HomeMy WebLinkAboutState Highway Access Permit' Conlact lhe Colorado Departmonl of Transporlatlon {CDOT) or your localgovarnm€nl lo delormlno your íssuing aulhority,
' Oontact thg issuing aulhority to dot€rmine what plans and olher documenls are r6quired to be submltl€d with your applícatlon.. Complglo thi¡ lorm (some querlions may not apply to you) and allach all necessary documonls and Submit ¡l to lhe issu¡ng aulhority.
- Submlt an applicalion for each accass alf€ct€d,
- ll you have any quEstions conlacl lhe lssuing aulhotity.
.ForadditionalinformationsgecDoT,sAcoessManagementwebs¡loal
lnstructlons:
Pleasø prlnt
or type
2) Applicanl or Agont lor permitleg (il dillerenl from properly ownsr)l) Property owner (Pemittee)
Burning Mountain Land and Cattle, LLC
Slreel address
5175 County Road 335, f1401
Mailing address
City, stale & zip
New Castle, CO,81647
Phone #
970-984-2943 I
Phono # (rsquired)Gity, slat€ & zip
E-mailaddr€ss
Russell@appletreepark, com
E-mail address if available
3) Address of prsperty to bo sorved by permit (required)
€{unty
Garlield
descript¡on of properlyl ll wilhin judsdiclional cily and/or County,
31
subd¡vlsion blocÌ lol soction townshlp rango
5 90
5) What State Highway are you requesting accê6s kom?
6
6) Whal side of lhe
[]r.r Hä""¡' flw
7) How many leet is lhg proposed accoss from lhe nearest mile posl?
teet Iru f1s ll'le f-lwl trom: 10550
How meny f€€l is lhe propos€d access from lhe ngar€st cross s¡reet?
reerEru [sEEtwl
toyou
4.1-2018
lhe approximale
9) Check here llyou are requesling a:
lnew access fltemporary access
llchangE in access use
lÍimprovement to exist¡ng access
fJelocation ol an existing access (provide detail)
)(duralion anlicipatêd:
lremoval ol access
t0) Provide existing property u6e
Agricultural
1 1) Do you have knowledge .of any Stat€ Highway access p6rmits serving this property,
Elno Eyes, if y€s. whât are the permil numbe(s) and provide copies:
or ad¡acsnt propertlss ln which you have a propony interest?
and/or, permitdatg:
12) Doos lhe properw owner own ot have any Intsrests ¡n any
Eno I v"t, it yes - please 6!s6¡¡5e; BML0,on SE side of hwy 6
Are th€re olhor existing or dedicated publ¡c strssls, roads, highways
Elno [yes, il yes . lisl them on your plans and indicáe
or accoss easomenls bordering or w¡lhin the propêrty?
the proposed and exfsting access po¡nls,
13)
you are requesting agricultural liEld access . how many aires will lhe access serve?
Parcel size is 581 acres but only approx. 20 acres will be in active agricultural use
area square footageand
business
14) lr
buslness/land use
15) lf you are commercial or access
1 6) lf you are requssting residsnlial developemenl access,
tvPe
what is lhe typs (single lamlly. aparlment,
number ol unils
townhouso) and numb€r of units?
type number ol unils
lzsingle famíly
17) Provide the following veh¡cle counl sstimales for vehicles that accêss. Leaving lhe property then returning two counls,use
lndlcate lf your countg are
fpeak hour volumos or filaverage daily volumes.
f ol pæaongor c8r8 and light trucks 6l pûak hour volumo8I I of mulll u¡ll truclG at poak ñour volumô8
C ot slnols unll votllclss üi srcass of 30 lL I ol larm v€hlcloÈ (liold oqulpngru
1
Tolal count ol all vehlcleeI
COLORADO DEPARTMENT OF TBANSPORTATION
STATE HIGHWAY ACCESS PERMIT APPLICATION
lssuing aulhor¡ly application
acceplance dale:
Provlous €d¡llons sro obsoloto may nol bo lrs€d Pagol of2 CDOTFoT¡n#137 01/t0
18) Chock wilh the issuing authorily lo delermino which ol the follorving documsûts a16 required 1o compl6ls tho review ol your application.
1- lt ls the applicant's rosponsibility to contact appropriate agoncios and obtain all environmental clêarances that apply
to theír act¡vit¡es. Such clearances may include Corps of Engineers 404 Permits or Colorado Discharge Permit Systom
permits, or ecologícal, archeological, ltistorical or cullural resource clearances. The CDOT Environmental Clearances
lnformation Summary presents contact information for agencies administering certain clearances, information about
prohibited discharges, and may be obtained from Regíonal CDOT Utilitylspecial Use Permit offices or accessed via the
CDOT Planning/Construction-Environmental-Guidance webpage http://www.dot.slate.co.us/environmental/Forms.asp.
2- All workers wilhin the Stale Highway right of way shall comply w¡th their omployor's safety and healtlr policies/
procodures, and all applicable U.S, Occupational Safety and Health Administralion (OSHA) regulations - including, but not
limited to tho applicable sections of 29 CFR Part 1910 - Occupational Safety and Heallh Slandards and 29 CFR Part 1926
- Safety and Health Regulations for Construction,
Personal protective equipment (e,9, head protection, footwear, high visibility apparel, safety glasses, hearing protection,
rospirators, gloves, etc.) shall bo worn as appropriate for the work being performed, and as sþecified in reguiátion. At a
minimum, all workers in the State Highway right of way, excepl when in their vehicles, shall wear ihe followíng personal
protective equipment: High visíbillly apparel as specífied in the Traffic Control provisions of the documentation
accompanying the Notice to Proceed related to this permit (at a min¡mum, ANSI/ISEA 107-1999, class 2); head protection
thal complies with the ANS|Z89.1-1997 standard; and at allconstruction siles orwhenever there is Oanger of injury to
feet, workerç shallcomply with OSHA's PPE requirements for foot protection por 29 cFR 1g'10.1g6, lg¿0.g5, an'o1926.s6. lf required, such footwear shall meet the requirements of ANSIz4'l-1g99,
Where any of the above-referenced ANSI standards have been revised, the mosl recent version of the standard shall
apply,
a) Property map indicating othor access, bordering roads and streets,
b) Highway and drivoway plan pro'ils,
c) Drainage plan showlng ímpact to tho highway right-oÊway.
d) Map and letters dolail¡ng ulilily locations before and af lor
dovelopment in and along the righl-of-way.
o) Subdivision, zoning, or development plan,
l) Proposedaccossdes¡gn.
g) Parcel and ownorship maps including easements.
h) lraffic sludios.i) Proofofownorship.
3' The Permiltee is responsÌble for complying with the Revised Guidelines that have been adopted by the Access Boardundsr the American Disabilities Act (ADA). These guidelines define traversable slope requirements and prescribe theuse of a defined pallern of truncated domes as detectable warnings at streel crossiÅgs. ih" nuw Standards plans andcan be found on the DesÌgn and construction project support web page at:
<htlp://www.dot.state,co.us/Des¡gnsuÞþort/>, thon click on Design Builetins,
lf an access oermil is issued to. yq!{, it will stale the lerms and conditions for its use, Any changes in the use of thepermitted acóess not consistent'wiÛi inä ieims ano conditions t¡si;d ;; Ëü;iñai"deions¡oered a viotation of thepermit.
The ap.pllcant declares under penalty of perjury ln the second.degree, and any other applicable slate or federalIaws, that all Informatlon provided on tnis tórrË and sunm¡ttel-JtiactrinentJãíe-t"ii.t;'u"ii or tnãiiïnäwreîg"true and complete.
I understand receipl of an access permlt does nol constitute permission to start access construction work.
nt or Agsnl for Permiltoe signaturoApplica Print name Dato
ll the.applicant ís not the owner of the property, we require
th.eir .le,gally a.uthorized repre sen ta tive ior'ottreíi acceptäblewith this application by ali owners-of-inierest unless btated
cases, wlll be listed as the permlttee,
this application also to be signed by the property owner orwrilten evidence). This signãture shall cónsiituté agreementin writing. lf a permit is issued, the property ownerl in most
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russell@app letreepark.com
From:
Sent:
To:
Cc:
Subject:
Attachments:
Aggen - CDOT, Kandis <kandis.aggen@state.co.us>
Monday, April 30, 2018 12:11 PM
Russell ïalbott
Roussin - CDOT, Daniel; Devin Drayton - CDOT
CDOT Access Permit 318037
ACC-3 1 8037-SH006D-M P 1 05.000-R.pdf
Hi Russell,
We have received your signed permit and fee in the amount of $50.00.
Attached you will find an issuance letter with a copy of the lssued Permit. The Access Permit is valid for one year, although it
may be extended for one year. The next step is to obtain the Notice to Proceed (NTP).
Your contact is Devin Drayton, R3 Access Project Manager, for the NTP step. You may contact him at 970-683-6286
or devin.drayton(ôstate.co. us
Please provide the permii number on all documents in the NTP phase of this project.
Thanks,
Kandis Aggen
Access Coordinator
Region 3 Traffic & Safety
x
P970.683.6270 | t 970.683,6290
2Z25-5lxth St., Rm 100 I Grand Junction I Colorado I 81501
kandis.asgen@state.co.us I www.codot.sov
1
x xX
a-vl COLORADO
Department of Trans¡tortatÍon
Region 3 Traffic, Access Unit
222 S 6th St, Rm 100
Grand Junction, CO 81501
PH 970-683-6284 FAX 970-683-6290
<<< E-maited>>>
Aprit 30, 2018
Burning Mountain Land & Cattte, LLC
5175 County Rd. 335 #401
New Castle, Cotorado 81647
Re: State Highway Access Permit No. 318037, located in Garfietd County on Highway 006D near
Mile Marker Reference Pt. 105 Left
Dear Permittee:
The Colorado Department of Transportation (CDOT) has received your signed permit and apptication
fee. A copy of the issued permit is enctosed. The next step in the CDOT access permitting process
is for you (Appticant) to request a Notice to Proceed (NTP) from CDOT. Failure to receìve an
approved Notíce to Proceed prior to any construction wíll be a violatìon of the State Híghway
Access Code (2 CCR ó01-1,"the Code") 5 2.4.
Notice to Proceed Reouirements
Wet[ in advance of construction, the Appticant shatt request a NTP in writing along with the submittat
of other items, such as construction drawings, drainage reports, design specifications, and any other
required documents to CDOT. The Applicant must submit a complete packet. of the listed
information that fotlows in this tetter, to Devin Drayton. Access Proiect Manager. lf the Appticant
chooses not to request the NTP,.this permit expires 0413012019 pursuant to subsection 2.3(11)(d)
of the State Access Code. (Upon written request, this permit moy be extended twice, each for a
one-year period, up to three (3) years total. lf the access is not constructed within 3 yeors, a new
application must be submitted.)
Once the request and complete packet submittal has been received, CDOT has seven days to
determine if the NTP submittat is comptete for review and then notify the appticant of any
deficiencies. lf complete, CDOT wit[ review and comment on the submitted information within 30-
days. lf CDOT determines the information is unacceptabte, missing, or in need of correction, the
Applicant shatl be notified and their submittal shall be corrected and resubmitted to CDOT.
Once resubmitted, CDOT witt review the revised NTP documents within 10-days. lf the revised
documents are satisfactory, CDOT witt issue a NTP. lf further corrections are necessary, the cycte
of submittat, review and comments witl repeat itsetf until approval is granted and the NTP is issued.
The request for NTP shatl include the fotlowing documents, atong with any other items specified in
the Terms and Conditions of your permit:
f) Cover Letter Requestine a NTP
(lf appticabte, ptease inctude the engineering firm name, Professional Engineer's name, and
their contact number(s). )
Zl Traffic Control Plan 12 copiesl
Region 3 Access Unit, 2Z2S,6th St, Rm 100, Grand Junct'ion, CO 8'1501 PH 970-683-6284 www.codot.gov
The traffic control ptan must be:
Conslstent wlth CDOT Standard Plans Manual for Malntenance and Signing
consistent with the MUTCD
Prepared by individuat with American Traffic Safety Services Association (ATSSA) or
Colorado Contractors Association certification - or seated (stamped) by a Cotorado
registered professional engineer
Acceptabte to CDOT prior to any construction within the right-of-way
Presented in a manner that provides a method of handling traffic (MHT) for each
different phase of construction. The MHT witt describe proposed construction phasing
and wit[ inctude dimensioned diagrams of work zone elements.
The finat traffic control ptan must be submitted a minimum of three (3) working days in
advance of construction. Such ptans may be revised as necessary with CDOT concurrence.
3) lnsurance LiabilitvCertification
ïhe Appticant or contractor shat[ be required to provide a comprehensive generat tiabitity and
property damage insurance for the period of access construction. As per the State Access
Code, Section 2 (11)(i), the certificate shatl name CDOT, and the [oca[ lssuine Authoritv (if
appticable) as an additional insured partv for egnerat tiabititv in the amounts.of not tess than
S1,000,000 per occurrence and automobite tiabitity insurance of 51,000,000 with combined
singte timit bodity injury and property damage for each accident. The additionat insured(s)
must be noted as such, not just "Certificate Holders".
4l Comolete Construction Plans
The Permittee/Appticant shatl provide two (2) stamped hard copies and one (1)digitat copy
of 11" x 17" construction ptans and specifications for the proposed improvements from a
licensed Colorado Professional Engineer. The ptans shatt:
A. Address, as appticabte, geometry, drainage, striping, signing, and signatization;
B. lnctude, but not limited to, layout of the access, highway improvements, utitity locations,
present and proposed drainage, present and proposed right-of-way tines, present and
proposed traffic contro[ devices, and clear zone anatygis;
.C. Conform to the,requirement of the permit "Terms and Conditions" ; and
D. lf appticabte, inctude the fottowing statement on the cover page of the ptans: "This design
is in fu[[ compliance with Section 4 of the State Highway Access Code, 2 CCR ó01-1 except
for the fotlowing approved design waivers:"
Fee[ free to contact me, or Devin Drayton, Project Manager (970-683-6286). Devln can also be
reached at Devin.DraWon@state.co.us with any questions you might have.
RespectfuIty,
A.
B.
c.
D.
E.
&â^'et^
Dan Roussin, Region 3 Permit Manager
Cc: Devin Drayton, Project Manager
Fite
jlu',li' -i ,¡i'1'
$TATE HIGHWAY ACCESS PERMIT
GDOT Permit No.
318037
State Hlghway No / MP / Slde
008D/105.000i1eft
Psrmll F9ê (W
.00e,'$s0 4\,r\,t
Date of Transmittâl
04t14/2A18
Reglon /Sectlon / Patrol / Nan¡e
3 / 02 12K10 Mike Bosshardt
Local Jurlsdlctir¡n
Garfield CountY
Burning Mountain Land & Cattle, LLC
5175 County 8d.335 #401
New Castle, Colorado 81647
(e70) 984-2943
ls horeby granted permission to have an access lo the state highway at the location noted below, The accêss shall be conslructed, malntalned and used ln
accordahcã w¡th this permlt, inoluding the State Highway Aocess Code and any attachments, lorms, cond¡tlons and exhlbits. Thls permit may be revoked
by the lssuing Authority lf at âny tlme the p€rmitled access and its use violale any parls of this permit. The issuing author¡ly, the Deparlment and theìr duly
appointed agents and òmployees shall be held harmless agalnsl any âclion for personal iniury or p¡operty darnage sustained by reason of lhe exercise of
the oermit.
The Applicant(s):The Permittee(s)
Locatlon: Located on north side of Hwy 6 at approx, MP 105
Access to Provide Service to: (L,andusecode)
210 . Single-Famllv Delached l{ousing 2 units
Total Traffic
(Síze)(Unirs)
2 DHV
MUNICIPALITY OR COUNTY APPROVAL
Required only when the appropriate local authority relains issuing authorlty.
Signalure Pr¡nt Name Date Title
Upon the signing of this perm¡t the permittee agrees to lhe terms and conditions and referenced attachments contained
herein. All constructÍon shall be completed in an expeditious and safe manner and shall be finished within 45 days from
lnltiation, The permftted access shall be completed in accordance wíth the terms and conditlons of the permit prior to
being used.
The permlttee shall notlfy Adonna McDade Ward 2K3 wlth the Colorado Department of Transportatlon, at (970)
384-3396 al least 48 hours pr¡or to commencing constructlon wlthln the State Hlghway right.of-way.
The person signing as th6 pormitto8 must bê the owner or legal rspres€ntative of the property s€rvêd by the permilt€d access and have full authority to
accepl the permit and ¡ts torms and condilions.
sà{
iPflnt Name'R.rsc.ejt'*î;;b--r{-Date
4'u4-ø
Cð-PermltleeBignature; (if applicable)F'ilnt Name uale
This permit is not valid until signed by a duly authorized representative of lhe Department.
cçlLoRADO DEPA!ìTMENT OF TBANSPORTATTON
0
Required:Make copies as necessary lor:
Local Aulhority lnspgctor
MTCE Patrol Trafflc Englßeor
êdlllons are obsofeto and mey not bê usêd
Page I of 3 CDOT Form #l 01 5/07l.Region
2.Applicânt
3.Stâff Accsss 36ctiÖn
4.Cêntral Filâs
Copy Dlslriburion