Laserfiche WebLink
COLORADO DEPARTMENT OF TRANSPORTATION lavtineauttwtay appiramn <br />I <br />STATE HIGHWAY ACCESS PERMIT APPLICATION a~°"°"`°~m <br /> <br />InstlvUlons: -contact tffe Departmera of Traz~sponadon or your Mcal govertlmerd to tletennine your issuiltg aWrodry. <br />- contact the tswing aulhodty ro detemtine what plans alM other documems are required ro be wbmdted <br />wiM your application. <br />- complete tltis form (some questions rosy not appy to you) alW attach ail necessary dowrnerns and <br />wbmd R ro the issuing authority. Suhmd an appaptbn for each access requested. <br />- it you have arty questons comaq the issuing audwrity. Please print or type <br />1) meow lPermtme) z1 pPP~as <br />H• rra <br />aYYtatN'aaA Cm' <br />S, 30 Ro eNfr se asset s, r+tl' <br />. 30 a.~ Prose <br />sere phmwa <br />0 0-~ - 36 amwezp <br />GO <br />9m -2Y9- 5<3 <br />3) Adbaaa a ptopeq m fH cervod M pane la Iatown 1 <br />q Ing+dosvivuan of ptwny: <br />. <br />.,evwr:~m wets v z3r~Y v.."°Y-9 ~~1~ <br />~ <br />1e <br />5)WMsmu hghwaYwaYcu nWwmig acmes hen? e)Wlrolslaa of malwghwer l1t~N O 5 O E O W <br />llsN s0 <br />7jFrow many teeth ew pmpuseE ecross hom merrwaslmtle post? Now mmiy feetfe me prapwedeaeas fmm aw nemettcroaa aVean <br />Irt drde: N S W horn: M ~Dl teat(side: N S W Ihun: ~ -3 <br />8) Clwd hate f l you an reamseap a <br />^ new access ^ temporary aaess O imprevemem to existing aaess change in access use O removal of access <br />e) Wbtia tM apptoanwmaw you inbMmhaginoonmucEOn? <br />N / 200/ <br />10)UaYOU Mowbopap wtY~bNfphwgazuaaPMnb~^9~P°P~Y.ors~amNPO{~as inwNCfi yw haws P^Parq'imeraat <br />rto ^ Yes, d yes -what are the permit number(s)?: arxLOr, perrnd data: <br />l linen maproP~wll' own orhaw asy bnanrohin wryatSamN at°PeM? <br />^ no !8~ yes, fi yB9 - pleaaB dB3CnbB: <br />P owr uw/es er ofN Sly /. t ei s eo' at <br />1~ m~tagewmuebryra romk le~wrysaamas ~ orwitldn do poperq? <br />l9`no Oyes, it Yes -list them on ya+r plans and trMkate the proposed atx! existng aaess poims. <br />18) Ityasarv regwshp mI1h11ardY ariMuaW swat Wass nd®mdwlypn erd wmbrol Wsirossesantl pnaadema flvwwaaupurefoompe of nd,. <br />businwa sQUwa 4ushtna a4uN <br /> <br /> <br /> <br />sas aA Ane.eang agrbtaaxal sea emn.-row merry awe swu eb.aon. emwy <br />i~aYauarerxpwaSig rvaimmial ~vebpanwMecwawhmia dw rype(aagla fanuly, aparanwit. mwaMucel andrxmbsaot uNts? <br />qw nenbrofunSS type mmhwolunds <br /> <br /> <br />7gPswide~ lolawitg vehicle txwMea6rtwbsla vaideamatwig use meacvu. [saving drpropwry man remmaq iaGw oounh. indmleilyaursaunhwe <br />'eak hour volumes or O averege daily voNrnes. <br />• aawwwmwa aderww - •dmw.savaw •ww.r w,.w. <br />S /~ <br />aa.vp, wa nowao a xm _ wawa Todeeunt of all vshidr <br />lyl Chetlt wim sa owing aumoriq m eMwnine wl:ds of sw Mowing doa.nenb an regibad m oamWen ma review of yow epWf moon. <br />(pbn ahddd m m mrgarmn 2PS 361 <br />i,amerp <br />oaoreuacabaaan~gmsaamMausah- <br />'" <br />t <br />~ <br />~ <br />~ <br />at NighweysMrfriveway Wan pofib. n <br />h) OraswghpM armwing impwbmetyphway tightoWwy. g) Pwdaixl wnorshmmepa itcbdxg aswnenh. <br />c( Map midlNNrs dahdep uAftybodans hebnand seer h) SlpnhgaM smPmB Pbw. <br />dwMaptaeM in andffinp masigM-oFway ] Tra~emnad qan. <br />~ subdriyan, zonbp. ordwobpmhntWan. a P~aWofeabitiq "x,wranm. <br />It an aaess permit is issued to you d will slate the terms slid arMdbns for its use. Arty charges in the use of the permdled <br />aaess not fxutsistent wCh the teens and cgndNons listed on the pennil rrtaY be arsidered a vblatbn of the perms <br />TTte applkaM d¢eieres under penahy of perfury in the second degree, and any other appltcable state w federal <br />laws, Mat a111MOtmatbn ptwWed on this form and sttDmNted ettachmems are to the best of tttelr ktwwledge tore <br />and oompleta- <br />i ~ o+ea ~~~~~ <br />the applicam is not the r el Me pmperry, we rerpdre this application also to he signed M the prepeny owner or then <br />legday authorized represernative (or other aaeptal>le wlaien miderlrxt). This signaNre shwa constitute agreemern with This <br />applieatbn by all owners~ot•imerest unless stazed in wdling. d a penni[ is authorized Ne property owner wig be listetl as <br />the permitlee. <br />a-+anyormersipumre nem <br />S~F.%l <br />