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DocuSign Envelope ID:2804A51B-B830-493A-9B92-2E96E404766F <br /> v.uLuKo;wU ur-rrvc r Men r ur t KAnarur(r w r wn CDOT Permit No. <br /> STATE HIGHWAY ACCESS PERMIT 120168 <br /> State Highway No/Mp/Side <br /> 070A/238.267/Right <br /> Permit Fee Date of Transmittal Region/Section/Patrol/Name Local Jurisdiction <br /> $100.00 12/21/2020 1 /09/41 Richard Berger Clear Creek County <br /> The Permittee(s): The Applicant(s): <br /> Harold Lesser Jeff Carter <br /> 6999 S Columbine Rd 15954 Jackson Pkwy B281 <br /> Evergreen,Colorado 80439 Monument,Colorado 80132 <br /> (720)545-5635 (719)237-5914 <br /> Is hereby granted permission to have an access to the state highway at the location noted below.The access shall be constructed,maintained and used in <br /> accordance with this permit,including the State Highway Access Code and any attachments,terms,conditions and exhibits.This permit may be revoked <br /> by the Issuing Authority If at any time the permitted access and its use violate any parts of this permit The issuing authority,the Department and their duly <br /> appointed agents and employees shall be held harmless against any action for personal injury or property damage sustained by reason of the exercise of <br /> the permit <br /> Location: This Milling egress access is located on the south side of Stanley Rd(1-70 Frontage)800 feet east of Fall River Road or Mile <br /> Point 238.154 <br /> Access to Provide Service to: (Land Use code) (size) (Units) <br /> 983 -Surface Mining Operation Milling Operation 63 ADT <br /> Additional Information: <br /> 500 Stanley Road <br /> MUNICIPALITY OR COUNTY APPROVAL <br /> Required only when the appropriate local authority retains issuing authority. <br /> Signature Print Name Date Title <br /> Upon the signing of this permit the permittee agrees to the terms and conditions and referenced attachments contained <br /> herein.All construction shall be completed in an expeditious and safe manner and shall be finished within 45 days from <br /> Initiation.The permitted access shall be completed in accordance with the terms and conditions of the permit prior to <br /> being used. <br /> The permittee shall notify Tanisha Alford with the Colorado Department of Transportation,at (303)880-3693 at <br /> least 48 hours prior to commencing construction within the State Highway right-of-way. <br /> The person signing as the permittee must be the owner or legal representative of the property served by the permitted access and have full authority to <br /> accept the permit and Its terms and conditions. <br /> rra <br /> ature: Print Name Date <br /> VD t nsSt,V' Harold Lesser 12/22/2020 1 2:13 PM PST <br /> CT-FdWKWISIbnature:Of applicable) Print Name Date <br /> This permit is not valid until signed by a duly authorized representative of the Department. <br /> Gl:DEPARTMENT OF TRANSPORTATION <br /> L <br /> � C � Print Name Title Date of issue <br /> Marilyn Cross access Manager 7 <br /> 12/ 2/20 0 1 3:23 PM Ps <br /> Copy Distribution: Required: Make copies as necessary for. Previous editions are obsolete and may not be used <br /> 1.Region 3.Staff Access Section Local Authority Inspector Page 1 of 3 COOT Form 0101 5107 <br /> 2.Applicant 4.Central Fibs MTCE Patrol Traffic Engineer <br />