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COLORADO DEPARTMENT OF TRANSPORTATION <br />UTILITY PERMIT <br />PFRAIPITF.F. APPLICANT <br />Name: JBS Five Rivers Callle feeding LLC To Be N <br />m <br />d DF.PARTNIMT l1.SF O NIX <br />a <br />e Dale Issu ed <br />Thano Mitonski ?--_ <br />__ __ <br />2 <br />Add Pernul n 2100172-U Iti1deiH,.I <br />ress: <br />25$ US 50 - `- <br /> <br />Lamar, CO 81052 <br />CO S.H.B <br />im <br />Rt <br />, 050 <br />02 427.00 <br />_ _ : <br />g <br /> S&Iimn 04 <br />'I'elcphfine: (719) 829.4841 <br />I1afnll -- <br />Marquili Walson - <br />NOTICE To PFRMrrrFI:: For underground facility location Infornallon. conflict Ilse 11111hy Notification Center or Colorado IUNCC1. thimunni to 9-IS-10.1 <br />C,RX year shall not Bake or begin excavation without first nnfiiyiag the UNCC and If necessary, then notifying the tier two members having underground <br />facilities in the area of such excavation. Notification stall also be given to the CDOT reglonal ptrmlliing office, or as otherwise directed by this Permil's Special <br />Provislons. Notice of the ammencenxnl, extent and duration of the excavation work shall be given at least two business days prior therein, lint Including the day <br />of actual nolhr. The UNCC nay be culled at 14 00.912.19117. ( ni rr nine be culled at 17191 BI-359h. <br />PURPOSE Plblslallaliolt _lAdjusuncnf r-Rennn'AI r Maiulcnmrre of exi+iing Fatcility <br />FACII.ITY I'ryix. sire. class of Inlnsnfitlwn, design pressure or clc. 112" water line under the roadway <br />Dfti(:ItIlrrloN OF 1VORK Bored 12" waterline under the roadway in a casino <br />NATURE OF INSTALLATION I Longiludinnl (Parallel) IV Trnnsversc (Crossing) <br />W Buried r Aerial/Gmund-mourned r-Auuch. To 1(wy. Sir. No. <br />L(X'ATION: _112 mile east nt I IR sn anri 9n7 iurrr•t;r+n !-I ......,. <br />County..--ef t Cityfrown: Lamar Project Info: Wa <br />ADDITIONAL REMARKS Contact Mark Nusskern (719.546-5433) at least 48 hours prior to starting permitted work. <br />(cola lefed h <br /> <br />__ _---_.__ Provisions arc I- and coOditluns of ibis <br />Any work shall only Ile in accordance with the approved plans and special provisions as set forth in this permll and its atlxchnfents. <br />The ('O(yr inslnxtor is _Mad1,,l.NU&3Ker0Telephone: 1.19.251-783Q Fe%: 719.546.5433 <br />Wink is In hr cnnnplCtcll INt nr hefitre: 12/31/2011 car within _- fifty-.. (:Is applicable) <br />Walk iiniv lesuiclion%: No work-in adverse waalhe[ cnndiI nnq <br />Iksignaawl nounnum cover is 60" I)csignated owthead cleunutce is <br />iAI SO SIT ATrACIIIiD S I ANDARD PROVISIONS. AND ADUrrIONAL SPECIAL PItuVISIt INSI. 01tHll'IC cowltol. Mtisl-cO\t'i)RAl TO Till.' MI FIVI )l <br />ofluv: REVIEW ATTACHED STANDARD and SPECIAL PROVISIONS. CONTRACTORS AND SUBCONTRACTORS <br />ARE. BOUND TO THESE REQUIREMENTS. Copy of permit most he on sNe. Erosion control m,easureWtesioration <br />flernliflce is prohihilyd rroin connnencing tiny work within bighway ROW prior ffi Issuance or it fully credo:slid rout vultdated permil. 11crinit. <br />plan exhibit, insurunce certincstels), still IrRMc control plan must he illoiluble fill she during work. Iligh visibility vests are required of all <br />tittles during working hours. <br />1. Your requ-.%t to use i nd/r occupy stale highway syslemt rlglm+ air vvny a+ deserllted alanve Is granted subject to file term. lint[ conditions at this In•,mil. <br />including the Standard and Special Provisions as. havvo nn the per,nk and all ollachroeoLs herrio. <br />2. I'n the exirnt :ndhurited by law. 1'ernnflter hrrrhy as+uu,rs, rrinmes and agrer+ hf indenmiry, t[errud, protect, and save the Sfalr of culurndo ha, odes. if rem <br />"till agalal any II?vs and/or datimlit% to the property or lite Slate or Colorado, third io,rlles nr life 1'ermltler's rarililim. and all Im+ onaUor damage om avrooto <br />or Injury in nr death nr any persm, wbnfirucvrr. Arising of am filar. caused by or groping lint or the ucculumon fir ('olorado Shale Illghony rights nr v, a% by <br />1'rrininee;x racililirs nn- uny part lhrreor. lurluding but lint Ihnllrd to inlallatlon, adjushnenl, rrlaxntinu, nnahnlrftauce car operation, fir n•movnl 1.1 riklilw <br />fudiffim onus such Muss and/or damage orlses from Ilse sole negllgrane car wRlrui coudnrf fit the State or cooradfi fir ifs empla) trs fir agrmts. <br />3. Fellure Ili) the Petotlllre to cntup)y 1v1111 oily nr Ilse Included lernt+ or cnndiintu may %allf e f 1111+ penaif to suspenslon or canrellailo t, at file dlu•reflon fir the <br />winsti trin or'rrfinstorta ion. <br />4. nun 11FRMIT IS NOT VALID UNTIL FULLY FNI)OPSED IIV ALL 11ARTIP-s. 1\•1711 DATE. OF I.SSIJV AFFIXED BY AN AUTHORIZED <br />I<t 'kIiSP:YI'.\'1'IVIS OF Tin: DIsP,\IfrAlliN'f. A Fum.v EXE('lrr!{D COPY OF TIIIS PERMIT Nt%ST IN: ON FILE A'1"r1 r. TRANSPORTATION <br />REGION OFFICE <br />5. In accepting fills perodt flit undersigntd, representing lite Prnnhlce, vcrines [flat he fir she fins flit authority to sign fur and bind the 11erinitfce, and [fill[ Inc fir <br />she has rood, n 1truands and accepts all the Included conditions. <br />Attested Drat --Signature Date <br />Title to e? a I m der 1 Title - <br />Print Name: , S (Print N e <br />COLORADO DEP RTMENT OF TRANSPORTATION 1 BY Date <br />Chief Engineer Ro Io at T Vnslo!ortaton Director or Designee ........... .....,, ..../ mmu r anu .ta?lAnq surer i <br />lenndluulA)rlrllt lit Inspector Mink J.Nusskunt CDOllw,n,r,uld, 111101 <br />MICU Palo) SI'Mr. M3rqu0t:Waisnn hV%flat \ %v"a-4n air u1,41kic,nnl .huuld son I n411 <br />