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<br />cowr;AOO DEPARTMENT OF HIG'..,AYS i: White Applicant <br /> Con.", Di.1rictFile <br />UtiLITY PERMIT ," P,nk Mlinl.fortlman <br /> GoldenrOd In.peel"r <br /> StanoaroP,o.i.ion. AppJicant <br />PERMITTEE .~ C 2 1988 DEPARTMENT USE ONLY <br />Name Co 1 orado Water Conservation Board <br /> epartment or Natura I Kesources _. c :...~ DATE ISSUED Julv 18 1988 <br />Address 1313 Sherman Street PERMIT NO. 44-88 <br /> Denver Colorado 80203 S.H.NO, 160 M.P. <br /> Nick Ioannides Chief Proiect Plannina/Construction DISTRICT 05 <br /> SECTION 03 <br />Telephone 13031 866-3441 PATROL 18 <br />Your request to use.and/or .o~cupy state highway system right 01 way as described below is granted subject to the terms and conditions of this permit, including the <br />Standard and Special ProvISions, as shown on the FRONT and BACK hereof. IT IS UNDERSTOOD Ihat the Permittee will accomplish the work at no expense to the <br />Department and will own arld maintain the lacilities permitted <br /> <br />ACTIVITY DESCRIPTION: (furnished by permittee) <br /> <br />PURPOSE lID Installation 0 AdjustmenURelocation 0 Removal 0 Mamtenance 01 eXlstmg facIlity <br />FACILITY (Type, size, class 01 transmlttant, design pressure or potential, etc) Dotable water transmission 1 ine. <br />12- and 14-inch ductile iron Class 50 pi'pp~. l}ravity flow <br />NATURE OF INSTALLATION Iil Longitudinal (Parallel) Xl Transverse (Crossing) <br />II Buried' 0 Aerial/Ground-mounted 0 Attach. to Hwy. Str. No. <br />LOCATION State Hwy. No. 160 County 'Montezuma CitylTown 'Cortez- Towaoc <br />Milepoint(s) or Intersecting feature(s} parallel Highway 1 fiO from r.nOH ma intpnanr.p far.; 1 ity two mil P-~ <br />south of Cortez. south 6.45 miles to Ute 'Mountain Ute Indian Reservation. <br />AOOITIONALREMARKS Bored crossings under Highway 160 at' McElmo Wrt"h. Isrriay Wash. and <br />Towaoc Road as shown on the Drawinqs. List of proposed proiect soecial provisions <br />and traffic control plan are attached. <br /> <br />"For underground location information, contact: r:o 1 nrrtdn <br />Chipf .Prnjpr.t Planning/r.nnc:trur.tion <br /> <br />Watpr.r.onsprvatinn ROnrdr Mr Nick 'Yonnnides. <br />, Telephon~ (30:n Rfifi-'3441 <br />" <br />PLANS: Attach plans or work sketch ("EXHIBIT A") Showing location, character, dimensions, and details of the work to be done. <br />4 sets minimum required. Compliance ~ith the plans or sketch, as approved by the Department, shall be a condition of this permit. <br /> <br />SPECIAL PROVISIONS (completed by Department) <br /> <br />The Special Provisions are terms and conditions of this permit. <br /> <br />Any work shall only be in accordance with the approved plans, Standard Provisions, and Special Provisions as set forth in lhis permit. <br /> <br />Permittee is prohibited Irom commencing any work within highway ROW prior to issuance of a fully endorsed and validated permit. <br />Permit, plan exhibit, insuranca certlficate(s)', and traffic control plan" must be available on site during work. ("See Std. ProviSions) <br /> <br />Permittee hereby assumes, releases and agree$to indemnify, delend, protect and save the Slate 01 ColoradO harmless Irom and against any loss of and/ordamagetothe <br />properly of the State 01 Colorado, third parties or the Permillee's facilities, and &1110$5 and/or damage on account 01 injury to or dealh 01 any persons whomsoever, <br />aflSing at any time, caused by or growing out 01 the occupation 01 COlorado State Highway rights of way by Permittee's facilities or any part thereof, including but not <br />limited to installation, adjustment, relocation, maintenance or operation, or removal 01 existing facilities. unless such loss andlor damage arises from the sole <br />negligence or wilful conduct of the Stale 01 Colorado or its employees or agents. ' <br /> <br />Failure by Permitteeto comply with any 01 the included terms or conditions may subject this permit to suspension orcancelllltion.lltthe discretion of the Departmentol <br />Highways. <br /> <br />THIS PERMIT IS NOT VALID UNTIL FULLY ENDORSED BY ALL PARTIES, WITH DATE OF ISSUE AFFIXED BY AN AUTHORIZED REPRESENTATIVE OF THE <br />DEPARTMENT. A FULLY EXECUTED COPY OF THIS PERMIT MUST BE ON FILE AT THE HIGHWAY DISTRICT OFFICE. <br /> <br />In accepting this permit the undersigned,representing the Per millee, verifies that he orshe has the authority to sign for and bin dthePermillee,andthalheorshehas <br />read. understands and accepls all of the Includedcondilions. <br /> <br /> <br /> <br />Signature <br /> <br />Title <br /> <br /> <br />x <br /> <br /> <br />Attested <br /> <br />~ f.. ~U/.}Jv/l...cl;oy, <br /> <br />O..trictEngmeer <br /> <br />PrevlouseIUon....otl.or....nd....ynollauNd <br /> <br />eDOH Form #3: <br />11/1 <br />