HomeMy WebLinkAboutApplicationGurfield County ONSITE WASTEWATER
TRËATMENÏ SVSTEM
(owrs)
PERMIT APPLICATION
Community Development Department
108 8th Street, Sulte 401
Glenwood Sprlngs, CO 81601
l970ls4s-82t2
www.sarfield-countv.com
X New lnstallation E Alteration tr
X Dwell E Transient Use tr Com ndustrial tr Non-Domestic
tr Other Describe
Mailing Address: 8191 E Kaiser Blvd Anaheim. CA 92808
Property Owner:5-Mile Ranch. LLC Phone; _
Contractor: TËP Rockv Mountain LLC Phone: ß701255-9377
PO Box 37O. Parachute. CO 81635Mailing Address:
Mailing Address: ... PO Box 370, Parachute. CO 81635 . , _ ..
Job Address: SG 34-26 Pad
Assessor's Parcel Number: 240926100163 Sub. _ Lot _ Block_
Bulldlng or Service Type: Tqmporarv offiçç & house #Bedrooms: j-.{jearbage Grinder No
llllas an €ffort made to connect to the Community Seu¡er System:
Phone: (970J 250-5505
NA
Distance to Nearest Community Sewer System:NA
E
Engíneer:David Fnv
tr SepticTank E Aeratlon Plant X Vault tr vault h¡W tr CompostÍngTollet
E Recycllng, Potäble Use E ßecycllng E Plt Pr¡vy E Incineratlon Toilet
Type of OWTS
tr Ghemical Tollet X Other
Ground Conditions Depth to 1st Gfound$rate¡tablê 8A Perc€ntGround5lope NA _
E Absorptlon trcruh, Bed or P¡t EI Underground Dispersal tr 'Above Grcund ölspersal
I Evapotranspiration E Wastewater Pond E Sand Filter
FinalDisposalby
X Other
tr Well E Spríng Ë streamorCreek E ClsternWater Source & Type
X Communlty Water System Name
Effluent WillEffluentbedischargeddirectlylntowðt€rsofthestate? E yes XNo
Applicant acknowledges that the completeness of the application is conditional upon such further
mandatory and additional test and reports as may be required by the local health department to be
made and furnished by the applicant or by the local health department for purposed of the
evaluation of the application; and the issuance of the permit is subject to such terms and conditions
as deemed nêcessary to insure compliance with rules and regulations made, information and reports
submitted herewith and required to be submitted by the applicant are or will be represented to be
true and correct to the best of rny knowledge and belief and are designed to be relied on by the local
department of health in evaluating the same for purposes of issulng the permit applied for herein. I
further understand that any falsification or misrepresentation may result in the denial of the
application or revocation of any permit granted based upon said applicatÍon and legal action for
perjury as provided by law.
I hereby acknowledge that I have read and understand the Notice and Certification above as well as
have provlded the requi which is correct and accurateto the best of my knowledge.
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Owner and Sign Date '/ ,/
Special Conditions:
Perm¡t Fee:
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Perk Fee:trÑ; u^,,\\dl^J s-¡5,oôTotal Fee¡:Fees Pald:ı75, oo
Septlc Perm¡t:
\tr9r;5514Bulldlng Permlt
tç
lssuê Dete:
tô/ rq/ lg Balance Due:ffi9o
BLD6 DIV:
DATE
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-ReëeotionË: 879861øltldtzua Ø2:18:46 Pl'l Je¿n Alberico
1 of 2 Rec Fee:$16.ØØ Doc Fee'ø.Øø GÊRFIELD CoUNTY C0
POWER OF ATTORNEY
KNO\UALL PERSONS BY THESE PRESENTS:
THAT TËp ROCKY MOUNTAIN LLC, a Delaware limited liability çompauy, hereby nominates,
constitutes, and appoints Bryan S.Ifohrd, as its true and lawful Attorney-in-Fact to execute and deliver
in the name and on behalf of IEP ROCKY MOUNTAIN LLC ('Principal") any of the following
designated instruments or documents in connection with the Prinoipal's operations in exploring for and
producing oil, gas, or otler minerals from lands, or interests in lands, o\ryned, held, or claimed by th"
United States, any stafe or political subdivision thereof, any pen¡on, corporation, parfirership or other legal
entity:
A. (1) Applications for permits or leases; (2) consents, stipulationg or agreements in connection with
the issuance of permits or leases; (3) acceptances of leases, subleases, or permits; (4) acceptances of all
insfuments ûansferring leases, offers to lease, permits, applications for permits, or subleases, or an interest
in any ofthese (including assignments of working or royalty interests) to Principal.
B. Applications for extensions or renewals of leases and permits.
C. (1) Prospecting, seismic, or exploration permits; (2) inshuments in connection with the acquisition
or maintenance of prospecting seismic, or exploration permits.
D. Instruments withdrawing applications for leases or permits.
E. (l) Requests for rights-oÊway and surface use permits; (2) acceptance of grants of rights-of-way
and surfaoe use permits, including any stþulation or condition in the grants; (3) any statements that may be
required in connection with applications for rights-of-way and surface use permits.
F. Requests for extension of time in which to drill wells.
Principal agfees to be bound by all rcpresentations the Attorney-in-Fact may make in any instrument or
document he or she is authorized to execute and deliver under this Power of Atüorney. Principal hereby
waives any defenses available to it to contes! negate, or disaffirm the actions of its Attorney-in-Fact under
this Powerof Attomey.
This Pourer of Attorney is effective July 1, 2016, and shall continue in full force and effect until revoked in
writing, and has the same force and effect as if the Prinoipal granted sepârâte special authority to the
named Attorney-in{act to execute and deliver each such insFument or document separately fo¡ each and
every such insffument or dooument so exçcuted and delivered.
EXECUTED by Principal on this 13ù day ofJuly,2016.
Terra Energr Partners LLC as sole member of
TEPRoclry Mountain LLC
AGREED TO A¡ID ACCEPTED
BY:
S. Lând s
TOÊdF$RRflHÐ
TÐFV
BY
ITS
4
President and CEO Attomey-in-Fact
ACKNOIWLEDGEMENT
State of Texas
CountyofHanis
This instrument was acknowledged before me on f,L, /3 by Michael S. Lafld known to.20r6
me to be the President and CEO of Terra Enerry Parbrefs LLC, tDelaware corporation, on bçhalf of the
corporation.
O{otary Seal)
N
ltFtÀNY CEDEr.t POttOCK
Notory Public, Slole ol Texos
MyComm¡ssion Expires
April 2ó, ?019
SG 32-26 PadVault System DescriptionThe site will temporarily office and house up to a maximum of eightindividuals during naturalgas drilling activities and is expected to becompleted in one year or less. The individuals will occupy up to fourindividual units located on the well pad. Office/houses have ColoradoDivision of Housing compliance tags.Four above ground sewage holding tanks with 1500-gallon (6000-gallon total) capacity on-site.The Vault $ystem is displayed in the pictures. Sewage flow is estimated to be 600 gallons perday (8 individuals x 75 gpcd). Sewage holding tanks need to be emptied approximately every10 days (6000 gallons/ 600 gallons per day). Wastewater vault is equipped with overflow alarmdevice. Terra Energy Partners utilizes the services of a licensed contractor to remove and haulthe wastewater to a state certified treatment/disposal facility.Two aboveground potable water tanks of approximately 3360 gallon capacity each on-site."Potable Water Only" signs will be posted on tanks. Potable water demand is estimated to be600 gallons per day (8 individuals x 75 gpcd). Required minimum fire suppression demand is2500 gallons.Road access to the site is maintainedyear round through the services of aprivate road maintenance andconstruction contractor.
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'l .) 10olo Swell Factor Applied to Earthwork Cut Volumes.
2.) Topsoil Volume Based on 12" Soil Depth.
3.)Total Dislurbed Area = t5.20 ac.
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ESTIMAIED EARTHWORK QUANTITIES (cy)
ITEM CUT FILL TOPSOIL EXCESS
PAD r 5,380 280 2,580 12,520
4,620 4,620TRENCH
2,580 17,140TOTALS20,000 280
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