal protective equipment: * Head protection that complies with the ANSI Z89-1-1997 standard; * At all construction sites or whenever there is a danger of injury to feet, protective footwear that complies with the ANSI Z41-1999 standard will be worn; * High visibility apparel as specified in the Traffic Control provisions of this permit (at a minimum, ANSUISEA 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. 408035 - 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. The Permittee is responsible for obtaining any necessary additional federal, state, and/or City/County permits or clearances required for construction of the access. Approval of this access permit does not constitute verification of this action by the Permittee. 12. All costs associated with the reconstruction of this access are the responsibility of the Permittee. This includes design, construction, signing and striping, utility relocation, testing of materials, and inspections. 13. No work will be allowed at 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. 14. Traffic detours or lane closures will not be allowed, unless pre -approved by the Department. 15. No construction vehicles shall be parked, or construction materials/equipment stored, on the State Highway right-of-way overnight. 16. No work shall be performed near a Department electronic traffic control device without coordination with Cobie Garbiso at (970) 350-2137. 17. Landscaping and site construction shall not obstruct sight distance at any State Highway access point. Landscaping within the State Highway right-of-way requires the Permittee to obtain a CDOT Landscaping Permit from the Traffic/Access Section. The access permit does not authorize that activity. Irrigation of features within the right-of-way may require the Permittee to install a subsurface drain in accordance with CDOT Standard M-605-1 or other approved system. The Permittee shall contact Linda McWilliams, at the Greeley Traffic Office, (970) 350-2147 to obtain the Landscaping Permit. 18. 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. • • State Highway Access Permit Attachment to Permit No. 408035 - Additional Terms and Conditions • • 19. All work is to conform to the plans referenced by this permit on file with the Department or as modified by this permit. (If discrepancies arise, this permit shall take precedence over the plans.) The Department plan review is only for the general conformance with the Department's design and code requirements. The Department is not responsible for the accuracy and adequacy of the design, dimensions, elevations, and any other elements which shall be confined and correlated at the work site. The Department through the approval of this document, assumes no responsibility for the completeness and/or accuracy of the plans. 20. Survey markers or monuments must be preserved in their original positions. Notify the Department at (970) 350-2173 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. 21. 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. 22. The Permittee or the contractor shall notify Linda McWilliams at (970) 350-2147 or (970) 301-1127 at least two working days prior to beginning any access improvements or construction of any kind within the State Highway right-of-way. Failure to comply with this requirement may result in revocation of this permit. 23. The Department inspector may suspend any work due to: 1) Noncompliance with the provisions of this permit; 2) Adverse weather or traffic conditions; 3) Concurrent highway construction or maintenance in conflict with permit work; 4) Any condition deemed unsafe for workers or the general public. The work may be resumed upon notice from the Department inspector. 24. The access shall be reconstructed at 25 feet wide with 20 feet radii. 25. Construction traffic devices, when not in use, shall be removed or turned away from traffic. 26. 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. 27. All required access improvements shall be installed prior to the herein authorized use of this access. 28. The access shall be resurfaced immediately upon completion of earthwork construction and prior to use. 29. Resurfacing of the access shall be maintained as per Exhibit "A". 30. No paved surface shall be cut unless specified in this permit. Asphalt removal shall be saw cut to assure a straight edge for patching. 31. If frost, water or moisture is present in the subgrade, no surfacing materials shall be placed until all frost, water or moisture is gone or removed. • • State Highway Access Permit Attachment to Permit No. 408035 - Additional Terms and Conditions • • • 32. The access shall be reconstructed and maintained in a manner that will not cause water to enter onto the roadway, and will not interfere with the existing drainage system within the State Highway right-of-way. Drainage to the State Highway right-of-way shall not exceed historical rate of flow. 33. The Permittee shall request final inspection by Linda McWilliams 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. 34. 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. 35. 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. 36. The design and reconstruction of access and/or development of this property shall not negatively impact adjacent nearby properties. Correction of the problem and cost resulting from damages shall be borne by the Permittee. 37. Two-way traffic shall be maintained throughout the work area at all times unless specific written authorization is obtained from the Department. 38. 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. 39. It is the responsibility of the Permittee to determine which environmental clearances and/or regulations apply to the project, and to obtain any clearances that are required directly for the appropriate agency prior to commencing work. Please refer to or request a copy of the "CDOT Environmental Clearance Information Summary" (ECIS) for details. The ECIS may be obtained CDOT Permitting Offices or may be accessed via the CDOT Planning/Construction-Environmental Guidance webpage at http://www.dot.state.co.us/environmental/Forms/asp. FAILURE TO COMPLY WITH REGULATORY REQUIREMENTS MAY RESULT IN SUSPENSION OR REVOCATION Of YOUR CDOT PERMIT, OR ENFORCEMENT ACTIONS BY OTHER AGENCIES. • • State Highway Access Permit Attachment to Permit No. 408035 - Additional Terms and Conditions • • • ALL discharges are subject to the provisions of the Colorado Water Quality Act and the Colorado Discharge Permit Regulations. Prohibited discharges include substance such as: wash water, paint, automotive fluids, solvents, oils or soaps. Unless otherwise identified by CDOT or the Colorado Department of Public Health and Environmental (CDPHE) Water Quality Control Division (WQCD) as significant sources of pollutants to the waters of the State, the following discharges to storm water systems are allowed without a Colorado Discharge Permit System Permit: landscape irrigation, diverted stream flows, uncontaminated ground water infiltration to separate storm sewers, discharges from potable water sources, foundation drains, air condition condensation, irrigation water, springs, footing drains, waterline flushing, flows from riparian habitats and wetlands, and flow from fire fighting activities. ANY OTHER DISCHARGES, including storm water discharges from industrial facility or construction sites, may require Colorado Discharge Permit System permits from CDPHE before work begins. For additional information and forms, go to the CDPHE website at: http://cdphe.state.co.us/wq/PermitsUnit/wqu. 40. The Pennittee shall extend the current 18 inch corrugated metal pipe and shall provide for proper side slopes. Culverts over 18 inches in diameter shall have end sections. \\''t • COLORADO DEPARTMENT OF TRANSPORTATION STATE HIGHWAY ACCESS PERMIT APPLICATION Issuing authority application acatriniteAri met, Instructions - Contact the Colorado Department of Transportation (COOT) or your local government to detemene your issuing authority. - Contact the Issuing authority to determine what plans and other documents are required to be submitted with your application. to thisform Complete ((s for each accessaffected. uton myof to you) and attach all necessary documents and Submit it to the issuing authority. Please print - Submit or type • It you have any questions contact the Issuing authority - For additional information see CDOTs Access Management websiteatbttnt'www dotstate co ta/AccasaPermltsandex him 1) Property owner (PenNtaa) , 44A4Nuec /3,4LbE72AS 2) Agent tor pennittee (if different from property owner) Street address 7- 4., 3 iliwy vs Mailing address City, state & zip F427 tu/'ToN,C'0 ?doe/ Phone I ([ :3c3- 35)-9/70 City, state & zip Phone I (required) E-mail address J 9 me i o..vSA/(i, ('v.al1 E-mail address if available 3) Address of property to be served by permit (required) ?5s 3 Nary8S" FACT Ir./2To4', <o roes % 4) Legal description of property: within jurisdictional limits of Municipality, city and/or County, which one? county eubn I block I I 30 I t'acrN I range`6' 1,1".E (-A ItllHniw` 5) What State Highway are requesting artess from? 6) What side of the - way? ❑N US W you /IMO/ 8S U E % 7) How many feet is the proposed access from the nearest mile post? .4' -\ How many feet is the proposed access from the nearest cross street? ENV) from: '-\1S feet aNiiS0E❑w)from. feet FIN iii SIDE 8) What is the approximate date you intend to begin construction? A.S,4f 9 Check here it you are requesting a: new access ❑temporary access (duration anticipated: ) Improvement to existing access E change in access use removal of access tlon of an existing access (provide detail) 10) Provide existing property use /[%✓ SC TO C.C./ SiuPeurrA x./1/!!1 11) Do you have knowledge of any State Highway access permits serving this property, or adjacent properties in which you have a property interest? pemit number(s) and provide copies: and/or, permit date: pino • yes, If yes - what are the 12) Does th p owner own or have any interests in any adjacent property? �no yes, if yes - please describe: 13) Are there other existing or dedicated public streets, roads, highways or access easements bordering or within the property? your plans and Indicate the proposed and existing access points. Vino ■ yes, if yes • list them on 14) If you are requesting agricultural field access - how many acres will the access serve? /vii 15) It you are requesting commercial or industrial access please indicate the types and number of businesses and provide the floor area square footage of each. business4and use square footage business square footage 272/1f0✓/t,13 YA/.1 I3/1 i 01 I I I 16) It 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 i I I I 17) Provide the following vehicle count estimates for vehicles that will use the access. Leaving the properly then returning Is two counts. Indicate if your counts are Desk hour volumes or Waverage daily volumes. a of passenger can and runt mucks a peek hair Mums /7 I of mutt unit trade at peak hour volumes a of angle unit vehicles In excise of 30 ft a a farm vehicles (Held equipment) Total count Wall vehicles X I1 Previous edWona are obsolete and may not be used Page 1 of 2 COOT Form 4137 12/04 18) Check with the issuing authority to determine which of the following documents a) Property map indicating other access, bordering roads and streets. b) Highway and driveway plan profile. c) Drainage plan showing impact to the highway right-of-way. d) Map and letters detailing utility locations before and after development in and along the right-of-way. are required to complete the review of you application. e) Subdivision, zoning, or development t) Proposed access design. plan. easements. g) Parcel and ownership maps inducing h) Traffic studies. i) Proof of ownership. 1- It is the applicant's responsibility to contact appropriate agencies and obtain all environmental clearances that apply to their activities. Such clearances may include Corps of Engineers 404 Permits or Colorado Discharge Permit System permits, or ecological, archeological, historical or cultural resource clearances. The CDOT Environmental Clearances Information Summary presents contact information for agencies administering certain clearances, information about prohibited discharges, and may be obtained from Regional CDOT Utility/Special Use Permit offices or accessed via the CDOT Planning/Construction-Environmental-Guidance webpage http://www.dot.state.co.uslenvironmentallForms.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: <htto://www.dot,state.co.us/DesignSupporti> then click on Design Bulletins. I. 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. Applicants signature Prim name Date If the applicant is not the owner of the property, we require this application also to be signed by the property owner or their legally authorized representative (or other acceptable written evidence). This signature shal 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. owner signature PropIP2a2 '"'Esido-t— Print name 44 itv1 ►3,+cc�e, Date Lia., v 1. • Previous editions are obsolete and may not to used Page 2 of 2 CDOT Form 0137 12/04 • Or E O U • -p A ) 3 { $ ) 7T Pt 'Dr[ ORME • • Street Atlas USN& 2006 • _ _117 Vicinity Map for Access Permit #408035 Qvohlmar L Data use subject to license. O 2005 Detomte. Street Atlas USA® 2006. www.delame.corn Scale 1 : 50000 1'=4166.76 Data Zoom 12-0 • • • • • MB Auto Sales & Salvage Waste Management Plan J32 I E 96 Arc. QrrttJ The following information is a detailed plan on how our facility will manage waste produced by wrecked and salvaged vehicles. Our goal is to operate an environmentally friendly business based on reusing, reselling and recycling. Wrecked & Salvage Vehicles: Our objective is to drain and collect all fluids from incoming vehicles as soon as possible, including fluids from the engine, fuel tank, transmission and radiators. If we are unable to drain fluids from an incoming vehicle immediately, they will be inspected for leaks. Our first priority will be given to vehicles received that are leaking fluids. Although it has been our experienced that wrecked vehicles often leak most of their fluids at the accident scene, the following is an explanation on how these situations will be handled. Vehicles received that are leaking fluids will be placed on a concrete slab in order not to contaminate the ground. Drain pans will be placed under vehicles to catch leaking fluids. Fluids will then be placed in specified containers. After all leaking fluids have been completely drained or stopped, the vehicle will either be moved into the police impound yard or the salvage yard. No further draining/recovery procedures will be taken on impounded vehicles. Salvage vehicles received that are not leaking fluids will be scheduled to be dismantled. At this scheduled time, all fluids will be properly drained and stored in appropriate containers. During the dismantling of the vehicle, all reusable and recyclable parts and materials will also be removed. Any fluids spilled on the concrete slab or inside the shop, will be cleaned using absorbent pads, floor dry, and/or spill prevention kits. All materials as a result of spills and cleanups that are unable to be recycled will be taken to the Weld County Hazardous Disposal Center. The following is an explanation of how fluids and materials will be properly reused, resold, and recycled. Vehicle Fluids Used Antifreeze Antifreeze removed from incoming vehicles will be filtered and reused or resold. If direct reuse is not possible, the antifreeze will be recycled by on offsite commercial antifreeze recycler. • • • Containers used to store used antifreeze that will be labeled: "used antifreeze or recycled antifreeze." Gasoline and Diesel Fuels Usable fuel removed from incoming vehicles may be directly reused in our shop or yard vehicles. Containers used to store fuels will be labeled: "usable gasoline, usable diesel, or hazardous waste fuel." If fuels are not reusable or recyclable, they will be disposed as hazardous waste by an offsite fuel recycler. Used Oil Used oil which includes motor oil, gear oil, power steering fluid, transmission fluid, differential oil, and transaxle fluid will be used for an on -site oil fired furnace. If the used oil is not recyclable because it has been contaminated or mixed with something that makes it a hazardous waste, it will be disposes as hazardous waste. Air Conditioning Gas Recovery Vehicles received that contain air conditioning gases such as Freon and R12 will be scheduled with a state certified recovery agent to have these gases removed. Vehicle Parts Used Oil & Fuel Filters Used oil and fuel filters from passenger vehicles and light duty trucks will be completely drained of oil and fuel prior to recycling or disposal. Filters will be placed on a drain rack for at least 24 hours. After a filter is completely drained, it will be placed in a scrap metal bin for recycling. Lead -acid batteries Batteries in good condition may be recharge and resold. If the battery is in poor condition, it will be recycled through a commercial battery recycler or supplier. Good lead -acid batteries will be stored indoors. Batteries to be recycled will be stored outdoors in closed polypropylene plastic containers or stored upright on pallets in an enclosed shed. Lead Parts Wheel weights, battery cable ends, radiators and heater cores that contain lead will be removed from salvage vehicles before crushing. These parts will be recycled as scrap metal. They will be put into bins or containers labeled scrap metal -lead. Catalytic converters Catalytic converters which contain metals such as platinum, rhodium and palladium will be recycled as scrap metal. • • • • • Tires Tires removed from salvage vehicles will be sold for reuse if they are in good condition. Otherwise, they will be sent offsite to a permitted waste tire recycling or disposal facility. Shop and Yard Operations Parts Washers Parts washers used at our facility will be maintained and serviced by the leasing company. Used Shop Rags Shop towels contaminated with solvents, used oil, and other contaminants will be cleaned by an industrial launderer and returned for reuse. Shop rags that are contaminated with a hazardous waste will be stored in an appropriate container labeled hazardous waste -shop towels. Spills & Clean Up Any fluids spilled on the concrete either indoors or outdoors, will be cleaned using absorbent pads and/or absorbent floor dry. Our facility will always have spill prevention kits on hand including absorbent pads and/or oil absorbent floor dry for unexpected spills and cleanups. All materials as a result of spills and cleanups that are unable to be recycled will be taken to the Weld County Hazardous Disposal Center. Auto Body & Collision Repair Facility Our fist step in operating an environmentally friendly repair facility is to look for opportunities to purchase and use eco- friendly materials and limit the use of hazardous materials. As a result this will generate less waste, have a cleaner and safer work environment and reduce our compliances for waste management. We will also explore new technologies that reduce air emissions, toxins and waste. Waste collected from the auto body and collision repair facility will be collected in containers provided to us by our paint suppliers. Our paint suppliers have agreed to reclaim and recycle left over materials such as paint thinners, paint strippers, and spray gun cleaning solvent. Waste Management References Tri-State Oil Recycling Cheyenne, WY Collins, CO 307-635-5332 All Recycling Englewood, CO 303-922-7722 Raptor Oil Fort 970-346-8208 cd • Bat Ritter, Jr. GOVERNOR Peter A. Weir EXECUTIVE DIRECTOR Colorado State Patrol Colorado Bureau of Investigation Division of Criminal Just:* Office of Preparedness. Security. and Fire Safety • DS COLORADO DEPARTMENT OF PUBLIC SAFETY January 30, 2009 M and B Towing Mr. Manuel Balderas Sr. 2732 Weld County Road 27 Ft. Lupton, Co 80621 Dear Mr. Balderas: Chid Mark V. Trostel Colorado State Patrol 700 Kiplino St. Suite 1000 Denver, CO 80215-5865 (303) 239-4500 TOO (303) 239-4505 FM (303) 239-4481 I am writing this letter in support of your move to your new location, located at 7853 Highway 85 near Ft. Lupton. I have visited your new site and observed the improvements you have made to the fencing, I am confident that the fence will provide adequate security for any CSP tows that may be towed and stored at your facility. You have graciously entered into an agreement to allow CSP the use of the enclosed garages at this location to store and hold vehicles we have towed for investigation of serious and fatal crashes. The use of your garages allows my Accident Reconstruction Team to complete their investigations more quickly as they are able to work inside and are not held up by weather. Many of these investigations result in the filing of felony charges, and the use of the garages allows us to meet short time lines for filing these type of charges. You have provided CSP Troop 3A (Weld County) exceptional towing service for over 20 years as a part of our rotation list, I look forward to many more in the future at your new location. I am a strong supporter for your operation at 7853 Highway 85. Sincerely, 1, C_ CLUAL- Captain Paul Matzke Commander Troop 3A Colorado State Patrol 3939 Riverside Parkway #B Evans, CO 80620 970-506-4982 Foal in Traffic Safely ABRIGHTON v _ January 16, 2009 POLICE DEPARTMENT "Prevent Crime and Disorder" To Whom It May Concern: Please accept this letter as a personal and professional recommendation for Manuel Balderas and his business MB Towing. I have known Manuel since 1985. At that time I was a Captain for the Brighton Police Department and Manuel also worked for the City of Brighton. Several years later both of us left our employment with the City, but we maintained a casual personal relationship. Since 1995, when I became the Chief of the Brighton Police Department, MB Towing has provided towing service for the City of Brighton. We are very satisfied with the services that they have given to the citizens of this area. On a personal level, I have found Manuel to be an honest, hardworking businessman. He and his sons have built a successful auto salvage, auto sales and towing/storage company from the ground up and I believe they have an excellent reputation for honestly and fair service in this area. One of Manuel's sons, Daniel, is a police officer for the City of Brighton. If you have any additional questions, please feel free to contact me at 303-655- 2303. Sincerely, Clint R Blackhurst, Chief of Police Brighton Police Department 3401 E. Bromley Lane Brighton, Colorado 80601 303-655-2300 Fax 303-659-6961 • • • • FORT LUPTON POLICE DEPARTMENT 130 S. McKinley Avenue, Fort Lupton, Colorado 80621 303-857-4011 Fax 303-857-2703 Ronald E. Grannis, Chief of Police To Whom It May Concern, The City of Fort Lupton Police Department has contracted with M&B Towing Service for the past two years. During that time we have found the owner Manual Balderas and his employees to be exceptional. Response times have been more than adequate when called to tow a vehicle. This is critical to both get the officer back on duty and to open roadways to prevent any further problems. M&B has stored vehicles of critical evidentiary value on several occasions. These vehicles were found to be secure and accessible at all times. This is a great help for court proceedings. The City has just renewed this contract for 2009. We are convinced that the high level of service provided by M&B will continue. Hello