2012-09-06_REVISION - M2008070 ‎(24)‎

• Permit No: M2008070
• IBM Index Class Name: Revision
• Doc Date: 9/6/2012
• Doc Name: AM-01 APPENDIX A: SITE INFORMATION
• From: WESTERN GRAVEL
• To: DRMS
• Type & Sequence: AM1
• Email Name: THM
• Media Type: D
• Archive: No

Feb.11.2011 01:19 PM
MIL.; ut U L UUN 1 Y ROAD AND PERMIT
DEPT.
RIGHT-OF-WAY ACCESS 1 ERMIT
:x^ PERMTTTEFa2 WQStprn Gr.?tr
So 8O8 Meeker CO 81 641
PURPOSE OF THIS ACCESS (summer or full -time residence, utility location, etc):
by
See Attached
APPROVAL TO CONSTRUCT ACCESS ACCORDING TO THE SPECIFICATIONS NOTED ABOVE:
Authorized County Representative
PAGE. 2/ 5
PERMIT NUMBER:
ROAD NUMBER:
DIST JCT NO;
SUPERVISOR;
DATE ISSUED:
Telephone 97 —82.8_— 55.64'
Is hereby requesting permission to construct and use an access to a county right -of -way at the Ideation noted below. The access shall be constructed,
maintained and used in accordance with the terms and conditlorts of this permit including fisted attachments. Sketch shall include frontage of lot along road,
distance from Centerline of road to property line, number of driveways requested, width of proposed driveways) and angles, distance from building(s) and /or
other facilities.
The applicant binds and obligates himself to construct and maintain the right -of -way access(es) in accordance with the provisions, specifications, and Conditions
enumerated in this document.
The issuing authority may revoke this permit if at any time the permitted access and its use violate any of the terms and conditions of this permit.
LOCATION (Please indicate county road and nearest mite post or address if one axrsts):
RBC Rd 5 Nearest Mile post is 42
To provide access to proposed WRC Gravel Pit
SKETCH: This permit shall he made available at the site where and when work is being done. A work sketch or Crewing of the proposed dnveway(s) must accompany application.
Proposed location must be marked or flagged before submitting this form,
, 3ENSRAri EgovtZTONS: (See reverse for Speeiticat},oael
1. The Applicant represents all parties in interest, and affirms that the driveway approach(es) is to be constructed by him for the bona fide purpose of securing
ac to.his property and not for the purpose of doing busine ee or servicing vehicles on the right -of -way.
Applicant shall furnish all labor and materials, perform all work, and pay all Costs in connection with the construction of the drlveway(s) and its
a 't anges on the right -of -way. All work shall be completed In an expeditious and safe manner and shall be finished within 30 days of the Permit date.
3. 'i :,e type of construction shall be as designated and /or approved by the Road Department and all materials used shall be of satisfactory quality and subject to
inspection and approval of the Department.
4. The travelling public shall be protected during the installation with proper warning signs and signals and the Department and Its duly appointed agents and
employees shall be held harmless against any action for personal Injury Or property damage sustained by reason of the exercise of the Permit,
5. No revisions or additions snail be made to the driveways) or its appurtenances on the right -of -way without the written permission of the Department.
5. Provisions and specifications outlined herein shalt apply on all roads under the jurisdiction of the Department.
7. Staking or flagging access boundaries is required prior to approval.
13, This permit does not allow any damage to occur On the existing county right -of -way. If Permittee causes damage to the county road, Permittee shall repair
road to the county's satisfaction.
4, 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 road right -of -way.
OTHER TERMS AND CONDrrrg1ss:
FEE $65.0Q
Upon signing thie permit the Permittee agrees to the terms and conditions and referenced attachments contained herein The permitted access shall be
completed in accordance with the terms of the permit prior to being used. The Permittee shall notify the District Supervisor with the Rio Slando County
Road and Bridge Dept immediately upon completion of the installation, At that time a representative will inspect driveway access for compliance. If
construction is not to the specification herein required, the County shall notify the Permittee and corrections shall be made immediately. If
corrections are not made to the satisfaction of the County, the access shall be removed.
The person signing as the Permittee must be the owner or legal representative of the property served by the permitted access and have full authority to accent
the permit and all its terms an. ions,
Data
Data T1t1s
This permit is not valid until signed by a duly authorized representative of the Department.
RIO BLANCO COUNTY ROAD AND BRIDGE DEP4iMENT
Meeker District 570 - 2nd Street Meeker, Colorado 81641 pro 878 - Q Fex (970) 878 -3396
Rangely District; 'f7497 Hwy. 64 Rsrrgely, Colorado 8160 (970) 67'6.3644 Fax {S70) 675 -8648
efr - 154.5