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Dui 1tl O1 04:OOp UNITED Companies <br />• <br />RIO BLANCO COUNTY ROAD AND BRIDGE DEPT <br />970-625-5605 p.] <br />• <br />• THE PErR~M-~RTEE:n f~ r C //~ <br />_~~L-.L~ ICIl1P t2 IC.t N•h. 1~ i~ ~hk ~% ~~ <br />,`, C: <br />PERWT NUMIER: ,tIJ ~~r <br />ROpp NUMa61: Cr2 :l <br />aslarr xo: <br />Uprn tigninp INa paenir Ira! perrrihae agrees to Ste krms end mndNpns arA relerennsd a8adtmerdt rdnained herein. Tne permirletl arless Shall ba cun~esec in eaordenz wiN tee <br />SIRERh30R: <br />la1TE IS8UE0: __ _ _ _ _ _ <br />t'n f?tl+rN if e1 Lr ~[YeDKy l-a] ~~~~ ralrphene~6~-ay ~' ysao <br />is hereby requesting permission to construct and use an access to a county right-of-way at the Ixafion noted below. The access shall be <br />constructed. maintained and used in accordance with the terms and conditions of this permit including listed attachments. Sketch shall <br />include trorriage of ;ot abng rDad, distance from centerilna of road to properly line, number of driveways requested,~widtn of proposed <br />ddvewrdy(s) and angles, distance from building(s) end/or other facilAies. <br />The applicant binds anti obligates himself to construct and Inaintaln the right-ol-way access(es) in accordance with the provisions. <br />apecigcations, and conditions enumereted in this document. <br />This permit may be revoked by the issuing authority 'rf at any time the permitted access and its use violate any of the terms and conditions of <br />this penult. <br />LOCATION: tPlaaw lrrdata canyroad vie neareel mtla poet haotllDpn to atldreas.l <br />~p~~1c « ~s ~~ .~sr,~s <br />ACCESS TO PROYOE SERNCE TO: <br />CeQAUe-I ~tY' <br />SKETCH: This pmms Snel.amade arailaWe at:he rile where antl when work is being done AwoM1. tMetch pr tlrawirg ortne propr~oCnvewayls)mua aCWmpary ap[:Ilcaapn. <br />GENERAL PR0Y1810N5: ItMe ra'rerw br 9pecr8uGoru) <br />7. The Applicant represents all parties in interest, and affirms that the driveway approach(es) is to be constructed by him for the bona fide <br />purpose of securing access to his property and not forme purpose of doing business or servicing vehicles on the right-ot~rlay. <br />2. The Applicant shall furnish all labor and materials, Parfortn all work, and pay as costs in connection with the construction of the driveway(s) <br />• and its appurtenances on the nghl-0f-way. All work shall be completed in an expeditious and safe manner and shall be tinrshe~d w"~hir~ <br />days of the Permit date. T~ "~ <br />3. The type of construction shall be as designated and/or approved by the Road DeparlmeM and an materials used shall be of saf`~lory <br />quality end subject to inspection and approval of the Department. <br />4. The travelling public shall be pmlected during the ins~llation wim proper warning signs and signals and the Oepartmenl and its duly <br />appointed agents and employees shall be held harmless against any action for personal InJury or properly damage sustained by reason of the <br />exercise of the Permit. <br />5. No revisions or addhlons shall be made fo the driveway(s) or its appurtenances on the right-ot-way without the written permissiDn df the <br />Department. <br />6. Provisons and specifications outlined herein shall apply on all roads under the jurisdiction of the Department. <br />7. Staking or flagging access boundaries Is required prbr to approval <br />8. This permit does not allow any damage to occta on the exlsbng county right-of-way. K permittee reuses damage to the county road, <br />permitlee shat repair mad b the county's sa65faLrtlon. <br />9. All driveways permitted must have 6" of/." road base on the surface from the point it intersects the county road to the edge of the county <br />road right-ot-way. <br />OTHER TERMS AND cONDR10NS: <br />leans or the penntl prior b being uactl. TTe parmltW shall noOly <br />The puson <br />and rantlia <br />APPROVAL: <br />must lro the <br />BlenrA taunry Rwtl and Bridge Dapt. <br />_at IaaSl G8 haaS prig to wmmMCinp constrveaon within Ora Rb BlarKp Caunty rightei+xay. <br />W tl~ property Served by tM Isermated arrests and have /JI aWhprity b aceq IM pamlil an0 a1 i0 Iamb <br />~ ` C oau G G <br />+.c... <br />•NGa9ar Okrrlct 370 • brd SL,pP.O. aox KK Nleker, Calpndo 41607 (Y70) 87B-5801 Rarpcly Dlstdtt T7A7 Hwy. G Ranpdy, 0oloretlo 81019 (970) 8718611 <br />ay ~ ~--Y~a`~_tL~_i oau 7- l FS ~ & J nee r a C-a c Rte I n AYn 2 <br />COPY 01ST IBUT N: White - Applinant Yellwv • ftoatl B Bridge Admin. Once Pink - evebpmen! Depatlment <br />RIGHT-QF-WAY ACCESS PERMIT <br />