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Division of Highwa ys, State of Colorado DOH Form No. 101 ..Rnvfse~ ~ Aeril, 197 ~ ` Copy Distribution White-Applicant Yellow-M[ce. Superin[enden[ glue-At[ce. Engineer Green-Mice. Patrolman Pink-U[ility Inspector RECEIVED MAR 2 ~ 1531 MINED LAND RECLAMATION~•COAL COLO. DEPT. OF NATURAL RESOURCl1 District No.... r.. .........05............ Mire. Sec. No... ........ ~3............ State HighwaY. ......1.s 1... ........ Permit No......... 3~-80.-,..,..._. DIVISION OF HIGHWAYS fx~~~ ~v STATE OF COLORADO ~j ~ ~/ APPLICATION FOR DRIVEWAY PE MIT ~•~-. ~ June 24; 11980 Application Date....~(~1.71G..~~. ]9:?....v.... C~~~yM~2t~~G~~• ~pG~l (herein called "Applicant") hereby requests permission end authority .................................................. 151 from the Division of Highways to construct a driveway approach(es) on the right•of-way of Stale Highway Number....~f~.... South ` 5 edfacent to h' roper(}' IOC fed on the..... .S..pK~.. ~'.1........... .side of the highwa , e distance of...~'.~ ................ .....mile(s) from Jct. Hwy ~Spl ants 1bS IDuectionl truck tyrnarouncs c-~c. `(1~'~.\ W ~S1 \to0 -fvv~c L ,rdavota,J .~............!T.}l.!s.....~ ..... ..... ..../.................... for the Purpose of obtaining access to 0...................~....`V.................... .....~. IRwd Jtl, ~ ly Limit, r ronvenienl Irndmerkl ISlete neturc of busineml Applicant submits herewith [or the consideration and approval of the Division a sketch (or blueprint) of the proposed installation showing all necessary specification detail including (1) (rootage o[ lot along highway, (2) distance from centerv line of highway to property line, (3) number of driveways requested, 14) width of proposed driveway(s) and angle of approach, (5) distance from driveway to road intersection, if any, (6) size and shape o[ area separating driveways it more then one approach, end f7) setback distance of building(s) andlor gasoline pump island(s). The applicant binds end obligates himself to construct end maintain the driveway approach(es) in accordance with the provisions, specifications, and conditions enumerated in this document. GENERAL PROVISIONS FIRST: The Applicant represents ell parties in interest, and affirms that the driveway approach(es) is to he ronstructed by him for the bona fide purpose of securing access to his property and not (or the purpose of doing business or servicing vehicles on the highway right-of-way. SECOND: The applicant shall furnish all labor and materials, perform all work, end pay ell costs in connection with the construction of the driveway(s) and its appurtenances on the right-of-way. All work shall be rompleted within 30 davs of the Permit date. THIRD: The type of construction shalt be as designated and/or approved by the Division oC Highways and all materials used shall be of satisfactory quality end subject to inspection and approval by the Division. FOURTH: The (coveting public shall be protected during the installation with proper warning signs and signals end the Division of Highways and its duly appointed agents and employees shall he held harmless against any action for personal injury or property damage sustained by reason ut the exercise of the Permit. FIFTH: The Applicant shell assume responsibility for the removal or clears nce of snow, ice or sleet upon any portion of the driveway approach(es) even though deposited on the driveway(s) in the course o[ the Division's snow removal operations. SIXTH: in the event it becomes necessary to remove any right-of-way fence, the posts on either side of the entrance shell be ~ecu rely breced before the fence is cut to prevent any slacking of the remaining fence. and all poets and wire removed shall be turned over to the District representative of the Division of Highways. SEVENTH: No revisions or additions shall be made to the driveway(s) or its appurtenances on the right-of-way without the written permission of the Division of Highways. EIGHTH: On those highways along which access rights ere restriclvd or for which service roads have been con¢truMed, driveways shall connect only to the service roads and not to the main traveled highways. NINTH: Proviaians and epeciticationa outlined herein shall apply on all highways under the jurisdiction of the Division of Hig!twaye, except thet~on highway connecting links within the corporate limits of mtiniripelitiea operating under home rule SYrwer5 the Tlivi¢inn mrlwfinn¢ aholl Fw nr6iert tri rnnrL rmnro F,v It,n L...ol ov.,.e :,..,e I:.,d..