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HomeMy WebLinkAbout1.01 General Application MaterialsGarfield County Community Development Department 108 8`h Street, Suite 401 Glenwood Springs, CO 81601 (970) 945-8212 www.garfield-county.com LAND USE CHANGE PERMIT APPLICATION FORM TYPE OF APPLICATION ❑ ❑ Administrative Review Limited Impact Review ❑ Development in 100 -Year Floodplain ❑ Development in 100 -Year Floodplain Variance ❑ Major Impact Review ❑ Code Text Amendment O Amendments to an Approved LUCP ❑ LIR ❑MIR ®SUP ❑ Rezoning []Zone District❑ PUD❑ PUD Amendment ❑ Minor Temporary Housing Facility ❑ Administrative Interpretation ❑ Vacation of a County Road/Public ROW ❑ Appeal of Administrative Interpretation ❑ Location and Extent Review ❑ Areas and Activities of State Interest ❑ Comprehensive Plan Amendmen ❑ Accommodation Pursuant to Fair Housing Act ❑ Pipeline Development ❑ Variance ❑ Time Extension (also check type of original application) INVOLVED PARTIES Owner/Applicant Name: Ursa Operating Company LLC Phone: ( 970 ) 284-3244 Mailing Address: 792 Buckhorn Drive City. Rifle State: CO Zip Code: 81650 E-mail: cmascioli@ursaresources.com Representative (Authorization Required) Name: Phone: ( ) Mailing Address: City: State: Zip Code: E-mail: PROJECT NAME AND LOCATION Project Name: Wasatch Bench - Brynildson Water Storage Facility Assessors Parcel Number: 2179 191 00 511 Physical/Street Address: Located approximately 5 miles Southeast of Rifle off of County Road 315 Legal Description: NW 1/4 of the NW 1/4 of Section 20, Township 6 South, Range 92 West of the 6th PM Zone District: Agricultural/Residential/Rural Property Size (acres): 328.48 PROJECT DESCRIPTION Existing Use: Processing, Storage and Material Handling of Natural Resources Proposed Use (From Use Table 3-403): Processing, Storage and Material Handling of Natural Resources Description of Project: Minor facility modification includes adding two tanks: a desander and a skim tank. The existing secondary containment will be modified to accommodate these two additional tanks. The loadout area will also be reconfigured and repiped. REQUEST FOR WAIVERS Submission Requirements ❑ The Applicant requesting a Waiver of Submission Requirements per Section 4-202. List: Section: Section: Section: Section: Waiver of Standards ❑ The Applicant is requesting a Waiver of Standards per Section 4-118. List: Section: Section: Section: Section: I have read the statements above and have provided the required attached information which is correct and accurate/to the best of my knowledge. ��, Y tQ 1%j Ty/�,.• 2116/17 Signature of (Property Owner Date OFFICIAL USE ONLY File Number: ____----_ Fee Paid:$ February 15, 2017 Mr. Glenn Hartmann Garfield County Community Development 108 81h Street, Suite 401 Glenwood Springs, CO 81601 RE: Letter of Authorization Dear Mr. Hartmann, I, Scott Brynildson, authorize Ursa Operating Company LLC to act on behalf of and represent in all matters regarding the Wasatch Bench Facility related to land use permitting in Garfield County. Sincerely, Scott Brynildson CC: John Doose, Ursa Operating Company LLC Cari Mascioli, Ursa Operating Company LLC