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COLORADODEPA MEIROFTRUCIN fAW0N <br /> UTILITY PERMIT <br /> PERaami[ APPLIDIINT OEPAIIiMENT UN Olfly <br /> Name:Martin Marietta Materials,RIverbend Naate: Dace Issued: 06/06/2019 <br /> REP:Steve Gordy REP: -- --— ParmitC4190361 Mitepost(al stda(a) <br /> Address -- Address: S.H.i 085 23&562 Left&Right <br /> 1627 Cole Boulevard - -- — --- <br /> Lakewood.Colorado SOM RgOon:4 <br /> Entail: steven gordy0martlnrandatta.corn Emell: - -- S.H.Section:C —— -- <br /> Taiaphotm 919-268-93W Telephone: Patrols 14 - <br /> L <br /> WTO►ERlAtRFf tForundergroundfadityll-red ktfer smtk ,enntaet the 1ftlNy Notlllostlot Center dColeredo(tMfOq.Ptasuarntto ti-1i103 C R S.you drabmsloe or begin exnwtlort w1lltattt in rtotffyktg the IINOC and H tveoessary,ifnsn noWytng the tier two naanben hatrkhg udergrosatd hdatlas Ln tM area dstadtr atim NotNintfen shall also to given to the CDOT regional permitting afRea,or as otherwise dbWAd by this Permtes Spacial Pravbtons. f*,tlw of the <br /> mencement,aatent and duraaan of the aeavaeon work shad be Shunt at Mast taw busman days prior dwnft,not IrWWrng the day of actual riot, .Thar IfNOC <br /> ACTr#M DESCRIPTION Fetn><aMed <br /> PURPOSE ®Irotaliatlon ❑Adjustment ❑Removal ❑Relocation ❑SUE/Other ❑Maintenance of Existing Facility <br /> FACILITY (Type,size,class of transrnittant,design pressure or etc.) Conveyor Bek Installation <br /> DESCRIPTION OF WORK.This work will Install a new material conveyor belt over Highway 85 <br /> NATURE OF INSTALLATION:❑LWtgittudirtal ®Transverse(Crossing) ❑Buried ®Aerlal/Ground4mounted <br /> LOCATION:This work will occur U.S.05,1/2 mile noRh of County Road 6 en both sides of the road.Pillars wiR be entirety an prhwte property. <br /> County:Weld County Clty/Town: <br /> ADDITIONAL REMARKS: CDOT RESERVES THE RH3HT TO REQUIRE THE POVATTEE HIRE AN INDEPENDENT 3RD PARTY INSPECTOR FOR <br /> CONSTRUCTION MAKA69MENT SERVICES WHO WILL REPORT TO THE MMD CDOT INSPECTOR,AT PJERFrtLT WS EXPENSE. <br /> SPECIAL PROVESIONS the ) The er.al ProvWom an terms and condffions of this t. <br /> Any work shali ordy be In*cwrdance with the approved plans and sputa prov(sfons as set forth In this permit and its attadunetAs. <br /> A precorutruction conference must be held by Pennittee.Bath COOT inspectors must be Inv ted to project preconstnrction conference.COOT reserves <br /> the right to delegate Inspection services to others: <br /> "Peterson (97O)302-7L40 kathleen.peterso state.co.us(En;treertng Residency) <br /> Kass Aflmmni (303)757-9079 kassim alkananf state co.us(COOTStaff Bridge) <br /> Work Is to be completed on or before:06/00020 or within 365 days,(as appik able) <br /> Work time resUkdons: 9 AM to 3 PM or 9 PM to 5 AM for lane c1mres. <br /> Designated mWrnum cover is Deslanatad overhead clearance is u fact <br /> (ALSO SEE ATTACHED STANOARD PROYtSXM,AND ADOM AL SPECIAL PROVISIONS), (TRAFFIC CONTROL MUST CONFORM TO THE MUfCD) <br /> Other:INSPECTION SERVICES REQUfRED.SEE ADDITIONAL SPEOtAL PROVOWNS <br /> Permlttee Is prohibked from cowdr acing any work wb.4&highway ROW prior to issuance of a fully andorsad and vaUdmad permit. Permit,plan <br /> sxh bh,Inst ranee aerdtieate(s),and traffic control plan rnust be available on she durtns work. High vidbinty vests are required st a0 times during <br /> working houm <br /> L Yaw requast to use and/a occupy state highway system rkttg of way as dascrffiad Above is grsuad subject to the terms end axw"orts dtfdt paMN inciudktg <br /> to Sbumiard and Spachd Prork3ans as shorn an the permit and all atudments hereto. <br /> L To the mum authorized by law,Mrmittw hereby assumes,rakases anal apses to ktdaa nVy,defend and sane the State of Colored o harmless from and <br /> tag I any Ins and/or damages to the property of the Stet of Colorado,third parties a the Pena s fediltin,and all Ion and/or damage on account of injury <br /> to or death of any parson whomsoever,trig at any time,mused by or irowbg out of the oca:patlan of Coloado State H40nm r e4ft of way by PermitteVs <br /> faditles or any part thereot,In ckaling but not DmNad to Irtstagatlorb adhetrma rdoatku r norm or ope or amoral of axitti g faaIltin.mdess such <br /> ion mWar dsrnap artsas irons the sole ra tige ncx a wiliful candmt of the State of CokmW*a its ernghweas of tptttt <br /> 3. Faffure by tha Pamtttee to comply wttlt any of the btduded terms or oonditlons may ld*j t this permit to suspatsion a unoaRatlan,at the discretion Of the <br /> Departrant of Trani.. a <br /> d. THIS PERMir IS NOT VALID UNTIL FULLY ENDORSO NY ALL PARTIES,WIN DATE OF ISSUE AFFD=BY AN AUTHORIZED REPRESENTATIVE OF THE DEPARThI Wr.A <br /> FULLY MCI= ED COPY OF TiDS►OMIT MUST u ON FILE AT THE TRANWITTATION REGION OFF M <br /> S.in ah:osptfng this permit the utuk"Wwd,nprasattlry the Parmktae,veriAes that he or she has the authority to sign for and bind the twm mtm and dM he a aM <br /> he reed,understands and aaapts all the included condltbM. <br /> �CWT Signature: Me peg ttea Signature Data <br /> COLORADO DEPARTMENT OF TRANSPORTATION Prig Name/Title <br /> ChWf Engineer,Regional Transportation Director or Desl r a <br /> Distribution: PAgIon File(Odgi nil) mm Landecapkv Super <br /> PermlRWApooard Inbpector C:DOT Form 8 0333 01M <br /> Mice Patrol&4m Prwiow versiam are obeolde sad Actual not be used. <br />