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• <br />• <br />OQLdRADd DEPARTMENT OF TRAHSPCItiTATIDN <br />UTILITY PERMIT <br />?ERlMflT6E DEPARTMENT USE. ONLY <br />Name Date issued 1LI19A]8 <br />B04VIlEIt~50iJEtCES,LLC Perrnitt! Ld;?17 <br />Atidros5 _ S.H.# 113A M.P.133mm <br />X3639 BOWIE Rt}AU, F.O. BOX A83 Region p3 <br />PA4t1A,CO81438 -- Seaion 02 _ <br />Telephone: (470}934.6257 Representative: BILL BEAR Patrol 2LA'1G'OL~i~13 <br />[YdIYCC 7t} PERMC!'IE6: Punuent to 9-L~li3 C.RS tau ehd ad maloc or heyi^ earnal[oa xltMal brat aailyiae the Vi[t[b' N^lilk+tlon Ce^ler of Gionio {11'CCL3 errd if <br />^ieesnrr, Ire^ odiry'at de her I+rs meiab+rs t^iri^gt anderpnrut lcdllelea is tit er:e of uc- t11ReYa~lea. Ai+r',iksMar ahr0 ^Uo he pvea i d^rs i^ edaeoe+f want ro tic CDb'r <br />reporel prrmlttinR elllre, or m +ISerwiu dlr+ehd 3y Itta f~er:dl'a Special Prvslaion hats CDOT ^adngrrlmd tatllirita. N+Nn of Ih+ oonsracwear, +ateat r~ ta~atla^ or the <br />euavari^^ w~^r!< shall be atnn ^t k*+t lr.'+ balirwr d^rs prln^ tber+et^, ad laciv~na the day of aelaal ulioe. The UI~CC mar be c^tled a t•s0692}'19S71I:DOT ('9701 6a31Yll. <br />AiCTlV1TY DESCRIPTION Futnbhed Pemilltee <br />Pt1RP05~C [~ [nslatlation XX Adjustment ~ Removal ~ MaittiCpetltoC of existing FBtiiity <br />FACIWT'Y [fypr:,sine,class of tranamiltant,design prevsure oretc. ;"°c ^' ^ s~~d'T~t+4F5'TEbl i1CLilDlti(' C:L'LVERT l~yl}ER SII133.TO <br />E}I. A~GF 1~1i WA71rR, j."DPti1;11[SCiL,AGE PFltl-i1T tH P1xiC~ iCl1F5;1o Cll•@OdIT761 <br />MATURE 4F WSTAi.LA'£ION Q LongilUdinal (Perafiel) 7iX 'transverse (Crossing} <br />^ Buried ^ AerialfGround-mauoted QAltach To Hwp. Su. Ha. <br />LOCATION State Hwy_ No. 11~ County DELTA Citylfown DELTA <br />Milepoinl(s) 13.3mm Jntersecting Feature(s): <br />ADDITIONAL RENIAAKS CII~NT IIVSURAH~E ~EICI'IiFI ~E L}~1i $1LE. tLEASE REVIE'4~~ ~ l;0ii~fl'LY 1yl'1'}I Tl1E AT'PACHED <br />LATIa FALI WIA'TER ~ RP`RIEI(P[}~~'cI~IJiP~lVti Ff1R~i17'i1•ITY iIVS~'ALLATLO:YS" <br />For underground Facility location information, ODntaeC UNCC &_~QT Telephone 7 'b27I <br />SPECI:ALPROYI3IQI~'S cam tad b tAe artlneat The S eciai Pravisiona are terms sad eonditioas of ffile rlait. <br />Any workshxll only be is a~ceordancewith the approved plum and special provisions as set forth it this peralit and its sttschmenta. <br />The CDO'P inspector is PRANK GALVIN Tdephorle {970) $?~73d3 (~111~7~.l~ <br />Wark is to be curnpleted on or before: 7fI5f0~9 or within _ days, (as applicable) <br />Wark time rxstriclwns: REF£RTOTt[E ATTACHED "SPECfA[. PI20~'ISO~[S FpR L"I'ILl't-Y Ih`53'ALLA'I'101\S''. <br />Designated minimum cover is iYfAA Uesignatsd o~ne~Jread clearance is IYla <br />(ALSO SEE hTFACFIED STANDARD PROYtSIDNS, AF}D ADD17'[ONAL SPECIAL PROVFSI(3Ti5)4 {TRAFFIC COTFIROL MUSTOONFORh+I'T+D TIIEMUTCI}) <br />Other: FiE:LD [~ISPECCOR S114LL 8E \OTIFIED 48 HOURS I'R1t7R TO BEGIAfN)EtYG WORK OR PERMIT IS VOfD. <br />Permittee is prohibited from eornnaencinB any work wllltia Mlghway ROW prior to iae<tlsnee oTa frlly erdsrled and ralitiated permit. Permit, <br />plan exhibit, inluranee oerti[icate(a), and traffi: conttrol plain must be availai-le or site during work. High risibility ruts arc repaired at IIII <br />tines during workirts hoots. <br />Your request to rse andfor oteap}:state higitmy syttrn righ+le of way as described shout is gr^ohi aabjeet to tAe terms and coadiliaas of IAis permit, <br />i rclndinE the Sia adard sad Special Prortstoss as sborvn oa the permrt and all >.ttarttmerls hereto. <br />To the estent authorised by law, Priotitteti ]tetchy atsrmety rtlesaa and agues to indelralfy, defsnd, protect, and :rrt tlla 51ate o[ Colando har+aless <br />from and against qay loos wdlar daatpge5 la the property d the Slab of Colorado, third pcreks ar the Pcrroilter's fat,'li6ta, and all kler s>rdfor daoage or <br />acaourit of I~~jucy loot death of ary person svhomsocvtr, arinng at sny time, cowed byergrowiogort of tht accapa[ion o[Lblrnr:do Stale Hlghlray rigJrb ofway <br />try Pmnittee`s faerLltes or any part thereof, including but not limited to irsirlIRifoo, adjusttar>tt, relocuioa, rnaiotraaoce or opera@oa, or removal a[eurtirg <br />faciHlies, unless each leas andfor dtmagt arises [rotr the sole reglgerce ar wip[ul condact of p1t:Slalt O! Calora4a oa! iW empToyw or agenu. <br />Failure by the Perm ittee to tAnaply sritla any of the included teraaa ar canditioas may sabJeet Chia permit m suspmsiot ar caseelMtian, at the discr+etirr of <br />I1t ~ 3eparEatent olTra^sporlaNoo_ <br />THIS PERMIT 15 tYDT VALID UIQ7'1L FULLY EiV11dASED BY ALL PAl;I'1E5~ WfTH DATE (}F ISSUE AI~IXED BY AN AUTIIDRIZED <br />R6YRFSEM'AT1YE OF 'l7iE DEPARTMEPCI', A F[SLLY F~LECU'TEU COPY OR 't HES t~RD11T tN[IST BB ON FTLR AT THB TRAd43POR'tATiON <br />RECIOtR OPFIt:6. <br />[n accepting thu permit tie undcrsigncd, reprsaeo[Ing tlse t'erwllter, vcri0es thtl ht ar she Ms tht autitorlty to sign for sad itiod the Permitkr, and that <br />ht or.she has read, rsderrhaads and acetpls all the induded eonditlam. <br />•- -~ -- - <br />A r~ Date l Signature <br />'Title rp Tide <br />I <br />COLORAI30 DEPARTMAENT OF TRANSPORTATION I By Datie <br />Chief Eflgjneer - WELDON ALL IICE VERKETIS I iiiisras <br />Dislrbullon: Dlsbieit Flla (dripinal} <br />1 Pan»ItteelAppfieanl Inspector CDQT Form # U333 Q2106 <br />Mice Parrot Super. NRee Landscap(ng Super <br />Previous versions aze ob~solehr said s}tould riot be used. <br />• <br />