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HomeMy WebLinkAboutApplication-PermitGarfield County No. I \Dt-c:ro I Building & Sanitation Department 108 8th Street, Suite #401 Glenwood Springs, Co. 81601 Office 945-8212 Inspection Line 384-5003 Job Address: Locality: 2135-273-00-015 Use of Building: Temp Employee housing( Camp 6) Owner: EnCana Oil & Gas Contractor: Mountain west oil field $437.66 Date: Amount of Permit: multi level modu. Fee + septic Total $650.00 $1,087.66 clerk: _· ....... S.....,;;_'Q"'-f~-'"") 0"'-'-\ __ _ ep, ":rc >a;,~;,~' "'" "' c c "·""" '''"" '' "' ''"'"' ""' lOS 8"' Stre.::-t, Suite 401, Glenwood Springs, CO 81601 Phon;:: 970-945-8212 /Fax: 970-3S4<H70 lllspection. Line: 970-384-5003 P(•rmic No: 4/-4-iii c), """e ,..1'- ·s:~·oci~··N·o-:· THIS PERM!T J'WCOMES NULL AND VOID IF' WORK OR CONSTRUCTION AUTHORIZED !S NOT COMMENCJ..;D WJTHLN 180 DAYS, OR, IF CONSTRUCT! ON OR W()I~K !8 SUSPEND!W OR ABANDON~D VOR A PERIOD CW 180 DAYS AT ANY TIM!~ i\FTSH W0!-<1..: !S COMMENCf~D. i HEREBY Cl.mTWY TH/\T! HAVE l<!I'~AD AND I~X!\M!NE:D THIS 1\PP!JCATJON AND KNOW Tl-11~ SAM I·: TO HI<; TRUE AND CORRJ~:cr. :\J,L PI<OVISIONS OJ:-Lr\WS GOVB!~NJNG TillS 'CYPE OF WOf~J< W!L!, !'31>: COMI'IA;;.TED WJT!-!!N WHI~THI'.:R SP!~CIFmD Hf~REJN OH NOT. T!li·~ GRAN'!)NG 0f A l'E!{.M!T DOBS NOT PI~ESUME TO GIVI~ AUTIW!<!TY TO VIOI,ATE OR CANCI::L Till~ J''RUV!SlONS OF ANY UTl !I~ I< STATI:~ OP I,OCAL Li\W Rl<~GULI\TINCi CONSTI~UCT!ON Ol~ THE i'l-:i<!·'OF!MANCi·; Ol'·'caSTfWCTlON. D~---~ S'i"C:N;\nJR'EC5f-~C5\YNt~!~ ·-·- 1\\. \\-')() -c/1 '' . ) • ' 1·. ·~"~-"-'­ ~ .J3-__ . _ _!:.)D,\1'~ Subd. I E::.::emption: :\Ci l-1 l·:l~,\-1 i-;,\ '!' 0 Single ~, ~~'''" D9~1b~c ::t6 .. --.. -..--. s-6 oo \ '0.-~i-C:)''¥ i>Li<~·11~1SJ!):~ iS ! i!·:t-~J·.~HY (',:~.\,\'1 ,;:) l'U 'I'l-l I~ A;'I)LH.:.'\:\-T :\:-? 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CU.\·~; ·;~t.iCTiil:'-:. :\:\U) USI·; r W THi' ABOVE; !'li-:SG~iHic:!! s·: .;i,Ct''.:1<'-: Ti!i~ i'l•;!,~·t!T .\1:\Y ili-:_, !<1·,\'0!\i·::) :lY \(IT!C!·: O'i<UM T!l!-: C(;:_.~·:·y :\\!) ;·;;_\':· r;:r-::---: :\,~1\! i"<!!·,!<i·: :T ~~iL\i! c:-> ., \;·, "\i,;i.], :\.\•_i) \-'i;:: ), Ti it-: i~~~~; \.\\:1-. IJi-' :\ ;'i·:iOl'!' Li:\SJ-:i) i '''( i\ i'l.:\.'l:' ·.;p;:;c: '· l:c\i {_1>::; :\\i) ()'! 'i::Y 1):\'i':\ :-j! {_,\:.:. ··;: /! "!(!·:\/1·:\'f 'j'' ;;.; i'Jl.' :.(.'i \(; ' ' :(. \' :-:~u\; ·r !!'·'!-1_).-•. '\FTi-Y lz .'_) :;.;:\~Til!·, U)!~i<H:T iJ.\ ()l i·:!.~i~(l:,>; '.\ ':\::1 !'L-·\~,:.;_ '-;;'1·,( 1!-'iC'.-\T! :;~:--; _-\.\!'! i/1 :(!:1< ll:\i'.'\ {)!~ l·I(U\-l! :-~!:_,;: \''" 'n i U J! \( ~ iJL'L!<i.-\ iU\ :1:·:: \·I: ' c:y;.:if :; o:.; '!I il·~:{'·:i.. \ i J ·.\< \\ i !i-.\ : ', ·.·in , \. · , . :-l ;~~ U !! ; -; Ui~ _-\\ .\. I;':'" ,' ;J:<: Ji\:\0\Ci-; Ui~ kLC ~ ;_,\ ~''(: , : J 1 I\ -·~ '!'.!' i .\:J·-· i ( i>' . r:-: ,;-<.:: ;, . /1( /d,__l\\lol M '\r ~ ~ "(, ¢ d--J.Io ~ ~~ The following items are required by Garfield County for a final inspection: i. A llnal Electricallnspccrion il-om the Colorado State Electrical Inspector; 2. Permanent address as:slgned by Garflcld County Building Department posted where readily visible from access road; 3. A finished roof~ a lockable house, complete exterior siding, exterior doors and windm:vs installed, a complete kitchen with cabinets, a sink with hot & cold running water, non-absorbent kitchen floor coverings, counter tops and llnished walls, ready for stove and rct!·igerator, all necessary plumbing; 4. All bathrooms must be complete, with washbowl, tub or shower, toilet stool, hot and cold running water, non-absorbent floors and walls finished and a privacy door; 5. All steps outside or inside over three (3) steps must have handrails, guard rails on balconies or decks over 30" high constructed to alllBC and IRC requirements; 6. Outside grading done to where water will detour away !i·om the building; 7. Exceptions to the outside steps, decks and grading may be made upon the demonstration of extenuating circumstances, i.e. weather, but a Certificate of Occupancy will not be issued until all the required items are completed and a final inspection made; S. A final inspection sign off by the Garfield County Road & Bridge Department for driveway installation, where applicable; as well as any final sign off by the Fire District, and/or State Agencies where applicahle. 9. If you will he connecting to a public water and/or sewer system, proof of the tap fees have been paid and the connections inspected by the service provider prior to issuance of a C.O. A CERTIFICATE OFOCCUPANCYWILL NOT BE ISSUED UNTIL ALL THE ABOVE ITEMS HAVE BEEN COMPLETED. ****A CERTIFICATE OF OCCUPANCY MAY TAKE UP TO 5 BUSINESS DAYS TO HE PROCESSED AND ISSUED. ''**'•CANNOT OCCUPY OR USE DWELLING UNTIL A CERTIFICATE OF OCCUPANCY (C.O.) IS ISSUED. OCCUJ>ANCY OR USE OF DWELLING WITHOUT A C.O. WILL BE CONSIDERED AN ILLEGAL OCCUPANCY AND MAY BE GROUNDS FOR V ACATJNG PREMlSKS lJNTIL ABOVE CONDITIONS ARE lVIET. I understand and agree to abide by the above condilions for occupancy: use and the issuance ot~n (_ 'crti llcatc of Occupancy ror the dvvel1ing under building pc-rn1i l # ') tgnnt.ur,~ H pc1pp l ie<:tlion!.'<J. o b~;r2. t)06 VALUATION FEE DETERMINATION -::Eo.:n:;;can=a.::O:!!il~an;:.:d=G:::as:._ ______ Subdivision Applicant Address Date Various Lot/Block -:1-:=1/~3~0/;-:::20:::0::::7;----------'--Contractor Mountain West Oil Field Finished <Livable Area): Main Upper Lower Other Total Basement: Unfinished Square Feet Valuation Conversion of Unfinished to Finished Total Valuation Garage: Valuation Crawl Space Valuation Decks/ Patios Covered Open Valuation Type of Construction: Occupancy: Valuation Total Valuation sf sf sf sf X $74.68 0 sf sf X $41.00 sf X $33.68 sf X $18.00 1710 sf X $9.00 Commercial sf X $24.00 sf X $12.00 sf X sf X sf X sf X sf X sf X 0.00 0.00 0.00 15,390.00 0.00 0.00 15,390.00 GARFIELD COUNTY BUILDING AND PLANNING 970-945-8212 MINIMUM APPLICATION REQUIREMENTS FOR CONSTRUCTION OF COMMERCIAL OR MULTI-FAMILY RESIDENTIAL BUILDINGS Including NEW CONSTRUCTION ADDITIONS ALTERATIONS And MOVED BUILDINGS In order to understand the scope of the work intended under a permit application and expedite the issuance of a permit it is important that complete information be provided. When reviewing a plan and it's discovered that required information has not been provided by the applicant, this will result in the delay ofthe permit issuance and in proceeding with building construction. The owner or contractor shall be required to provide this information before the plan review can proceed. Other plans that are in line for review may be given attention before the new information may be reviewed after it has been provided to the Building Department. Please review this document to determine if you have enough information to design your pro,ject and provide adequate information to facilitate a plan review. Also, please consider using a design professional for assistance in your design and a construction professional for construction of your project. Any project with more than ten (10) occupants requires the plans to be sealed by a Colorado Registered Design Professional. To provide for a more understandable plan aud in order to determine compliance with the building, plumbing and mechanical codes, applicants are requested to review the following checklist prior to and during design. Plans to be included for a Building Permit must be on draft paper at least 18"x 24'"' and drawn to scale. 1 Plans must include a floor plan, a concrete footing and foundation plan, elevations all sides with decks, balcony steps, hand rails and guard rails, windows and doors, including the finish grade and original grade line. A section showing in detail, from the bottom of the footing to the top of the roof, including re-bar, anchor bolts, pressure treated plates, floor joists, wall studs and spacing, insulation, sheeting, house-rap, (which is required), siding or any approved building material. Engineered foundations may be required. Check with the Building Department. A window schedule. A door schedule. A floor framing plan, a roofing framing plan, roof must be designed to withstand a 40 pound per square foot up to 7,000 feet in elevation, a 90 M.P.H. windspeed, wind exposure B or C, and a 36 inch frost depth. All sheets need to be identified by number and indexed. All of the above requirements must be met or your plans will be returned. All plans submitted must be incompliance with the 2003 IBC, JPC, IMC and IFGC. Applicants are required to indicate appropriately and to submit completed checklist at time of application for a permit: I. Is a site plan included that identifies the location of the proposed structure, additions or other buildings, setback easements, and utility easements showing distances to the property lines from each comer of the proposed structure prepared by a licensed surveyor and has the surveyors signature and professional stamp on the drawing? Slopes of 30% or more on properties must be show on site plan. (NOTE: Section 106.2) Any site plan for the placement of any portion of a structure within 50 ft. of a property line and not within a previously surveyed building envelope on a subdivision final plat shall be prepared by a licensed surveyor and have the surveyors signature and professional stamp on the drawing. Any structure to be built within a building envelope of a lot shown on a recorded subdivision plat, shall include a copy of the building envelope as it is shown on the final plat with the proposed structure located within the envelope. Yes Y.. 2. Does the site plan when applicable include the location of the I.S.D.S. (Individual Sewage Disposal System) and distances to the property lines, wells (on subject property and adjacent properties), streams or water courses? This information must be certified by a licensed surveyor with their signature and professional stamp on the design. Yes _>( No Not necessary for this project __ _ 3. Are the plans submitted for application review construction drawings and not drawings that are stamped or marked identifying them as "Not for construction, for permit issuance only", "Approval drawings only", "For permit issuance only" or similar language? Yes No__ Not necessary for this project f.... 2 4. Is the I.S.D.S. (Individual Sewage Disposal System) designed, stamped and signed by a Colorado Registered Engineer? Yes ~ No__ Not necessary for this project __ _ 5. Does the site plan indicate the location and direction of the State, County or private road accessing the property? Yes__:b_ 6. Do the plans include a foundation plan indicating the size, location and spacing of all reinforcing steel in accordance with the uniform building code or per stamped engineered design? Yes No__ Not necessary for this project_!i_ 7. If the building is a pre-engineered structure, is there a stamped, signed engineered foundation plan for this building? Yes--4=.. No__ Not necessary for this project __ 8. Do the plans indicate the location and size of ventilation openings for under floor crawl spaces and the clearances required between wood and earth? Yes__ No__ Not necessary for project_L 9. Do the plans indicate the size and location of the ventilation openings for the attic, roof joist spaces and soffits? Yes ¥ No__ Not necessary for this project __ 10. Do the plans include design loads as required under the me or IRC for roof ~lo~.' (a minimum of 40 pounds per square foot in Garfield County)? ~ No _L Not necessary for this project __ 5t e_ IJ.,.,}.L...,J..._ .,._ 11. Do the plans include design loads as required for floor loads under the me or IRC? Yes "7--No__ Not necessary for this project __ 12. Does the plan include a building section drawing indicating foundation, wall, floor, and roof construction? Yes _Y::_ No__ Not necessary for this project __ 13. Is the wind speed and exposure design included in the plan? Yes~ No__ Not necessary for this project __ 14. Does the building section drawing include size and spacing of floor joists, wall studs, ceiling joists, roof rafters or joists or trusses? Yes~ No__ Notnecessaryforthisproject __ 3 15. Does the building section drawing or other detail include the method of positive connection of all columns and beams? Yes-,k_ No__ Not necessary for this project __ 16. Does the elevation plan indicate the height of the building or proposed addition from the undisturbed grade to the midpoint between the ridge and eave of a gable or shed roof or the top of a flat roof? (Check applicable zone district for building height maximum) Yes__ No__ Not necessary for this project ">( 17. Does the plan include any stove or zero clearance fireplace planned for installation including make aud model and Colorado Phase II certifications or Phase II EPA certification? Yes No Not necessary for this project~ 18. Does the plan include a masonry fireplace including a fireplace section indicating design to comply with the IBC or IRC? Yes__ No__ Not necessary for this project~ 19. Does the plan include a window schedule or other verification that egress/rescue windows from sleeping rooms and/or basements comply with the requirements of the IBC or IRC? Yes X No__ Not necessary for this project __ 20. Does the plan include a window schedule or other verification that windows provide natural light and ventilation for all habitable rooms? Yes--.:¥--No__ Not necessary for this project __ 21. Do the plans indicate the location of glazing subject to human impact such as glass doors, glazing immediately adjacent to such doors; glazing adjacent to any surface normally used as a walking surface; sliding glass doors; fixed glass panels; shower doors and tub enclosures and specifY safety glazing for these areas? Yes ~ No__ Not necessary for this project ~ 22. Do the plans include a complete design for all mechanical systems planned for installation in this building? Yes---1:.-No Not necessary for this project. __ _ 23. Have all areas in the building been accurately identified for the intended use? (Occuy:cy as identified in the IBC Chapter 3) Yes No__ Not necessary for this project __ _ 24. Does the plan indicate the quantity, fonn, use and storage of any hazardous materials that may be in use in this building? Yes__ No__ Not necessary for this project_J_ 4 25. Is the location of all natural and liquid petroleum gas furnaces, boilers and water heaters indicated on the plan? Yes__ No__ Not necessary for this project_X_ 26. Do the plans indicate the location and dimension of restroom facilities and if more than four employees and both sexes are employed, facilities for both sexes? Yes__)S_ No__ Not necessary for this project __ 27. Do the plans indicate that restrooms and access to the building are handicapped accessible? • 1 Yes No__ Not necessary for this project~ 28. Have two (2) complete sets of construction drawings been submitted with the application? Yes_L No 29. Have you designed or had this plan designed while considering building and other construction code requirements? Yes__ No ___:i.._. Not necessary for this project __ 30. Does the plan accurately indicate what you intend to construct and what will receive a final iJ:spection by the Garfield County Building Department? Yes 'f.-No ---- 31. Do your plans comply with all zoning rules and regulations in the County related to your zone district? For comer lots see supplemental section 5.05.03 in the Garfield County Zoning Resolution for setbacks. Yes X No __ 32. Do you understand that approval for design and/or construction changes are required prior to the implementation of these changes? Yes_l(_ No __ 33. Do you understand that the Building Department will collect a "Plan Review" fee from you at the time of application and that you will be required to pay the "Permit" fee as well as any "Septic System" or "Road Impact" fees required, at the time you pick up your building permit? Yes~ No __ 34. Are you aware that you are required to call for all inspections required under the IBC including approval on a final inspection prior to receiving a Certificate of Occupancy and occupancy of the building? 5 Yes '/-No 35. Are you aware that the Permit Application must be signed by the Owner or a written authority be given for an Agent and that the party responsible for the project must comply with the Uniform Codes? Yes __f;,. No __ 36. Are you aware that you must call in for an inspection by 3:30 the business day before the requested inspection in order to receive it the following business day? Inspections will be made between 7:30a.m. and 3:30p.m. Monday through Friday. Inspections are to be called in to 384-5003. 37. Are you aware that requesting inspections on work that is not ready or not accessible will result in a $50.00 re-inspection fee? Yes__:f:_ No ___ _ 38. Are you aware that prior to issuance of a building permit you are required to show proof of a driveway access permit or obtain a statement from the Garfield County Road & Bridge Department stating one is not necessary? You can contact the Road & Bridge Department at 625-8601. Yes X No ---- 39. Do you understand that you will be required to hire a State of Colorado Licensed Electrician and Plumber to perform installations and hookups? The license number will be required at time of inspection. Yes X No ___ _ 40. Are you aware, that on the front of the building permit application you will need to fill in the Parcel/ Schedule Number for the lot you are applying for this permit on prior to submittal of the building permit application? Your attention in this is appreciated. Yes 'f-_ No ___ _ 41. Do you know that the local fire district may require you to submit plans for their review of fire safety issues? Yes X No (Please check with the building department about this ;~irement) 6 42. Do you understand that if you are planning on doing any excavating or grading to the property prior to issuance of a building permit that you will be required to obtain a grading permit? Yes .\( • hone:Cj/Q · U35· Z&~(days); CJJO · ?>01· §10& (evenings) Project Name: ~ftJ~'Y( <. mp/one 1-hvs.'11t Project Address: P,.lfer~o..J 1?7 C<'~-"'f? riC. Note: If you answered "No" on any ofthese questions you may be required to provide this information at the request of the Building Official prior to begim1ing the plan review process. Delays in issuing the permit are to be expected. Work may not proceed without the issuance of the permit. *If you have answered "Not necessary for this project" on any of the questions and it is determined by the Building Official that the information is necessary to review the application and plans to determine minimum compliance with the adopted codes, please expect the following: A The application may be placed behind more recent applications for building permits in the review process and not reviewed until required information has been provided and the application rotates again to first position for review. B. Delay in issuance of the pennit. C. Delay in proceeding with construction. *If you answered "No" to this question the circumstances described in the question could result in a "Stop Work Order" being issued or a "Certificate of Occupancy" not being issued. Bpcomm Feb2005 7 PLAN REVIEW CHECKLIST Applicant ft...>c. 1'/'v--'!'r t> /-.r-415 Date II-'5o -v 7 Building ~ngineered Foundation _dDriveway Permit £-IC~ fa•<J.J,.. -t.Lsurveyed Site Plan ~ ~~ Vseptic Permit and Setbacks ~ '1-\.\-o..J_ __.L.Gradetropography 30% t..}L_Attach Residential Plan Review List /'Minimum Application Questionnaire 4-Subdivision Plat Notes _0ire Department Review ~luation Determination/Fees ~ed Line Plans/Stamps/Sticker 4Attach Conditions ~pplication Signed ~an Reviewer To Sign Application /rarcel/Schedule No. __0o# Snowload Letter-Manf. Hms. L/~oils Report GENERAL NOTES: Planning/Zoning ~roperty Line Setbacks _0oft Stream Setbacks Vrlood Plain ~ding Height ~ing Sign-off ~oad Impact Fees VHOA/DRC Approval Voradetropography 40% ~Planning Issues ~ S"f l../£ubdivision Plat Notes Conditions to Approval of Building Permit (1) Approval is subject to compliance with all conditions of Special Use Permit. (2) Separate electrical permit is required from Colorado State Electrical board and final inspection perfom1ed by same with approval provided to GAR CO Building Dept prior to C.O. (3) Provide letter of Inspection and approval from Colorado Dept. of Health for Kitchens. (4) Provide Letter of inspection and approval from Colorado Dept. of Fire ssafety or Fire District having jurisdiction for fire sprinkler system. ( 5) Any deviation from approved plans will require letter from Engineer of record for approval of amendment. (6) Use of building is restricted to Colorado Dept of Housing approved plans, no modifications to factory unit allowed without acquiring new stamped CDOH plans. Inspection Report COLORADO STATE ELECTRICAL BOARD INSPECTION REPORT I CORRECTION NOTICE Page 1 ofl Date Received: 02-JUL-08 Permit Number: 650056 Contraclor/HomeOwner: BRAD'S ELECTRICAL SERVICE CR215 Address: Type of Inspection: Final Action: Accepted Comments or Corrections: Elecbical Final OK lnspeclors Name: Cyrus Tuchscher Phone Number: 970-625-5085 Date: 02-JUL-08 COLORADO STATE ELECTRICAL BOARD DEPARTMENT OF REGULATORY AGENCIES 1580 Logan St Suite 550 Denver, Colorado 80203-1941 Phone: (303) 894-2985 https://www.dora.state.co.us/pls/real!Ep _Web _Inspection_ GUI.Process _Page 7/7/2008 (• i<J.;;;·J • 2 1 R<~.l~ '----·- State of Colorado Oil and Gas Conservation Commission WELL LOCATION I NESE fu;.c: :ill Tw;::~: SS Rng: 39.5!!2122 itl.. GrounO Elevation 5935' 1~. CotJnty: -~\t!_kf _ ''"""" i. 17 6th "'" J ~Permit iOP COGCC X X X .. 1 '"'"''. Uru\1 c) i ' z.: Mineral Ownershl~: IT ~e:e nslate _JF_~Y-~eral ! :. ?~· Surfa~il' Owner-;htp: _[!_ Fe_e r!S\ate jh , I i Lease# 23. ~!he Mineral~(?. fx ~ No Suriace Su1ety 10# 23a.lf23lsYe~: Is the 'i '"~I' til. I, X !Yes ONe '-------- 23b.!!23lsNo: Osur~ace ' . · tAitJ ,.,{, I__ $25,DOOBiankeiSurfa-::e8orni D$2,D00Silrlact~"So(ld QSS,O"v0Surface9ond 2.4. Using standard Q!rOtr. Set, Tw;:. Rr.g lormat er.t~:r entire. 1 , , I upon which lflis proJXJsed wells1le is located (a!!ech S(lparaie s!\e<:trmap tlyou ptcler): s""'" i 11·114;:,;;:"'' I ,_,,. Prod"""' : 8-3!4' I ;,:./8' I <-112' i PI"""', 20. To"l DRILLING i "' I '\1.6# I I ! '"'" 11130 SEilA'I'fA~SOOFP~~:~vALf>.llD CONDITIO .. NOT!C!l iO OPERA TORS 2500' """ 0None COLORADO OEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 4300 CHERRY CREEK DRIVE SOOTH DENVER, CO 80246-1530 PHONE (303) 692-3620 FAX (303) 753-6809 . Page one~ License# ;;?..,Z~ ;l Cf(Cf?J. · RETAIL FOOD ESTABLISHMENT INSPECTION REPORT Items circled below identify violations to be corrected as indicated by the regulatory authodty. Fuilurc to comply may result in further action by the regulatory authority. Temperature Control Procedures a. Rapidly cool foods to 41 "F or less b. Rapidly reheat to 165° For greater c. Hot. hold at 135° For greater Temperature Control Equipment f. FQod thermometer (probe-type) d. Required cooking temperature e. Coldholdat4l°Forless g. Adequate: equipment to maintain food temperatures * l_rcvH _lnspectlonReporl~ 0506 Yes Nonfood-contact surfaces TESTING DEVICES Refrigeration units provided with accurate, conspicuous thennometer Dish machine provided with accurate them1ometer & gauge cock Chemical test kits provided, accessible CLEANING OF EQUIPMENT AND UTENSILS Nonfood-contact SlJrfaces Dishwashing operations Wiping cloths UTENSILS, SINGLE-SERVICE ARTICLES Utensils provided. used, stored Single-service atticles stored, dispe-nsed, used No articles f Locker rooms Plumbing: installed, malnmincd Garbage and reruse g. Premises maintained Floors, '"'alls, ceilings h. Separation of living, laundry Lighting i. Restroom facilities c. Ventilation OTHER OPERATIONS a. Pernonnel: clean clothes, hair restraints, authorized b. Linen properly stored Recommende-d Regulatory Action(s) 0 I ~1 Notification of Non-Compliance 0 Additional Notification ofNon- Compllance 0 Notice of Civil Penalty 0 Final Order of Civil Penalty 0 Revocation/LiceJISC Suspension On-site Regulatory Actions 0 Voluntary Closure 0 Embargo Notice 0 Voluntary Condemnation Resolution(s) & Interventions 0 l$t Compliance \Varning Letter D Additional Compliance Waming Letter D Voluntary Closure Release 0 Embargo Release 0 Compliance Agreement 0 On~Site Training 0 HACCP Study D Announced Inspection 0 FDA Documented Inspectiori COLORADO,EPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 'J<.ek _ F?mJ INSPECTION REPORT Page __Cl!:,or _;2_ Items described below identify violations to be corrected as indicated by the regulatory authority. Failure to comply may result in further action by the regulatory authority. ESTABLISHMENT £~ (1/14 • '"' 6 ITEM # I CITY 1?7~ REMARKS I FIRMID 1/0<rJ'f/ Method of/for CORRtCT BY Correction (MMIDDIYY) . cos f/ . " g ~ V I I I' MethWr/for ~orrection Corrected On stte (COS) CIVCS Follow-up (FlU) Compliance Agreeement (CA) Form RFOOJ-2_revF_PageTwolnspectionRepon_0706 This is a Follow-up to the Regular Inspection conducted on: ------ )_R 0010 (09103) .$rArE:d~cdLoRADO *** MOBILE DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT • ··· .. • ;;.7• •.. liCENSE TO OPERATE A RET AIL FOOD ESTABLISHMENT·~··· *** MOBILE *** $ 154.00 USE ACCOUNT NUMBER for all references 25-24190-0009 2008 *** MIS LICENSE MUST BE POSTED AT THE FOLLOWING LOCATION: This certifies that licensee·Shown hereon ·i_s authorized .and licensed~_O eng.Sge in b.usiness in accordanc:e yvith the proviSions of the law and regiJ·Iatlons of the Color~<io Department of f'ublic Health and Environroel':'l~ ENCANA OIL & GAS USA INC ENCANA CAMP #6 Any alteratiO'n.s made on this f.icens·e_ Will aUtomatiCallY make it null and Voict. 370 17TH ST STE 1700 DENVER CO 80202-5632 POST INA CONSPICUOUS PLACE T DETACH HERE T -------·-·------,-----· -- I'EW AUTOMATED SERVICES FOR AND ABOUT BUSINESSES The Colorado Department of Revenue Sales Tax Information System provides the fo11owing automated services; * Colorado Sales Tax Rates -find specific city, county and special district rates. * Verification of Sales Tax Licerise Exemption Numbers-determine whether a Colorado sales tax license or exemption certificate is valid * T .ax Rates by Account Number -find sales tax rates and locations for specific safes tax accounts. TheSe services make it possible for taxpayers to help themselves to information 24 hours a day -without requiring the assistance of a customer service representative. In this way, more complicated or confidential tax information inquiries can be reserved for speaking to a live agent Listen and look for these services on the departmenrs business tax information phone line at 303-238-FAST (3278) tor specific account information. Call303-238-SERV (7378} for general Information OR visit the DOR Web site at......w.taxcolorado.eom Web users can try the system online at www .. taxview..state..co.us We are interested in your comments about the system. You can send us an e-mail with your comments through our Department of Revenue Web site. DR 1465 (09103) COLORADO DEPARTMENT OF REVENUE ---9ENV~0013--·' · ·~---- Either method 1 or .2. maybe used if sales of processed food exceed 25% of your total business sales. Sales Tax Account No. Method 2 must be used if sales of processed food <ices not exceed 25% of your total business sales. Year METHOD 1 METH002 1. Monthly cost of gas and electricity used for restaurant operation 1. Total sales for year (do not include room sates for minus sales tax: hotels, motels, etcJ 2. Processed food sales for immediate consumption January May September made during the calendar year minus liquor sales: February June October 3. Amount on line 2 x.005 = March July November Deduction from taxable safes to be entered on reverse side of Sales TaxReturn(DR 0 10D), line 7. April August December 2. Total cost of gas & electricity usedfor year: TYPE OF RETURN DUE ATTACH THIS Monthly February COPY TO 3. Amount on line 2 x.55= Quarterly April SALES TAX RETURN Deduction from taxable sales to be entered on line 7 under 11 0ther Seasonal Submit with season's last return (DR0100) f'\no4o ,,..i·i""""'" n.f ~,,..,.,. T<::~>v t2atnrn fnR 01 On) l'!lOCtED IN A. NO~'t', THfH HOirmEAm.RlY OIRECDON fROM f'AAACtwr£. COLOIW>O APf'ROXJMA.T£lY 11,1 MILES TO ntE JUNCTION OF TliiS ROAD AND AN EXISTitfG ROAD TO THE NORlmAST: TURN ll'IGKf AND PI?OCEEO IN A NORTHE.lSTtRlY DIMCTION Af'PROlOMAlt\.Y 1 . 1 MILES TO tHE 8EGINN!H$ Of THE PROPOSED ACCESS ROA.D TO THE NOJI'JHWEST; FOllOW ROAD ft..AG:SlN A NORJHW£STEflt.Y DHI:ECTION ~y 2SO'TO lHE EXISTlNG LOCAnoN. TOTAl.. DJSlAHCE fROM PAAACHUT£ COlOWlO TO THE EXJSnNG l~ t.SAF'PROXJMAl1:lV 12.2 UW. MAN CI.MP lOCATION: tAJlM)£ .)9' 34' 5$.59" lONGITUDE lOB 05' 33.07' a..£VA.llON 5955' LEGEND: ==:...;,;::;.;;__ _________ N 0 I'ROPOSEO LOCATION Uintnh Engineering & Land Surveying 8S Soui:b 200 Eau~.-Vernal. Utnh 84078 (43!5) 789-lOJ7.,. FAX (435) 789-1813 130A 595 MAN CAMP SECTION 30, T5S, R95W, 6th P.M. NE 114 SE 1/4 EnCana OIL & GAS (USA) INC . ..: __ :.:_::._:::_..:_:.:_..:_:::_..:_-_-_-_-_-__ -P-R(-)P-0-SE-'D_A_C_CE-.cS_S_R(-)A_O ____ N ---===:;:f3:-;0;::.A::::;.59;;5::-,.;M:;;;A:...:N:.:;. :...,C~A:::.M~f>:.!..,;==-- -------EXISTING ROAD SECTION 30, T5S, R95W, 6th P.M. 85 South 200 East Vernal. Utah 84078 (435) 789-1017 "' FAX: {435) 789-1813 NE 1/4 SE 1/4 ("o""J ' 2 f Rov ,).IQS ' '------ State of Colorado Oil and Gas Conservation Commission 11iJ}linl:I:.<TI Sf1¢1.it, $:1~. 501. O=f,wc, Co~;l{.o 00<03 Ph~: {3WJ89:·2100 Fa:.:(:ID~)SS'4-2hJ9 APPLICATION FOR PERMIT TO: D Deepen. D R~-enter. 0 REWmpie\U ?mi Opera!e COAL8ED0 OTHER: MULTIPLE Z.ONESJr:iX'T-~--CO"'"'t·"~t;'"1lN"''Gl""E'-ZONESr B N:)m(} 1:!! OpamtorEnCane~ Oil & Qls (USA) !n:;. S. Address: 370 17thSiree! Sull:emm -( COOCC Cpem!or Numw: ~'~"~'~'''--------f--------+"'---+'""-''1 City: p0o~"~'~' --:-::-c:--:--c----S~te: ~ Zip: ~80l()ti·~l':::::cc:::-c e. Colltact Name: Julia M. Cn:sius Phcnc: 120.876.5240 Fox: "702.0".6~706",6,1040'---F"'""""-''"'----+-"-+--i 7. Well Nama: K Parachuw ·"----··--·-··-···-·-----------------VVe~ Numbe!": -~'~'%=A"~"0~13ll"A"6~9~5-P'"-'""'----f-"+--i 8. Unit Name (if appl)'"'---:-::---:---:--:::--:::---:--:::--:::::-------Un\t Number": --------f""'"-'""'-'""'----+-"+--i S, Proposed Total Measured Onp\h; 11730' MD 10650' TVO WELL LOCATION INFORMATION 11) 0\rQir, NESE SiX:: _L Tw;J: 5S Ro3: SSW latiludtr 39.552122 Ob' :!iva Rlrrnati(ln.iSi 'h'lUiums fork \.ongitntl">? 100.0!11667 .. ------1 29. \'1J1!sa:t (:-15,000 ppm TDS C!/~r oil based m1..'ds be oset: d\lrir.g drllW,g? Yes []] No 1;: ~,~::,::::~,£;;!,::~., ~~;··-[]:!''' "''j~'§ :ID. If quesfu:or;$ 27 or28 arc y¢t~, !s this rocation in a sens\!ive ama{Rule 903)? Yes []] No If 26, 29 or 30 are "Yes" a pit ~rmit m:~y be r~quirod. 31. Mud dispcsaj: B Qj!sRe m Onslte Metho:i: Land Farming D lal'lc! Sprea:!i1lQ D Disposal Facility mOther; Recycle and Buf)' NOTE: The use of an ear1hen.nit fo:-Recomp!elkm fluids re(J\Ilre$ a pi! pmmil tRoll:! 9DSb.) If sir/gas drim~g. notify Iota! fire officials. ~ng Size ol Hc!e Siza o! C<!sil: V'k,i"h1 Pur Foot .. .• Se\\1 Dllptll Sacks Cement Cement Bottom Cement Top 676 2500' . 4-1!2" 11.6# 1173('1 1302 11730' 1 ·-~age Too! 1 32. BOP E;rJipment Typ.;;:: m Annular PteVS\'l'.Ct D Double Rzrn D Rotating Head D None .33. Comma!lts £r.C&'1a Oil & G«s {U&A)lr'l~; owns surla-oli, EriC<l!,le ~~fl_£ra1s_ p\eese ~ee <l\1echeU re?ps' ?~. Initial R\Jfe 306 Consultallon took pta<;€ on {date) NA .was waived, oris net required. PfQvide supporting documentation if consultation 1\33 been Wl:!lved or if good fuith effort did f!Ot re~ult in corwu11ation. PERMIT SUBMITTED TO COGCC: PRJ OR TO COMPI.I'ANCE W!TH RULE 306 CONSUL TAT ION SHAll BE RETURN EO UNAPPROVED. I hereby cer!ify that 3 complete permit package has been lien! to ltn:t applicable Local Govt>rnment Des!gnee(s), and a!! stetements made In this form «re. to the best or my knowledge, true. conect. eml cmnpi(!.!e. I ··,,/. ' . Signag,;__~~)tt_.t.1-. .Yd~L--·---------Print Name: JuliaM. CM·~:'~'--,----------------1 Title: _RegulatoryJPcrm1al;:g_&lE}Et" _ ~ _ ___ OG!lc: 11iJ/ri 7 -~ Ema~: Based on the info;matio:1 P:W~ed he~ejp. p;ts ~tiOfi r;r Penn!t~.o·DrlU. complies Wi!h COGCC Rules and app\!cahle orders and is he~by _appro~ed. COGCC Approved: £>1 rJJttfjJI do-_!j~ -~M~ Director of COGCC Dale: / /· Z 6 ·· 0 2 .------,.==:-----,Penn;tN,mber. 2 Q Q 7 5 !) 3 i I API NUMBER I CONDITIONS OF APPROVAL. IF ANY: ~··ms · 12011 -oo E>:plration Date: II-25 06 Job Address ~t-T"2:Stc:J>':f-· ~tbacks: Front-,--___ Rear ____ RH ____ LH ____ Zoning ___ _ \e\f'v'\\[) -p{v\p \~~\)'5\VB INSPECTIONS Soils Test---------- Footing---------- Foundation ________ _ Grout __________ _ Underground Plumbing _____ _ Rough Plumbing -------- Framing _________ _ Insulation----------Roofing _________ _ Drywall ----------Gas Piping ________ _ *-~cl~ ~· \1\1J£,?(1,3;: .:}~ Other------------- NOTES fr~~~~ (continue on back) INSPECTION WILl NOT BE MADE UNLESS THIS CARD IS POSTED ON THE JOB 24 HOURS NOTICE REQUIRED FOR INSPECTIONS BUILDING PERMIT GARFIELD COUNTY, COLORADO Date Issued..li!.\:~r.?.l •. zoned Area ............................... Permit No ....• \.Q}.q~············ AGREEMENT In consideration of the issuance of this permit, the applicant hereby agrees to comply with all laws and regulations related to the zoning, location; construction and erection of the proposed structure for which this permit is granted, and further agrees that if the above said regulations are not fully complied with in the zoning, location, erection and construction of the above described structure, the permit may then be revoked by notice from the County Building Inspector and IMMEDIATELY BECOME NULL AND VOID. \f:i Use ~ ¥. (hV$1;,tf . /)« fh-.>ow . !77 <' _, A c.- 1 AddressorL<:gaiDescriptlon_(?MJp &, -~ .:1;_3<>,4 59£ t;P ~I .~-~o · 5" lo Owner lY/@ft? fPlll (jqS Contractor fwrinriiiJ R$/-OIL .pet/ Setbacks Front Side Side Rear This Card Must Be Posted So It is Plainly Visible From The Street Until Final Inspection. . INSPECTION RECORD Footing Driveway Foundation Underground Plumbing Insulation . Rough Plumbing Drywall Chimney & Vent Electric Final (by State Inspector) Gas Piping Final 1-ro ·tJA /i)]]L · Electric Rough (By State Inspector) Septic Final •/O·()g ~ Framing Notes: S,/)1{{! s- (To include Roof in place and Windows f1f9Si 1?/ 5"/ /7 }3~ I /7 /38' and Doors installed). ALL LISTED ITEMS MUST BE INSPECTED AND APPROVED BEFORE COVERING. WHETHER fNTERIOR OR EXTERIOR, UNDERGROUND OR ABOVE GROUND. THIS PERMIT IS NOT TRANSFERABLE For Inspections Call384-5003 I 08 8th Street Glenwood Springs, Colorado APPROVED DO NOT DESTROY THIS CARD Date 10-i:hf.-\B-By r'Jut=-M- IF PLACED OUTSI -COVER WITH CLEAR PLASTIC Parcel Detail Page 1 of 5 Garfield County Assessor/Treasurer Parcel Detail Information As!iessor!Irsei!S!JierPmPseitY Sei!Id! I At>se2£or Subset .Query I Asse1;sor Sale~Se.i!Ic1\ (1erk&RsecorderRecsePlionSei!rcl! Parce!_Petail I Y alue Detail Sales Detail I Residential/Commercia] Impro\ls;ment Detail Land Detail I Photographs I Tax Area II Account Number II Parcel Number 1/ Mill Levy I I o26 II R460005 II 213527300015 II . 36.682 I Owner Name andMailing Address IENCANA OIL & GAS (USA) INC. I jC/0 LOGAN & FIRMINE I 13615 S. HURON STREET, SUITE 200 I IENGLEWOOD, CO 80110 I Legal Description lsECT,TWN,RNG:27-5-96 DESC: SEC 2 I ILOT 4(NET 27 .16A) ALSO A TR IN SEC I 12&11 DESC: CONT 341.07 A SEC 3 S2NE, I ls2NW, S2 LOT 1(40.82A) DESC: I2(40.69A) 3(40.57A) 4(40.44A) SEC 4 jS2NE, S2NW, DESC: S2, LOT 1(40.33A) I2(40.21A) 3(40.11A) 4(39.99A) DESC: ISEC 5 S2NE, S2NW, S2 LOT 1(39.80A) j2(39.52A) DESC: 3(39.24A) 4(38.96A) I jSECS 8,9,10 ALL SEC 14 W2NE, DESC: I jNW, S2 SEC 15 W2NE, NENE, NW, S2 I jsEC 16 ALL SEC DESC: 17 E2 SEC'S I 121,22,23,24 ALL SEC 25 TR I 137(107.06A) DESC: LOTS 1(37.84A) I I2(37.42A) 6(6.55A) 7(11.27 A) N2NE, I http://www. garcoact.com/ assessor/parcel.asp ?ParcelN umber=213 52 7300015 7/16/2007 Parcel Detail Page 2 of 5 jDESC: W2, SWSE SEC'S 26,27,28 ALL I lsEC 33 N2NE, NENW, DESC: E2NWNW SEC I j34 NE, N2NW, SENW SEC 35 N2 SEC 36 I jN2, DESC: & PT OF THE SE(NET I j116.68A) EXCEPT APT ALONG DESC: I jTHE C/L OF PARA. CRK. TO POB CONT I j43.32A SEC 15-DESC: 5-95 APT OF I jSEC 15 CONT 467.62A SEC 16 ALL THAT I jDESC: PT LYING S OF SOUTHERN MOST I jMAHOGANY MARKER CONT DESC: 386A SEC I 117 S2S2, THAT PT OF THE N2S2 LYING I Is oF DEsc: THE souTHERN MOST I jMAHOGANY MARKER CONT 41A SEC DESC: I 119 E2, LOTS 1(40A) 2(40A) 3(21.41A) I j4(21.42A) 5 DESC: (40A) 6(40A) I j7(40A) 8(40A) 9(21.44A) 10(21.45A) I jDESC: 11(40A) 12(40A) SEC'S I 120,21,22,27,28,29 ALL SEC DESC: 30 I IE2 LOTS 1(40A) 2(40A) 3(21.49A) I .I4(18.78A) 6( DESC: 40A) 7(40A) j8(40A) 9(40A) 10(14.95A) 13(18.21A) IDESC: 14(40A) 15(40A) TR 37(12.93A) jsEC 31-5-95 NE LOT DESC: 1(40A) j2(40A) 3(21.79A) 4(21.93A) 5(40A) I6(40A) DESC: 7(40A) 8(40A) I I9(22.07A) 10(22.21A) 11(40A) I j12(40A) DESC: SE SEC'S 32,33,34 ALL I jSEC 1-6-96 LOT 3(43.51A) DESC: I j4(43.41A) 5(43.31A) 6(43.21A) I I7(40A) 8(40A) 9(40A) DESC: 10(40A) I I11(40A) 12(40A) 13(40A) 14(40A) SEC I 12 SW, DESC: SE, LOT 1(43.12A) I j2(43.05A) 3(42.97A) 4(42.90A) DESC: I j5(40A) 6(40A) 7(40A) 8(40A) 9(40A) I j10(40A) 11(40A) DESC: 12(40A) SEC 3 I jE2SW, SE LOT 1(42.81A) 2(42.72A) I jDESC: 3(42.63A) 4(20.87A) 5(19.63A) I j6(40A) 7(40A) 8(40A) DESC: 9(40A) I http://www .garcoact.com/assessor/parcel.asp ?Parce1Number=213 527300015 7/16/2007 Parcel Detail Page 3 of 5 /I0(40A) 11(40A) 12(19.65A) I /13(19.67A) 14( DESC: 19.69A) SEC 4 I /LOT 3(52.68A) 4(54.26A) 6(42.70A) I IDESC: 7(39.50A) 8(39.57A) 9(40.27A) I /10(41.11A) 12(41. DESC: 53A) I Location Physical Address: //MINE & RETORT AREA PARACHUTE/ Subdivision: I Land Acres: //26441.91 I Land Sq Ft: /lo Section II Township II Range I I 27 II 5 II 96 I Property Tax Valuation Information 1/ Actual Value II Assessed Value I I Land: I/ 442,7301/ 128,390/ I Improvements: // 714,64011 207,250/ I Total: II 1,157,370/1 335,640/ Sale Date: //6111/2004 Sale Price: //26,445,000 Basic Building Characteristics Number of Residential !o I Buildings: Number of Comm/Ind is I Buildings: I Commercial/Industrial Building Occurrence 1 Characteristics I I TOTAL HEATED AREA: 115,120 I I ABSTRACT CODE: IIREFINING/PETROLEUM I I ARCHITECTURAL STYLE: /IOFFICE I I EXTERIOR WALL: 1/PREFAB MTL I I ROOF COVER: 1/PREFAB-MET I I ROOF STRUCTURE: //PREFAB-MET I http://www. garcoact. com/ assessor/parcel.asp ?Parce IN umber=213 52 7300015 7116/2007 Parcel Detail INTERIOR WALL: IIDRYWALL I INTERIOR WALL: IIA VG PANEL I FLOOR: llcARPET I FLOOR: llsHT VINYL I I HEATING FUEL: IlGAS I I HEATING TYPE: IIFORCED AIR I I STORIES: llsTORIES 1.0 I I BATHS: 12 I ROOMS: 11 I UNITS: 11 I BEDROOMS: I 0 I YEAR BUILT: 111982 I Tax Information I Tax Year II Transaction Type II Amount I 2006 I Tax Payment: Whole II ($18,236.08)1 2006 I Tax Amount II $18,236.081 2005 Tax Payment: Whole II ($18,272.88)1 2005 Tax Amount $18,272.881 2004 Tax Payment: Whole ($6,840.14)1 2004 Tax Amount $6,840.141 2003 Tax Payment: Whole I ($7,556.98)1 2003 Tax Amount II $7,556.981 2002 II Tax Payment: Whole II ($7,265.32)1 I 2002 II Tax Amount I $7,265.321 I 2001 II Tax Payment: Whole ($7,749.94)1 2001 II Tax Amount $7,749.941 2000 II Tax Payment: Whole I ($11,463.96)1 2000 II Tax Amount II $11,463.961 1999 II Tax Payment: Whole II ($8,815.74)1 1999 II Tax Amount II $8,815.741 ThJ;Lof_p~~ AssessorRatahase Sear<::h0Pti9nS I Treasurer DataJ:>ase Search Opti9m cled~ &Rer;or\ierDatahaseS~i:!r<::!:tOptiPns http://www.garcoact.com/assessor/parcel.asp?ParcelNumber=213527300015 Page 4 of 5 7/16/2007