HomeMy WebLinkAbout20082466.tiff IDDEPARTMENT OF PLANNING SERVICES
918 10th Street, Greeley, Colorado 80631
Phone (970)353-6100, Ext. 3540 Fax (970) 304-6498
USE BY SPECIAL REVIEW (MINING OPERATION)APPLICATION
FOR PLANNING DEPARTMENT USE DATE RECEIVED: ______
RECEIPT# /AMOUNT # _______1$ CASE # ASSIGNED: ___
APPLICATION RECEIVED BY__ __ PLANNER ASSIGNED:
To be completed by APPLICANT is accordance with procedural guide requirements:
1. I (we),the undersigned, hereby request a hearing before the Weld County Planning Commission concerning
a proposed__Gi(L R V E.L __ (gravel, coal, borrow pit, etc.) mining operation for the following described
unincorporated area of Weld County:
Legal Description S.EE T A74C NED ,Section_Li, Township 5_North, Range GS West
Flood Plain:__7E5___ Zone District: A , Total Acreage:__3 __.13_ , Overlay District: A/V
Geological Hazard:__r3LO , Airport Overlay District: YG 5 ,
2. Surface owner(s) of area of land described ,f
Qu. 75uY 8'^, g
Name: Dc r —i,., 4Z . Pylrs_ Address: Gra-a.i tut,.CD Phone:;`o) 59Q — /04 ?
Name: Address: aQy 3 - . 1 Phone:
• 3. Owner(s) of mineral rights or substance to be mined
Name: _&..,-.e. e. I1tic,✓e.- Address: Phone:
Name: Address: Phone:
1.4-C
4. Applicant's name:_gr.,kz.•. 4rxsx 1, vQ tr'+jh24 Email Address DAR Na_OE.RR.j1 , n, Corn
Address:- `1j_4j._ ;� [{_v_z � :w k,,, G i1 C.0 $O4 l__Phone: 'tn — /043
5. Identify any prior permits for mining held by applicant or affiliated person:
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 that the si atory has to legal authority to sign for the corporation.
ignature: Owner or Authorized Agent Date Signature: Owner or Authorized Agent Date
• 15 EXHIBIT
2008-2466 1 ' 3
EXHIBIT N
Source of Legal Right to Enter
By Owner of Affected Land and Substance to be Mined:
Darwin D. Derr
Post Office Box 898
Greeley, Colorado 80632-0898
Mr. Carl B. Mount
Senior Environmental Protection Specialist / Range Ecologist
Department of Natural Resources
Division of Reclamation, Mining and Safety
1313 Sherman Street
Room 215
Denver, CO 80203
Re: Derr Pit— Broken Arrow Investments, LLC, Construction Material Regular (112)
Operation Reclamation Permit Application
• Mr. Mount:
Please accept this letter as evidence that the applicant, Broken Arrow Investments,
LLC, has permission to enter and initiate a mining operation on the affected lands. By
signing this letter, I warrant that I have the legal and sole ownership of the affected
lands and substance to be mined, and authority to offer this permission.
Thank you, 6
Darwin D. Derr
State of O1w-ticI—
)ss
County of U.,C
The foregoing instrument was acknowledged before me this C14-L'•• day 1 of' 11
Co3` , by OP.Q_wkr' D O..wg. as MGncL*L of Qy w,. I\fLR-e.,i rrve�yr� is,LL
-
•
Notary Public
• My Commission Expires 11O3 1, (-a-
Derr Pit Project
DRMS112 Permit
A J&T Consulting, Inc.
• Legal Description
A TRACT OF LAND LOCATED IN THE NORTHEAST QUARTER OF SECTION 4, TOWNSHIP 5
NORTH, RANGE 65 WEST OF THE 6TH P.M.,WELD COUNTY, COLORADO, AND BEING MORE
PARTICULARLY DESCRIBED AS FOLLOWS:
COMMENCING AT THE NORTH QUARTER CORNER AND CONSIDERING THE WEST LINE OF SAID
NORTHEAST QUARTER TO BEAR S00°24'03'W WITH ALL OTHER BEARINGS CONTAINED HEREIN
BEING RELATIVE THERETO;
THENCE S00°24'03'W, 1507.94 FEET ALONG THE WEST LINE OF THE NORTHEAST QUARTER OF
SAID SECTION 4 TO THE TRUE POINT OF BEGINNING;
THENCE ALONG SAID FENCE LINE BY THE FOLLOWING FIFTEEN (15) COURSES;
1) N90°00'00"E , 290.53 FEET;
2) N86°48'59"E , 483.95 FEET;
3) N88°20'49"E , 281.65 FEET;
4) S59°51'23"E , 195.73 FEET;
5) S67°17'50"E , 39.30 FEET;
6) S84°15'58"E , 77.44 FEET;
7) S86°56'57"E , 124.39 FEET;
• 8) S44°10'17"E , 74.23 FEET;
9) S22°32'06"E , 52.16 FEET;
10) S10°07'53"E , 78.92 FEET;
11) S06°19'41"E , 231.20 FEET;
12) S04°38'46"E , 154.72 FEET;
13) S02°25'33"E , 103.63 FEET;
14) S58°10'43"E , 259.10 FEET;
15) S00°45'19"W , 179.93 FEET TO A POINT ON THE SOUTH LINE OF SAID NORTHEAST
QUARTER;
THENCE N89°14'26"W, 1815.36 FEET ALONG SAID SOUTH LINE TO THE SOUTHWEST CORNER
OF THE NORTHEAST QUARTER OF SAID SECTION 4;
THENCE N00°24'03"E, 1051.95 FEET TO THE TRUE POINT OF BEGINNING.
SAID TRACT CONTAINS 39.19 ACRES MORE OR LESS.
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• •
• STATEMENT OF CONSENT BY THE MEMBERS AND MANAGERS
OF DUST& DIRT EX CAVATING LLC
The undersigned, being all the members and managers of Dust & Dirt Excavating LLC, a
Limited Liability Company(the"Company"), in the manner authorized by C.R.S.Section 7-80-711,
and in lieu of an annual meeting, do hereby consent to the adoption to the following resolutions:
RESOLVED,that Darwin Derr,Douglas Derr be reelected to the offices of Manager to serve
the Company for the following year or until such time as their successors are duly elected.
RESOLVED, that Darwin Derr be reelected to the office of President, Douglas Derr be
reelected to the office of Vice President, Douglas Derr be reelected to the office of Secretary and
Douglas Derr be reelected to the office of Treasurer to serve the Company for the following year
or until such time as their successors are duly elected.
RESOLVED, that the actions of the managers and members for the fiscal year of the
company, ending December 31, 2004, be, and hereby are, ratified and confirmed in all respects.
IN WITNESS WHEREOF,the undersigned have hereto affixed their respective signatures
in their capacities as members and managers, it being understood that this Statement of Consent
shall be effective without any further action as of the date hereof. This written consent of the
members and managers entitled to vote has the same force and effect as a unanimous vote of
such members and managers. The action taken by this Company as members and managers is
• effective when all managers and members have signed this consent,unless this consent specifies
ad different effective date.
DATED this 9th day of March, 2004.
M NAGERS:M BERS:),,16.A\
- 1 jet&I\Z6O,t,
Darwin Derr arwin Derr
DouglasOerr Douglas Derr
•
C:\Documents and SettingslOwner'Mty Documents1WPDOCS12U04 LLC Minutes.wpd
•
• •
Use by Special Review (Mining Operation)
Questionnaire Responses
• The following information addresses each section of the Use By Special Review questionnaire and is
separated into responses for each specific section.
1. A detailed description of the method of mining operation.
The mining process is explained in the attached mining plan and 112 Permit Application that is
currently being reviewed by the State of Colorado Division of Reclamation, Mining, and Safety.
A water truck will be used to treat all on-site areas (haul roads, aggregate processing area, etc.) in
order to suppress dust.
a. The types and numbers of structures that will be erected (built)on site including operation
and processing equipment to be employed.
Aggregate Mining/Processing Facility:
The operation will include a dry screen, a crusher, an electrical/control trailer, conveyors, and
stacking facilities as shown on the Extraction Plan map. Al aggregate will be mined with an
excavator, dozer, and/or loader with the raw product being conveyed to the processing facility via
haul trucks and conveyors. A scale and scale operator trailer are located at the entrance to the
aggregate processing facility area.
No lighting is currently being used or is anticipated to be used for this processing facility.
b. The number of shifts to be worked and the maximum number of employees.
• Aggregate Mining/Processing Facility:
One shift will be worked with a maximum of 6 employees.
c. Whether the operation will involve a wet or dry pit
The aggregate mine operation will be conducted as a dry pit.
d. County roads and bridges to be utilized, along with site entrance/exit points. (Coordinate
with County Engineer).
All traffic to and from the site will use State Hwy 263 (8th Street) and County Road 41 ''A (Balsam
Avenue). One entrance to the pit will be on County Road 41 'A (Balsam Avenue). There will be
one entrance to the aggregate processing facility as shown on the Extraction Plan map.
All commercial traffic exiting the site will travel south on County Road 41 IA to State Hwy 263. All
commercial traffic, with the exception of local deliveries, will then proceed west on State Hwy 263
to US Hwy 85 or east on Hwy 263.
Commercial traffic entering the site will originate from US Hwy 85 or State Hwy 263. Traffic from
US Hwy 85 will travel east on State Hwy 263 to County Road 41 Y: and north on County Road 41
IA to the site entrance. Traffic from State Hwy 263 will travel west on State Hwy 263 to County
Road 41 IA and north on County Road 41 A to the site entrance.
e. The size of the area and stages to be worked at any one time.
• The area that is included in the permit boundary is 39.19 acres 31.85 acres within the permit
boundary are to be mined and reclaimed As shown on the Extraction Plan map the mine will
Broken Arrow Investments,LLC
"lad1 JaT Consulting, Inc. USR Application
Use by Special Review(Mining Operation)
• •
Use by Special Review (Mining Operation)
Questionnaire Responses
• progress in phases. 1 to 2 phases will be actively mined at any given point in time after Phase 1
is mined. The phases range in size from approximately 4.84 acres to 27.98 acres.
f. A time table giving the periods of time and number of phases to be worked, which will be
required for the various phases of the operation.
There will be 7 phases of mining. Broken Arrow Investments, LLC anticipates mining and
reclaiming the site in approximately 15 to 18 years. Annual production is expected to be between
150,000 and 250,000 tons depending on market demands. This production rate translates to 17
to 28 months of time required to mine each phase. Reclamation will progress concurrently with
the mining activity as each phase is completed.
g. The depth and thickness of the mineral deposit to be mined and the thickness of
overburden to be removed.
The final depth of the pit will vary from 70 to 90 feet. Overburden thickness ranges from 2.5 to 7.5
feet throughout the site. The gravel deposit thickness ranges from 0 to 90 feet. See the attached
soils investigations by Terracon and Two Rivers Testing for more detailed information.
h. The proposed use of reclaimed lands and an explanation of the reclamation process.
The mine will be reclaimed as a lined water storage reservoir. The reclamation process is
explained in the attached reclamation plan submitted to the State of Colorado Division of
Reclamation, Mining, and Safety.
i. The source of technical advice in that type of reclamation for open cut mining land.
•
The sources of technical advice for this type of reclamation are the West Greeley Soil
Conservation Service and J&T Consulting, Inc.
2. A statement which explains how the proposal is consistent with the Weld County
Comprehensive Plan.
Section 22-5-80 of the Weld County Comprehensive Plan, paragraph A. CM.Goal 1 states"Conserve
lands which provide valuable natural mineral deposits for potential future use in accordance with state
law." This site contains a valuable commercial deposit of sand and gravel located in the alluvium of
the South Platte River which is available for extraction.
Paragraph B CM.Goal 2 states "Promote the reasonable and orderly development of mineral
resources. There are other mines are within one-quarter mile or less of the site. This indicates that
the parcel proposed to be mined in this permit application is in a reasonable area for sand and gravel
extraction activities and the orderly development of the resource can occur.
3. A statement which explains how the proposal is consistent with the intent of the district in
which the use is located.
This site is in the"A"Agricultural Zone District. Section 23-3-40 of the Weld County Code, paragraphs
A. 3. and A. 4. list "Open pit MINING and materials processing as "mineral resource development
facilities" allowed by obtaining a Use by Special Review permit. The proposed use of the site as an
aggregate mine is consistent with this guideline.
•
- Broken Arrow Investments, LLC
V I J&T Consulting,Inc. USR Application
Use by Special Review(Mining Operation)
• •
Use by Special Review (Mining Operation)
Questionnaire Responses
• 4. If applicable, a statement which explains what efforts have been made, in the location decision
for the proposed use, to conserve productive agricultural land in the agricultural zone district
According to the "Important Farmlands of Weld County Colorado" map prepared by the USDA-Soil
Conservation Service and Colorado State University Experiment Station, the site is located in the
"Irrigated Land (Prime), "Irrigated Land (Not Prime)", and "Other Land" categories of farmland. The
majority of the permit boundary is within the"Irrigated Land (Not Prime)and "Other Land"as indicated
on the map.
5. A statement which explains there is adequate provision for the protection of the health, safety
and welfare of the inhabitants of the neighborhood and the County.
Broken Arrow Investments, LLC will follow The Design Standards in the Weld County Code (Section
23-2-240), and the Operation Standards (Section 23-2-250), which provide adequate provisions for
the protection of the health, safety and welfare of the inhabitants of the neighborhood and the County.
6. A statement describing the existing surrounding land uses and explaining how the proposal
will be compatible.
The surrounding land uses include irrigated agriculture land to the north and to the west, a residence
to the west, a gravel mine to the east, a couple of residences to the southwest, and vacant land,
commercial/industrial businesses, and a gravel mine to the south. The site is bounded by County
Road 41 1/2 on the west.
Sand and gravel operations are located in areas similar to this along the Poudre River corridor as
evidenced by other mines being in close proximity to this site. The end use for the site will be a lined
•
water storage reservoir which is compatible with the agricultural nature of the general area.
7. A statement describing the existing land use.
Current Parcel:
The current parcel is operating as a vacant agricultural field. One oil/gas well and a tank battery are
located on the parcel. The well and tank battery are to be re-located in the future pending approval of
final surface use agreements. The surface use agreements with the pertinent oil/gas company are
attached in draft form. The agreements are in the stage of preliminary approval from the oil/gas
company's legal department. All proposed well and tank battery locations have been provided to the
oil/gas company as shown in the extraction plan. The final recorded versions of these agreements will
be forwarded to the County when they are obtained.
8. Describe, in detail, the following:
a. How many people(employees, visitors, buyers, etc.)will use this site?
There will be a maximum of 6 employees on the site on any given day. The average number of
employees per day will be 3. There will be approximately 5 visitors per week on the site. See
section 8.d.for the number of haul/delivery trucks that will access the site.
b. What are the hours of operation?
The standard operating hours will be during daylight hours for all facilities on the site. Because
federal highway paving projects are often required to conduct their work activities at night to
• minimize the impacts to traffic flows, the aggregate processing facilities may occasionally operate
during night time hours if work on these types of projects is done.
- Broken Arrow Investments,LLC
a ' UT Consulting, Inc. USR Application
Use by Special Review(Mining Operation)
Use by Special Review (Mining Operation)
Questionnaire Responses
•
c. What type and how many animals, if any,will be on this site?
There will be no animals on site.
d. What kind (type, size,weight)of vehicles will access this site and how often?
Aggregate Mining/Processing Facility:
Passenger cars, pickups, 16 ton haul trucks, and 22 ton haul trucks will access the site daily.
Occasional access will be made by mechanic's trucks, fuel trucks, etc.
It is anticipated that the passenger cars and pickups, combined, will make a maximum of 12 trips
per day and an average of 6 trips per day to the site.
It is anticipated that the 16 ton gravel trucks will make a maximum of 15 trips per day and an
average of 10 trips per day to the site.
It is anticipated that the 22 ton gravel trucks will make a maximum of 30 trips per day and an
average of 25 trips per day to the site.
It is anticipated that the mechanical trucks, fuel trucks, etc. will make a maximum of 2 trips per
day and an average of 1 trip per day to the site.
e. Who will provide fire protection to the site?
• Union Colony Fire Rescue Authority
f. What is the water source on the property? (Commercial well or water district).
Bottled water will be used for domestic use. There will be no irrigation on the property. Water
taken from the pit dewatering once ground water is exposed will be used for dust suppression
and washing if the operator chooses to wash the material. Prior to ground water being exposed
the operator will utilize City of Greeley potable water for dust suppression. The operator will
purchase potable water from the City of Greeley. The operator plans to obtain a fire hydrant
meter from the City of Greeley to use water from the fire hydrant at the intersection of Hwy 263
and Balsam Avenue.
A well permit will be obtained prior to ground water being exposed. At this time the proposed
operation will not be washing the material during the aggregate processing.
A temporary substitute water supply plan will be provided to the State Engineer for the mining
operation prior to ground water being exposed. This plan will provide details of the consumptive
use associated with the operation of the mine and the source of the replacement/augmentation
water that will be used prior to ground water being exposed. The plan will be provided to the
County when it is approved.
Broken Arrow Investments, LLC will continue to follow the attached well monitoring plan (as
described in Exhibit G in the DRMS permit application) to determine if the dewatering of the pit,
when ground water is exposed, has any effect on the surrounding wells, and to take the
necessary steps to mitigate any damage to the wells. Broken Arrow Investments, LLC will
implement groundwater recharge ditches around the perimeter of the pit as part of their operation
• in an effort to ensure that no damage will occur prior to ground water being exposed.
Broken Arrow Investments,LLC
� ' Consulting, Inc. USR Application
Use by Special Review(Mining Operation)
• •
Use by Special Review (Mining Operation)
Questionnaire Responses
• g. What is the sewage disposal system on the property? (Existing and proposed).
Aggregate Mining/Processing Facility:
The existing property does not have a sewage disposal system.
The proposed gravel mine will apply for a sewage disposal system permit. A permit will be
obtained and the system will be installed to be utilized by the proposed mining facility.
h. If storage or warehousing is proposed,what type of items will be stored?
Overburden and aggregate stockpiles will be located as shown on the Extraction Plan map. The
maximum height of the largest stockpiles is expected to be 30 feet. Most stockpiles will be an
average of 15 to 20 feet in height.
i. Explain where storage and/or stockpile of wastes will occur on this site.
The waste generated by the scale/operator houses will be stored in standard storage bins located
adjacent to the scale/operator houses.
j. Explain the proposed landscaping/screening for the site. The landscaping shall be
separately submitted as a landscape plan map as part of the application submittal.
All disturbed areas will be reclaimed and seeded with the seed mix shown in the attached
reclamation plan when the reclamation activity for each phase is completed. A mixture of
evergreen and deciduous trees will be planted along the perimeter of the mine for screening as
•
shown on the Extraction Plan map.
k. Explain how long it will take to construct this site and when construction and landscaping
is scheduled to begin.Timetable 23-2-260.C.12.
The mining process is expected to begin in 2008 and is anticipated to take a total of 15 to 18
years to complete. Final seeding of disturbed areas will occur concurrently with the mining as
reclamation activities occur. The reclamation is expected to be completed one year after the
mining activities are completed. The screening trees will be planted as the mining progresses and
as the need for screening each phase arises.
I. Explain any proposed reclamation procedures when termination of the Use by Special
Review activity occurs.
The reclamation will follow the procedures outlined in the attached reclamation plan currently
under review by the State of Colorado Division of Reclamation, Mining, and Safety. The
reclamation will occur concurrently with the mining as each phase is completed with final
reclamation completed approximately one year after the conclusion of mining.
m. Explain how the storm water drainage will be handled on the site.
The stormwater generated on the undisturbed portions of the site will follow the historic flow
patterns by either infiltrating into the soil or flowing to the existing drainage ditches. The
stormwater on the disturbed portions of the site will be directed to the pit and discharged to the
Cache La Poudre River with the pit dewatering effluent.
•
Broken Arrow Investments,LLC
JaT Consulting,Inc. USR Application
Use by Special Review(Mining Operation)
Use by Special Review (Mining Operation)
Questionnaire Responses
• n. Method and time schedule of removal or disposal of debris, junk and other wastes
associated with the proposed use.
The only wastes generated by the site will be from the scale/operator houses. This waste will be
collected in standard storage bins and disposed of by commercial trash haulers.
o. A statement delineating the need for the proposed use.
Construction aggregates are in high demand along the Front Range. This site contains a
significant quantity of valuable commercial grade sand and gravel which is ideally suited for
meeting these needs.
p. A statement which explains the Use by Special Review area is not located in a flood plain,
geologic hazard and Weld County Airport overlay district area; or that the application
complies with Chapter 23, Article V, Overlay District Regulations as outlined in the Weld
County Code.
According to the Federal Emergency Management Agency Flood Insurance Rate Map (FIRM)
Community Panel No. 080266-0629C, revised September 28, 1982, portions of the project site lie
within Zone AO, which is within the 100-year floodplain, as well as Zone B which is within the
500-year floodplain. All structures will be anchored to protect against flooding and all electrical
components will be installed a minimum of 1 foot above the 100 year flood elevation.
Based on the Greeley-Weld County Airport"Airport Master Plan", Exhibit IV"Airport Airspace(Far
Part 77 Surface)", dated March 3r°, 2004, the site is in the Weld County Airport overlay district
area. The permit applicant has obtained confirmation from the FAA that there is a determination
•
of no hazard to air navigation based on the Aeronautical Study No. 2008-ANM-561-OE. Please
refer to the attached study for more specific information.
According to the"Geologic Hazard Area Map of Potential Ground Subsidence Areas in Weld
County, Colorado", dated May 10th, 1978, the site is not in a geologic hazard area.
Items referenced in this narrative with copies of each included in the overall County application:
• DRMS mining plan
• DRMS reclamation plan
• Draft oil/gas surface use agreements
• Terracon and Two Rivers Testing Soils Reports
• FAA Aeronautical Study No.2008-ANM-561-OE
•
Broken An-ow Investments,LLC
lid"
-u UT Consulting,Inc. USR Application
Use by Special Review(Mining Operation)
• •
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•
•
SURFACE USE AGREEMENT
This Surface Use Agreement ("Agreement") is dated and made effective this day
of January, 2006, and is between Kerr-McGee Rocky Mountain LLC ("KMG") with an address
of 1999 Broadway, Suite 3700, Denver, CO 80202, and
"[Gravel Company]") with an address of
Whereas:
A. [Gravel Company] is the current lessee of a sand, gravel and aggregate mining
lease covering that certain tract of land located in the
more particularly described on Exhibit "A" attached hereto, being a portion of the
Property, County, Colorado (hereinafter referred to
as the"Property");
B. Surface ownership of the Property is subject to the rights of the oil and gas
mineral leasehold estate, a portion of which is now owned by KMG;
C. [Gravel Company] has received a mining permit from the State of Colorado
Division of Minerals & Geology ("DMG") for the purpose of
known as the . The mined
• out Property is to be reclaimed for use as a water storage reservoir.
D. KMG currently operates wells on the Property, (the "Existing
Wells") generally located in the described above, and has
the right to develop its oil and gas leasehold estate by drilling additional wells (the
"Future Wells"and together with the Existing Wells, the"Wells") on the Property; and
E. This Agreement sets forth the parties' rights and obligations regarding the
relationship between the development of the Property by the [Gravel Company] and
KMG's operation and development of its oil and gas leasehold estate underlying the
Property, such rights and obligations to be binding upon the parties' successors and
assigns.
Now Therefore:
In consideration of the mutual covenants contained herein, and other good and
valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the
parties agree as follows:
1. AREAS RESERVED FOR THE EXISTING WELLS AND FUTURE WELLS;
WELL LOCATIONS.
[Gravel Company] shall set aside and provide to KMG that portion of the Property
hereinafter referred to as the, "Oil and Gas Operations Areas", such areas being depicted on
• Exhibit A attached hereto. The Oil and Gas Operations Areas are to be made available to KMG
• •
• in their present condition for any operations conducted by KMG in connection with any Well,
including, but not limited to, drilling and production activities, workovers, well deepenings,
recompletions, fracturing and replacement wells. All Wells will be limited to the Oil and Gas
Operations Areas shown on Exhibit A, unless this Agreement is amended by consent of[Gravel
Company] and KMG. Except for the Oil and Gas Operations Areas, and the access roads and
Petroleum Pipeline Easements (as defined below) as provided in this Agreement, KMG shall not
occupy the surface of the Property except in the event of an emergency or for reasonable
incidental, temporary and non-damaging activities, for which KMG shall be strictly and solely
responsible for any damages that may occur to the Property.
KMG shall have the right to drill Future Wells within the Oil and Gas Operations Areas,
including horizontal and directional wells that produce from and drain the Property and/or lands
other than the Property. As part of the consideration for this Agreement, [Gravel Company]
hereby waives its right to, and covenants that it shall not protest or object to any such exception
location or application for same by KMG. KMG shall not otherwise have the right to drill new
wells on the Property. The wellhead location for any Future Well drilled from the Oil and Gas
Operations Area shall not be closer than 200' from a the edge of the Oil and Gas Operations
Area. In no event shall [Gravel Company] stockpile mined materials within a radius of 150 feet
of any Existing Wells.
2. EXTRACTION IN VICINITY OF OIL AND GAS OPERATIONS AREAS;
SETBACK REQUIREMENTS.
[Gravel Company] reserves the option to mine the gravel within each of the Oil and Gas
Operations Areas in accordance with the terms of this Agreement. In the event that [Gravel
Company] elects to mine the gravel in an Oil and Gas Operations Area, [Gravel Company] shall
notify KMG in writing 60 days prior to commencing mining operations within the Oil and Gas
Operations Areas and shall first place temporary concrete barriers around the Existing Wells as
directed by KMG prior to commencing any mining operations on the Property. [Gravel
Company] shall conduct its mining operations in the Oil and Gas Operations Areas as quickly as
reasonably practicable. [Gravel Company] shall conduct it mining within the Oil and Gas
Operations Area by excavating pie shaped wedges of gravel and aggregate and thereafter
backfilling and compacting the area with overburden or other suitable material prior to
excavating the next pie shaped area; provided, however, that in no event shall [Gravel Company]
mine within 90 feet of any Existing Well or Production Facilities and provided further that in no
event shall more than one quarter circle segment of the pie shape be excavated at any one time.
Excavation in the Oil and Gas Operations Areas will be coordinated with KMG in a mutually
acceptable manner so as to avoid conflict with KMG's oil and gas operations and to ensure there
is an appropriate safety plan and interim emergency procedures. [Gravel Company] will bear all
costs associated with the mining operation, including permanent or temporary rerouting and
replacement of access roads, and flowlines and utility lines in order to prevent unnecessary
interruption of production from any affected Well. In addition, [Gravel Company] and its
successor and assigns shall indemnify and hold the KMG harmless from any and all damage, loss
and liability, including attorney's fees, incurred as a result of[Gravel Company]' operations in
an Oil and Gas Operations Area.
•
• [Gravel Company] will not locate any lot line, building, or structure within any Oil and
Gas Operations Area. [Gravel Company] understands and acknowledges that the COGCC has
rules and regulations that apply to the distance between a wellhead and public roads, production
facilities, building units and surface property lines, among other things. In order to give full
effect to the purposes of this Agreement, [Gravel Company] hereby waives its right to object to
the location of any of KMG's facilities on the basis of setback requirements in the rules and
regulations of the COGCC, as they may be amended from time to time. [Gravel Company]
further and similarly waives its right to object to any other state or local setback requirements or
other requirements or regulations that are or become inconsistent with this Agreement or that
would prohibit or interfere with the rights of KMG, its successors and assigns, to explore for and
produce the oil and gas in accordance with this Agreement. KMG or its successors and assigns
may cite the waiver in this paragraph in order to obtain a location exception or variance under
COGCC rules or from any other state or local governmental body having jurisdiction. [Gravel
Company] agrees not to object to the use of the surface in the Oil and Gas Operations Areas so
long as such use is consistent with this Agreement and [Gravel Company] will provide KMG or
its successors and assigns with whatever written support they may reasonably require to obtain
permits from the COGCC or any local jurisdiction.
3. GATHERING LINES AND FLOWLINES.
Subject to the limitations hereinafter described, KMG has a continuing right and
entitlement to own, operate, maintain, repair and replace all existing and future flowlines,
• gathering lines and other pipelines that may be necessary or convenient to its operations on the
Property ("Pipelines"). The construction and burying of additional Pipelines shall be at the sole
cost and expense of KMG or its gas purchaser.
Although this Agreement is intended to confine the placement of the Pipelines to certain
specified locations within the Property, nothing herein shall be construed as a limitation on
KMG's ultimate right to make all necessary well connections to any Existing or Future Well.
Specific locations have been designated on Exhibit A for the location of the Pipelines
("Petroleum Pipeline Easements").The Petroleum Pipeline Easement shall be fifty feet (50') in
width during construction, installation or relocation operations and otherwise reduced to thirty
feet (30') in width for post-construction usage.
[Gravel Company]' development plans anticipate that a roadways will cross over
Existing and Future Pipelines. [Gravel Company] agrees to abide by the General Guidelines for
Design and Construction Activities On or Near Kerr- McGee Gathering LLC and Kerr -
McGee Rocky Mountain Corporation Pipelines and Related Facilities revised 3-2004. In
particular, [Gravel Company] shall maintain a minimum of 48 inches and not more than 72
inches of cover over all Pipelines during any of[Gravel Company]' operations on the Property.
KMG may install and maintain markers on its Petroleum Pipeline Easement. KMG shall mark
its flowlines at all locations reasonably requested by [Gravel Company].
[Gravel Company] will not allow any extraction to occur, commencing at the surface of
the original ground, closer than 25 feet from any Pipeline of KMG unless a soils stability report
prepared by an engineer licensed in the state of Colorado indicates that a lesser set back will be
adequate for preservation of the integrity of said pipeline and provided that upon completion of
• such extraction [Gravel Company] shall back fill and level the area within 25 feet from any
• Pipeline. Notwithstanding anything herein to the contrary, in no event shall [Gravel Company]
allow any extraction to occur, commencing at the surface of the original ground, closer than 15
feet from any Pipeline without KMG's prior written approval.
[Gravel Company] shall not allow any stockpile of soil to be placed over any Pipeline of
KMG.
When crossing KMG Pipelines with heavy equipment, like earth moving equipment,
[Gravel Company] will maintain a minimum of four foot and a maximum of six feet of dirt
coverage, in addition to the existing cover over the pipeline. When crossing KMG pipelines with
trucks and lighter equipment, [Gravel Company] will maintain a minimum of two foot and a
maximum of six feet of dirt coverage, to the existing cover over the pipeline.
The depth of cover over the KMG Pipelines shall not be reduced or drainage over KMG's
pipeline altered without KMG's written approval.
Any utility crossing must be a minimum of 18" inches vertical separation from KMG
Pipelines. Parallel utilities must maintain a minimum of ten-foot separation, unless KMG grants
a lesser distance of separation which grant shall not be unreasonably withheld. It would not be
unreasonable to withhold such consent due to reasonable safety or operational concerns. [Gravel
Company] will request that all utility companies contact KMG prior to laying lines parallel to
KMG pipelines.
• Construction of any permanent structure within KMG's Petroleum Pipeline Easement is
not permitted. Planting of trees and shrubs is not permitted on KMG's Petroleum Pipeline
Easement.
4. ACCESS.
a. [Gravel Company] shall provide KMG with continuous access to all of the Oil
and Gas Operations Areas and the Petroleum Pipeline Easement. The access roads to be used by
KMG will either be those roads that currently are in place or those that are anticipated to be
constructed by [Gravel Company] at its sole cost and expense as part of [Gravel Company]'
development of the Property. KMG agrees to access the Property according to the routes
depicted and described on the attached Exhibit A. Access to the Oil and Gas Operations Areas
may be changed by mutual agreement of[Gravel Company] and KMG.
[Gravel Company] shall maintain and keep any access jointly used by [Gravel Company]
and KMG in a condition and state of repair that serves the needs of[Gravel Company]. In the
event such joint access roads needs to be improved in order to serve the needs of KMG, the
parties agree to coordinate any such improvements as may be required by KMG in order to
conduct its operations, provided that any such improvements shall be at KMG's sole cost and
expense. Neither KMG, nor [Gravel Company] shall unreasonably interfere with the use by the
other party of access roads.
•
[Gravel Company] agrees that it will not mine or extract any portion of the access roads
set forth on Exhibit A or as mutually agreed to by the Parties without the written consent of
KMG. [Gravel Company] agrees to post and enforce a 10 mile per hour speed limit along the
stretch of access road that is jointly used by KMG and [Gravel Company] and shall install speed
bumps along those stretchs of road.
5. BATTERIES AND EQUIPMENT.
KMG shall have the right to locate, build, repair and maintain tanks, separators,
dehydrators, compressors and other equipment ("Production Facilities") reasonably appropriate
for the operation and production of the Existing Well or the Future Well at the locations depicted
on Exhibit A.
With respect to KMG's Production Facilities other than flowlines or pipelines:
a. KMG shall install and maintain, at its sole cost and expense, all fences
around the Existing Well and any Future Wells in compliance with the Rules and
Regulations of the COGCC;
b. KMG shall install and maintain, at its sole cost and expense, all gates and
locks reasonably necessary for the security of any wells or facilities in the Oil and Gas
• Operations Areas. Such gates and locks shall be the standard gates and locks used by
KMG;
c. KMG shall paint any production facilities for any Wells, including
wellhead guards, with paint that is approved by the COGCC; and
[Gravel Company] shall not inhibit KMG's access to the Oil and Gas Operations Areas or
inhibit KMG's operations within the Oil and Gas Operations Areas or in the vicinity of the
Production Equipment by landscaping or other improvements, unless otherwise agreed upon
between [Gravel Company] and KMG. [Gravel Company] shall place temporary concrete
barriers around all Production Facilities as directed by KMG before any mining operations
commence. In no event shall [Gravel Company] mine within 90 feet of any Production Facilities
or stockpile mined materials within a radius of 50 feet of any Production Facilties.
6. NOTICE OF FUTURE OPERATIONS.
KMG shall provide at least seven (7) days prior written notice to [Gravel Company] of
any operations in connection with the reworking, fracturing, deepening or recompletion
operation on an Existing Well or Future Well; provided, however, that KMG shall provide at
least thirty (30)days prior written notice to [Gravel Company] of the initial drilling of any Future
Wells. Regardless of the foregoing notice requirements, KMG shall have immediate access to
any of its facilities in the event of an emergency.
•
• After receipt of the above notice, but not less than five (5) working days prior to KMG's
mobilization on the applicable Oil and Gas Operations Areas, either KMG or [Gravel Company]
may request an on-site meeting. The purpose of the meeting shall be to inform [Gravel
Company] of the expected activity and to coordinate site access, hazards, barricades, restoration
or any other issues that affect the use and safety of[Gravel Company]' development.
7. COMPLIANCE WITH SAFETY REGULATIONS .
KMG understands that [Gravel Company] surface mining operations on the Property are
subject to certain OSHA regulations. KMG agrees that while conducting operations on Property,
it will comply with such reasonable OSHA requirements which [Gravel Company] notifies KMG
are applicable to KMG's operations on the Property. KMG also agrees to inform its contractors
and subcontractors about such requirement.
8. DRILLING AND COMPLETION OPERATIONS.
KMG shall endeavor to diligently pursue any drilling operations to minimize the total
time period and to avoid rig relocations or startup during the course of drilling. [Gravel
Company] waives any objections to continuous (i.e., 24-hour)drilling operations.
9. SHUT-IN OF WELLS.
In the event [Gravel Company] interferes with KMG's operations on the Property which
• result in KMG shutting-in or prevents KMG from repairing or returning to production one or
more of the Wells, then [Gravel Company] shall pay to KMG as liquidated damages (actual
damages being difficult to ascertain) ($5,000) per day per Well for each day the Well(s) are not
producing . Both parities agree that such amount is a reasonable estimate of actual damages
which would be difficult to calculate with certainty. [Gravel Company] shall provide a bond in
the amount of$50,000 as security for payment of such liquidated damages. Such bond shall be in
form and from bonding agents acceptable to KMG, shall name KMG as an obligee and shall
expressly permit the KMG direct access to and recourse against the issuer of such bond. Copies
of such bond shall be provided for KMG's approval not less than 30 days prior to the
commencement of mining on the Property.
10. GOVERNMENTAL PROCEEDINGS.
[Gravel Company] shall not oppose KMG in any agency or governmental proceedings,
including but not limited to the COGCC, County, or other governing body
proceedings, related to KMG's operations on the Property, including but not limited to drilling,
workovers, well deepenings and recompletions, provided that KMG's position in such
proceedings is consistent with this Agreement.
11. DEVELOPMENT PLANS.
[Gravel Company] has provided herewith copies to KMG of its Mining Permit, and the
engineering structural report prepared in connection with the Mining Permit (the "Plans"). KMG
• acknowledges receipt of said Plans and has no objections to said Plans as approved by the DMG.
• This acceptance by KMG in no way waives KMG's rights in this Agreement or obligations of
[Gravel Company] under the terms of this Agreement. [Gravel Company] acknowledges that
KMG may conduct oil and gas activities within the applicable Oil and Gas Operations Areas as
provided herein and shall not oppose KMG before any agency or governmental proceeding if
such oil and gas activities are proposed and carried out in accordance with the terms of this
Agreement.
12. LIMITATION OF LIABILITY, RELEASE AND INDEMNITY.
a. No party shall be liable for, or be required to pay for, special, punitive,
exemplary, incidental, consequential or indirect damages to any other party for activities
undertaken within the scope of this agreement;
b. Except as to claims arising out of pollution or environmental damage
(which claims are governed by Section 13 below) or out of other provisions of this
Agreement (which claims shall be governed by the terms of this Agreement), each party
shall be and remain responsible for its own liability for all losses, claims, damages,
demands, suits, causes of action, fines, penalties, expenses and liabilities, including
without limitation attorneys' fees and other costs associated therewith (all of the aforesaid
herein referred to collectively as "Claims"), arising out of or connected with each such
party's ownership or operations on the Property, no matter when asserted, subject to
applicable statutes of limitations. Each such party shall release, defend, indemnify and
• hold the other parties, their officers, directors, employees, successors and assigns,
harmless against all such Claims. This provision does not, and shall not be construed to,
create any rights in persons or entities not a party to this Agreement, nor does it create
any separate rights in parties to this Agreement other than the right to be indemnified for
Claims as provided herein;
c. Upon the assignment or conveyance of a party's entire interest in the
Property, that party shall be released from its indemnification in Section12.b. above, for
all actions or occurrences happening after such assignment or conveyance.
13. ENVIRONMENTAL INDEMNITY.
The provisions of Section 12 above, except for Section 12.a., shall not apply to any
environmental matters, which shall be governed exclusively by the following, subject to the
limitations of Section 12.a. above:
a. "Environmental Claims" shall mean all Claims asserted by
governmental bodies or other third parties for pollution or environmental damage of any
kind, arising from operations on or ownership of the Property or ownership of the oil and
gas leasehold interest, whichever is applicable, and all cleanup and remediation costs,
fines and penalties associated therewith, including but not limited to any Claims arising
from Environmental Laws or relating to asbestos or to naturally occurring radioactive
material. Environmental Claims shall not include the costs of any remediation undertaken
voluntarily by any party, unless such remediation is performed under the imminent threat
• of a Claim by a governmental body or other third party;
• b. "Environmental Laws" shall mean any laws, regulations, rules,
ordinances, or order of any governmental authority(ies), which relate to or otherwise
impose liability, obligation, or standards with respect to pollution or the protection of the
environment, including but not limited to, the Comprehensive Environmental Response,
Compensation and Liability Act of 1980, as amended (42 U.S.C. § 9601 et seq.), the
Resource Conservation and Recovery Act of 1976 (42 U.S.C. §§ 6901 et seq.), the Clean
Water Act (33 U.S.C. §§ 466 et seq.), the Safe Drinking Water Act (14 U.S.C. §§
1401-1450), the Hazardous Material Transportation Act (49 U.S.C. §§ 1801 et seq.), the
Clean Air Act, and the Toxic Substances Control Act(15 U.S.C. §§ 2601-2629); and
c. Environmental Indemnification. KMG shall protect, indemnify, and hold
harmless [Gravel Company], homeowners association and any lot owner who purchases a
lot from [Gravel Company] from any Environmental Claims relating to the Property or
oil and gas leasehold thereunder that arise out of KMG's ownership and operation of the
Oil and Gas Operations Areas and it's ownership and operation of its Petroleum Pipeline
Easements or rights-of-way on the Property. [Gravel Company] shall fully protect,
defend, indemnify and hold harmless KMG from any and all Environmental Claims
relating to the Property that arise out of [Gravel Company]'s development of the
Property.
13. EXCLUSION FROM INDEMNITIES.
The indemnities of the parties herein shall not cover or include any amounts which the
• indemnified party is actually reimbursed by any third party. The indemnities in this Agreement
shall not relieve any party from any obligations to third parties.
14. NOTICE OF CLAIM FOR INDEMNIFICATION.
If a Claim is asserted against a party for which the other party would be liable under the
provisions of Section 12 or 13 above, it is a condition precedent to the indemnifying party's
obligations hereunder that the indemnified party give the indemnifying party written notice of
such Claim setting forth all particulars of the Claim, as known by the indemnified party,
including a copy of the Claim (if it is a written Claim). The indemnified party shall make a good
faith effort to notify the indemnifying party within five days of receipt of a Claim and shall affect
such notice in all events within such time as will allow the indemnifying party to defend against
such Claim.
16. REPRESENTATIONS.
Each party represents that it has the full right and authority to enter into this Agreement.
KMG does not represent that it has rights to settle matters for all of the mineral owners or any
other lessees in the Property and this Agreement shall only apply to and bind the KMG leasehold
interest in the property.
17. SUCCESSORS.
The terms, covenants, and conditions hereof shall be binding upon and shall inure to the
• benefit of the parties and their respective heirs, devises, executors, administrators, successors and
• •
• assigns; provided, as to KMG, successors and assigns shall be deemed to be limited to lessees
under the oil and gas leases which KMG owns.
18. TERM.
This Agreement shall become effective when it is fully executed and shall remain in full
force and effect until the earlier to occur of the following: (a) KMG's leasehold estate expires or
is terminated, and KMG has plugged and abandoned all wells and complied with the
requirements of all applicable oil and gas leases pertaining to removal of equipment,
reclamation, cleanup and all other applicable provisions of the leases and existing laws and
regulations or (b) [Gravel Company]' sand, gravel and aggregate mining lease expires or is
terminated and [Gravel Company] has complied with the requirements of it mining lease and
Mining Permit pertaining to removal of equipment, reclamation, cleanup and all other applicable
provisions of the lease, Mining Permit and existing laws and regulations. When this Agreement
ceases to be in full force and effect, the Parties shall execute any and all releases necessary to
evidence the fact that this Agreement shall no longer apply to the Property
19. NOTICES.
Any notice or other communication required or permitted under this Agreement shall be
sufficient if deposited in U.S. Mail, postage prepaid, addressed to each of the following:
If to KMG:
• Kerr McGee Rocky Mountain LLC
1999 Broadway, Suite 3700
Denver, Colorado 80202
Attention: Director of Land Denver Basin
[Gravel Company]:
Any party may, by written notice so delivered to the other parties, change the address or
individual to which delivery shall thereafter be made.
20. RECORDING.
This Agreement, any amendment hereto shall be recorded by KMG, which shall provide
the other parties with a copy showing the recording information as soon as practicable thereafter.
•
• 21. SURFACE DAMAGES.
[Gravel Company] hereby waives all surface damage payments pursuant to any COGCC
or local regulation, state staute, common law or prior agreement, for each and every well that is
drilled within the Oil and Gas Operations Areas and for any access road, flowline, or pipelines
constructed on the Property. KMG may provide a copy of this Agreement to the COGCC as
evidence of this waiver.
22. ARBITRATION.
Any controversy or claim arising out of or relating to this Agreement, or the breach
thereof, shall be resolved by arbitration conducted in Denver, Colorado and shall be administered
by the American Arbitration Association under its commercial rules, and judgment on the award
rendered by the arbitrator(s)may be entered in any court having jurisdiction thereof.
23. APPLICABLE LAW.
This Agreement shall be governed by and construed in accordance with the laws of the
State of Colorado, without reference to its conflict of laws provisions.
24. ENTIRE AGREEMENT.
This Agreement sets forth the entire understanding among the parties hereto regarding the
matters addressed herein, and supersedes any previous communications, representations or
• agreement, whether oral or written. This Agreement shall not be amended, except by written
document signed by all parties.
25. EXECUTION AND BINDING EFFECT
This Agreement may be executed in any number of counterparts each of which shall be
deemed an original instrument but all of which together shall constitute one and the same
instrument, and shall be binding upon and inure to the benefit of the parties, and each of their
respective heirs, executors, administrators, successors and assigns and is executed by the parties
as of the Effective Date set forth above.
•
• The parties have executed this Agreement on the day and year first above written.
KERR-McGEE ROCKY MOUNTAIN LLC
By:
JAMES P. WASON
Attorney-in-fact
[GRAVEL COMPANY]
ACKNOWLEDGMENTS
STATE OF COLORADO )
•
CITY AND )ss.
COUNTY OF DENVER )
The foregoing instrument was acknowledged before me this_ day of
2006, by James P. Wason, as Attorney-in-Fact of Kerr McGee Rocky Mountain LLC, on behalf of
such company.
Witness my hand and official seal.
Notary Public
My Commission Expires:
STATE OF COLORADO )
)ss.
COUNTY OF
The foregoing instrument was acknowledged before me this day of 2006,
by
Witness my hand and official seal.
Notary Public
My Commission Expires:
•
• Federal Aviation Administration
Air Traffic Airspace Branch, ASW-520
2601 Meacham Blvd.
Fort Worth, TX 76137-0520
Aeronautical Study No.
2008-ANM-561-OE
Page 1 of 2
Issued Date: 03/30/2008
JC York
JC York
1400 W 122nd Ave Suite 120
Westminster, CO 80234
**TEMPORARY DETERMINATION OF NO HAZARD TO AIR NAVIGATION**
The Federal Aviation Administration has conducted an aeronautical study under the provisions
of 49 U.S.C., Section 4478 and if applicable Title 14 of the Code of Federal Regulations, part 77,
concerning:
Structure: Crane Den Crane
Location: Greeley, CO
Latitude: 40-25-48.67N NAD 83
Longitude: 104-39-55.43W
Heights: 140 feet above ground level (AGL)
• 4777 feet above mean sea level (AMSL)
This aeronautical study revealed that the temporary structure does not exceed obstruction
standards and would not be a hazard to air navigation provided the following condition(s), if any,
is (are) met:
As a condition to this Determination, the structure is marked and/or lighted in accordance with
FAA Advisory circular 70/7460-1 K Change 2, Obstruction Marking and Lighting, flag marker -
Chapters 3(Marked)&12.
This determination expires on 09/30/2008 unless extended, revised or terminated by the issuing
office.
NOTE: REQUEST FOR EXTENSION OF THE EFFECTIVE PERIOD OF THIS
DETERMINATION MUST BE POSTMARKED OR DELIVERED TO THIS OFFICE AT
LEAST 15 DAYS PRIOR TO THE EXPIRATION DATE.
This determination is based, in part, on the foregoing description which includes specific
coordinates and heights. Any changes in coordinates and/or heights will void this determination.
Any future construction or alteration, including increase to heights, requires separate notice to
the FAA. This determination does include temporary construction equipment such as cranes,
derricks, etc., which may be used during actual construction of a structure. However, this
equipment shall not exceed the overall heights as indicated above. Equipment which has a height
• greater than the studied structure requires separate notice to the FAA.
1 oft
• •
• This determination concerns the effect of this temporary structure on the safe and efficient use
of navigable airspace by aircraft and does not relieve the sponsor of compliance responsibilities
relating to any law, ordinance, or regulation of any Federal, State, or local government body.
A copy of this determination will be forwarded to the Federal Aviation Administration
Flight Procedures
Office if the structure is subject to the issuance of a Notice To Airman (NOTAM).
If you have any questions, please contact our office at (817) 838-1995. On any future
correspondence
concerning this matter, please refer to Aeronautical Study Number 2008-ANM-561-OE
Signature Control No: 564624-101956290 (TMP)
Alice Yett
Technician
•
•
2of2
• WELD COUNTY ROAD ACCESS INFORMATION SHEET
Weld County Department of Public Works
1111 H Street, P.O. Box 758, Greeley, Colorado 80632
Phone: (970 )356-4000, Ext. 3750 Fax: (970) 304-6497
Road File#: _ ___ _— Date: 45- Z )=o B __
RE # : _____--__ Other Case #:
1. Applicant Name 6rvke.►- Phone (TO 590- (v"3
Address 699 N. Firs-}, /1.va-nwc- City Gv-e e-lr=y State Co Zip C164731
2. Address or Location of Access
Section L-/ Township 5n/ Range 66 Subdivision Block Lot_
Weld County Road#: y/ Z Side of Road C43 1 Distance from nearest intersection
3. Is there an existing access to the property? Yes X No # of Accesses I
4. Proposed Use:
❑ Permanent ❑ Residential/Agricultural❑ Industrial
❑ Temporary ❑ Subdivision IS Commercial ❑ Other
•*********************************•*********************************************************wive****
5. Site Sketch
Legend for Access Description:
• AG = Agricultural
RES = Residential
O&G = Oil&Gas
D.R. = Ditch Road
O = House
O = Shed
A = Proposed Access
. o.V
A = Existing Access e0T‘.e
u
NT � 94.? Fr
JTa ZC3
********************************
OFFICE USE ONLY:
Road ADT
Date
Accidents Date
Road ADT Date Accidents Date
Drainage Requirement Culvert Size Length
Special Conditions
❑ Installation Authorized ❑ Information Insufficient
Reviewed By: Title:
•
11
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