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DEpD. ~TMENT OF HIGHWAYS <br />STATE O7`COLORADO~ <br />DIVISION OF HIGHWAYS <br /> <br />Date of acceptance by ~ ~S 8 S „~~ <br />Issuing Authority <br />DOH Form No. 137 APPLICATION FOR ACCESS APPROACH PERMIT <br />Rev. September, 1982 . <br />INSTRUCTIONS: Complete this iorm and attach all necessary documents prior to submitting it to the issuing authority. <br />Check with the issuing authority for what plans and other documents are required to be submitted with your application. <br />Contact the nearest office of the Department of Highways or your local government to determine the issuing authority. <br />Some questions may not apply to you. Contact the issuing authority for questions. <br />1. Applicant Colorado Marketing Associate 770-0633 <br />Name hone <br />Address 5660 S. Syracuse C>_r. City Eng e~woo~c -State CO 7jp 80111 <br />2. Property Owner,(Permittee) <br />Name Keel>_ncr & Co. Phone 751-5320 <br />Address 2800B S- HPa+har GardPnc Way City Aurora State CO lip <br />3. Address of Property to be served by Permit (if it has an address) <br />N/A <br />4. Legal description of property Subdivision ,Block ,Lot <br />See attached Exhibit. Section G _ F.. 1 /4 GP~4 ,Township S`i Range _SZfoL <br />5. The requested access approach would be located on the East side of State Highway I-25 , a distanceof <br />approximately,;aeeo feet R/etT.f~from milepost /4S .Precise location of the proposed access <br />approach may be required to be illustrated on plans or maps. The applicant expects to begin construction on or <br />about Summer,198~ate). <br />6. Is there existing access to thepropertytYes X ,No~lfsoshowonplan.Dootherexistingordedicatedpublic <br />streets, roads or highways abut the propertyT Yes X , No ~ List them or show on plans. <br />This approach is to the East side frontage road of I-25 <br />7. For commercial and industrial requests answer the following: <br />a. How many businesses will be servedT 2 <br />b. What types of businesses will be served and what is the floor area square footage of each. <br />Gravel Pit & Farming <br />(This plan is to reopen an old existing gravel pit) <br />8. For an agricultural field access, how many acres will the access server <br />9. For residential development provide type(s), e.g., single family, apartments, townhouses, and number of dwelling <br />units to be served. N/A <br />10. What is the anticipated average daily traffic volume count for each vehicle type that will be using this access <br />approachf (Leaving property then returning is two cour~J.(this question is not answered, the issuing authority will <br />make an estimate based upon standard references. (~~ r <br />r <br />Number of passenger cars ~.cMulti unit ucks ~ <br />Heavy single unit trucks arm vehicles 0 <br />Other, (specify) <br />11. The following documents may be required by the Issuing Authority to complete their review of the application. <br />Submitted plans should be no larger than 24" x 36". <br />a. Highway and driveway plan ancf profile. <br />b. Complete drainage plan showing impact to the highway right-of-way. <br />c. Map and letters detailing utility locations before and after development in and along the right-of-way of the <br />highway. <br />d. A subdivision zoning or development plan. <br />e. Property map indicating other access approaches and abutting public roads and streets. <br />f. Proposed access approach design. <br />12. If an access permit is issued pursuant to this application, the terms and conditions of the permit shall be based in part <br />upon the information provided by the applicant. Changes in the use o(the permitted access approach that are not <br />consistent with the terms and conditions of the permit or this application may be considered a violation of the <br />permit. <br />THE APPLICANT HEREBY DECLARES THAT ALL INFORMATION PROVIDED ON THIS FORM AND ANY SUBMITTED <br />ATTACHMENT(S) FOR THE PURPOSES OF OBTAINING AN ACCESS APPROACH PERMIT ARE TO THE BEST OF HIS <br />KNOWLEDGE CORRECT AND COMPLETE. <br />SIGNATURE(X) (`nl nrarln Mar]{r~+i n4 Acvnni at c . mAL£ (j - /~-j.T <br />Relationship to property. (owner7, lessee2, please specify.) gy; .~_~ <br />Lessee <br />Since an approved access approach becomes an important and integral part of the property, we require that when the <br />applicant is not the surface rights owner of the property, this application must also be signed by the surface rightsowner <br />or his legally authorized representative(orotheracceptablewrittenevidence) one rringin[hisa lication.lfapermitis <br />authorized, the property o ner ill be listed as the p mit he authorized cess permit y be recorded in the <br />county of record. ' <br />Property Owner (X) • j~° ate ^-f <br />~~ ~• <br />80014 <br />