HomeMy WebLinkAboutPERMIT 621 Big Thompson Ave State Highway Access Removal of Access (2) 2010-04-165’COLORADO DEPARTMENT OF TRANSPORTATION Issuing authorhy applicationSTATEHIGHWAYACCESSPERMITAPPLJCATIONacceptancedate:
Instructions:-Contact the Colorado Department of Transportation (CDOT)or your local government to determine your issuing authority.-Contact the issuing authority to determine what plans and other documents are required to be submitted with your application.-Complete this form (some questions may not apply to you)and attach all necessary documents and Submit it to the issuing authority.Please print -Submit an application for each access affected.or type -If you have any questions contact the issuing authority.
-For additional information see CDOTs Access Management website at http:I/www.dot.state.co.uslAccessPermitsiindex.htm
1)Property owner (Permittee)2)Agent for permittee (if different from property owner)Safeway Stores 46,Inc.,c/o Dan Clayton Kathleen L.Krager,Krager and AssociatesStreetaddressMailingaddress6900SouthYosemiteStreet1390StuartStreet
City,state &zip iie#City,state &zip ‘Phone #(required)Centennial,CO 80112 303 843 7561 Denver,CO 80204—1243 303 446 0269E-mail address
E-mail address if availabledan.clayton@safeway.corn kkrager@kragerandassociates.corn
3)Address of property to be served by permit (required)
621 Big Thompson Avenue,Estes Park,CO
4)Legal description of property:If within jurisdictional limits of Municipality,city and/or County,which one?county subdivision block tot section township range(See attached)
I5)What State Highway are you requesting access from?6)What side of the hi hway?SH 34
N S E w7)How many feet is the proposed access from the nearest mile post?How many feet is the proposed access from the nearest cross street?
feet UN QS OF OW)from.249 feet JN QSQEIW)from:Steamer Drive8)What is the approximate date you intend to begin construction?
5/24 /2 010
9)Check here if you are requesting a:
new access temporary access (duration anticipated:)Eimprovement to existing accessEJchangeinaccessusefjremovalofaccessErelocationofanexistingaccess (provide detail)
10)Provide existing property use
Residential
11)Do you have knowledge of any State Highway access permits serving this property,or adjacent properties in which you have a property interest?IIno eyes,if yes -what are the permit number(s)and provide copies and/or,permit date:
12)Does the property owner own or have any interests in any adjacent property?
EElno yes,if yes -please describe:
Safeway Grocery Store
13)Are there other existing or dedicated public streets,roads,highways or access easements bordering or within the property?i:no yes,if yes -list them on your plans and indicate the proposed and existing access points.
14)If you are requesting agricultural field access -how many acres will the access serve?
15)II you are requesting commercial or industrial access please indicate the types and number of businesses and provide the floor area square footage of each.business/land use square footage business square footage
16)If you are requesting residential developement access,what is the type (single family,apartment,townhouse)and number of units?
_________________
type number of units type
________________
number of Units
17)Provide the following vehicle count estimates for vehicles that will use the access.Leaving the property then returning is two counts.
Indicate if your counts are 1iassengei cars and hgnt trucks at peak hour volumes 5 of muiS und trucks at peak boul volumespeakhourvolurnesoraveragedaUyvolumes
S ot single unit vehicles vi escess of 30ff hot farm vesicles Ikeld equipmentl Total count of all vehicles
0
Previous editions are obsolete and may not be used Page 1 of 2 CDOT Form #137 2I04
18)Check with the issuing authority to determine which of the following documents are required to complete the review of your application.r •
a)Property map indicating other access,bordering roads and streets.e)Subdivision,zoning,or development plan.b)Highway and driveway plan profile.Proposed access design.c)Drainage plan showing impact to the highway right-of-way.g)Parcel and ownership maps including easements.d)Map and letters detailing utility locations before and after h)Traffic studies.development in and along the right-of-way.
i)Proof of ownership.
1-It is the applicant’s responsibility to contact appropriate agencies and obtain all environmental clearances that applytotheiractivities.Such clearances may include Corps of Engineers 404 Permits or Colorado Discharge Permit Systempermits,or ecological,archeological,historical or cultural resource clearances.The CDOT Environmental ClearancesInformationSummarypresentscontactinformationforagenciesadministeringcertainclearances,information aboutprohibiteddischarges,and may be obtained from Regional CDOT Utility/Special Use Permit offices or accessed via theCDOTPlanning/Construction-Environmental-Guidance webpage http:llwww.dot.state.co.uslenvironmentallForms.asp.
2-All workers within the State Highway right of way shall comply with their employer’s safety and health policies/procedures,and all applicable U.S.Occupational Safety and Health Administration (OSHA)regulations -including,but notlimitedtotheapplicablesectionsof29CFRPart1910-Occupational Safety and Health Standards and 29 CFR Part 1926-Safety and Health Regulations for Construction.
Personal protective equipment (e.g.head protection,footwear,high visibility apparel,safety glasses,hearing protection,respirators,gloves,etc.)shall be worn as appropriate for the work being performed,and as specified in regulation.At aminimum,all workers in the State Highway right of way,except when in their vehicles,shall wear the following personalprotectiveequipment:High visibility apparel as specified in the Traffic Control provisions of the documentationaccompanyingtheNoticetoProceedrelatedtothispermit(at a minimum,ANSIIISEA 107-1999,class 2);headprotectionthatcomplieswiththeANSIZ89.1-1997 standard;and at all construction sites or whenever there is danger ofinjurytofeet,workers shall comply with OSHA’s PPE requirements for foot protection per 29 CFR 1910.1 36,1926.95,and 1926.96.If required,such footwear shall meet the requirements of ANSI Z41 -1999.
Where any of the above-referenced ANSI standards have been revised,the most recent version of the standard shallapply.
3-The Permittee is responsible for complying with the Revised Guidelines that have been adopted by the Access BoardundertheAmericanDisabilitiesAct(ADA).These guidelines define traversable slope requirements and prescribe theuseofadefinedpatternoftruncateddomesasdetectablewarningsatstreetcrossings.The new Standards Plans andcanbefoundontheDesignandConstructionProjectSupportwebpageat:<http:/lwww.dot.state.co.us/Desig nSupportl>,then click on Design Bulletins.
If an access permit is issued to you,it will state the terms and conditions for its use.Any changes in the use of thepermittedaccessnotconsistentwiththetermsandconditionslistedonthepermitmaybeconsideredaviolationof thepermit.
The applicant declares under penalty of perjury in the second degree,and any other applicable state or federallaws,that all information provided on this form and submitted attachments are to the best of their knowledgetrueandcomplete.
I understand receipt of an access permit does not constitute permission to start access construction work.
Applicant’s signature ‘Print name DatehieenL.Kraqer 03/20/2010
If the applicant is not the own,p(of Fproperty,we require this application also to be signed by the property owner ortheirlegallyauthorizedrepresentative(or other acceptable written evidence).This signature shall constitute agreementwiththisapplicationbyallowners-of-interest unless stated in writing.If a permit is issued,the property owner,in mostcases,will be listed as the permittee.
Property owner gnature Print name ‘DateJJ-J
__________________________________
Previous editions are obsolete and may not be used Page 2 of 2 CDOT Form #137 12.04
CDOT Permit No.COLORADO DEPARTMENT OF TRANSPORTATION 410037
SH/S/MPSTATEHIGHWAYACCESSCODE34A/62.751 /L
Local JurisdictionNOTICETOPROCEED Estes Park
Permittee(s):Applicant:
Safeway Stores 46,Inc.Krager &Associates,Inc.
Dan Clayton Kathleen L.Krager
6900 Yosemite Street 1390 Stuart Street
Centennial,CO 801 12 Denver,CO 80204-1243
The permittee is hereby authorized to proceed with access construction within state highway right-of-way in
accordance with the above referenced State Highway Access Permit and this Notice to Proceed.
This Notice to Proceed is valid only if the referenced Access Permit has not expired.Access Permits expire
one year from date of issue if not under construction,or completed.Access Permits may be extended in
accordance with Section 2.3(1 l)(d),of the Access Code.
Adequate advance warning is required at all times during access construction,in conformance with the Manual
on Uniform Traffic Control Devices for Streets and Highways.
All construction shall be completed in an expeditious and safe manner and shall be finished within 45 days
from initiation.The permittee or applicant shall notify the Department prior to commencing construction as
indicated on the Access Permit.
Both the Access Permit and this Notice To Proceed shall be available for review at the construction site.
This Notice to Proceed is conditional.The following items shall be addressed prior to or during construction as
appropriate.
Municipality or County Approval (When the appropriate local authority retains issuing authority)
Make copies as necessary for:
Local Authority
MTCE Patrol
7-Estes Park
Inspector Lee Ireton
Traffic Engineer
By Title Date
(X)
This Notice is not valid until signed by a duly authorized representative of the Department
Colorado Department of Transportation
(X)
J
Title Date
6/3/20 10
Copy,distribution:Required:
Region (original)
Applicant
Staff Access Section
Form 1265 8/98,6/99
is hereby granted permission to have an access to the state highway at the location noted below.The access shall be constructed,maintained and used inaccordancewiththispermit,including the State Highway Access Code and any attachments,terms,conditions and exhibits.This permit may be revokedbytheissuingauthorityifatanytimethepermittedaccessanditsuseviolateanypartsofthispermit.The issuing authority,the Department and their dulyappointedagentsandemployeesshallbeheldharmlessagainstanyactionforpersonalinjuryorpropertydamagesustainedbyreasonoftheexerciseofthepermit.
Location:The access to be closed is located on State Highway 34,a distance of 3,965 feet east of Mile Post 62 on the north/left side.
Access to Provide Service to:(Land Use Code:)(Size or Count)(Units)
ACCESS CLOSURE I EACH
Additional Information:
1.The Notice to Proceed will be issued upon receipt of acceptable construction drawings.
2.The construction drawings will be filed with the Notice to Proceed for Permit #4 10036.
3.The Permittee must conduct a preconstruction conference prior to any work within CDOT right-of-way.The CDOT AccessInspectormustbeinattendanceatthismeeting.
4.The Permittee must provide contractor’s certificate(s)of insurance to the CDOT Access Inspector prior to beginning any workwithintheCDOTright-of-way.
MUNICIPALITY OR COUNTY APPROVAL
Required only when the appropriate local authority retains issuing authority.
Signature Print Name Title Date
Upon the signing of this permit the permittee agrees to the terms and conditions and referenced attachments containedherein.All construction shall be completed in an expeditious and safe manner and shall be finished within 45 days fromInitiation.The permitted access shall be completed in accordance with the terms and conditions of the permit prior tobeingused.
The oermittee shall notify Lee Ireton with the Colorado Deaftment of TransDortation inGreeley,Colorado at (970)350-2147,at least 48 hours prior to commencing construction within theStateHighwayright-of-way.
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 toacceptthepermitanditstermsandconditions.
Permittee Signature Print Name Date
This permit is not valid until signed by a duly authorized representative of the Department.
COLORADO DEPARTMENT OF TRANSPORTATIONSigna,Pnnt Name Title Date 7issue)
Required:Make copies as necessary for:Previous editi ns re obsolete an may not be used
1 Region 3,Staff Access Section Local Authority Inspector ge I of 3 COOT Form #101 51072Applicant4.central Files MTCE Patrol Traffic Engineer
COLORADO DEPARTMENT OF TRANSPORTATION CDOT Permit No.410037STATEHIGHWAYACCESSPERMIT
Safeway Stores 46,Inc.
Dan Clayton
6900 Yosemite Street
Centennial,CO 80112
303-843-7561
[jf 01 I 7-Estes Park
The Permittee(s);Applicant:Ref No.:
Local Jurisdiction
Estes Park
Krager &Associates,Inc.
Kathleen L.Krager
1390 Stuart Street
Denver,CO 80204-1243
303-446-0269
CopDi,lributlon:
State Highway Access Permit .1
Attachment to Permit No.410037 -Additional Terms and Conditions
1.If there are any questions regarding this permit,please contact Gloria Hice-Idler at (970)350-2148.
2.The Permittee shall refer to all additional standard requirements included with this permit and any
enclosed additional terms,conditions,exhibits,and noted attachments.
3.Incorporated as part of this permit are the following:
Application for Access Permit (CDOT Form No.137)
Permit (CDOT Form No.101)and its two page attachment
Exhibits:
“A”-Construction Plans (to be filed with the Notice to Proceed for Permit #4 10036
“B”-Vicinity Map
4.This permit is issued in accordance with the State Highway Access Code (2 CCR 60 1-1),and is based
upon the information submitted by the Permittee.This permit is only for the use and purpose stated in the
Application and Permit.Any changes in traffic volumes or type,drainage,or other operation aspects may
render this permit void,requiring a new permit to the be applied for based upon existing and anticipated
future conditions.
5.Access construction methods and materials shall conform to the Colorado Department of Transportation
Standard Specifications for Road and Bridge Construction (current edition).
6.If necessary,minor changes,corrections and/or additions to this permit may be ordered by the
Department inspector,other Department representative or local authority to meet unanticipated site
conditions.Changes may not be in violation of the State Highway Access Code.All major changes to the
plans must be approved in writing by the Department prior to commencement of any work on or within the
State l-Iighway right-of-way.
All workers within the State Highway right of way shall comply with their employer’s safety and health
policies/procedures,and all applicable U.S.Occupational Safety and Health Administration (OSHA)
regulations —including,but not limited to the applicable sections of 29 CFR Part 1910 -Occupational
Safety and I-Iealth Standards and 29 CFR Part 1926 -Safety and Health Regulations for Construction.
At a minimum,all workers in the State Highway right of way,except when in their vehicles,shall wear the
following personal protective equipment:
•Head protection that complies with the ANSI Z89.1-1997 standard;
•At all construction sites or whenever there is danger of injury to feet,protective footwear that
complies with the ANSI Z41-l999 standard will be worn;
•High visibility apparel as specified in the Traffic Control provisions of this permit (at a minimum,
ANSI/ISEA 107-1999,Class 2).
Where any of the above-referenced ANSI standards have been revised,the most recent version of the
standard shall apply.
7.This permit is subject to revocation due to:1)Noncompliance with the provisions of this permit;2)
Abandonment;3)Supersedure by new permit covering the same installation;or 4)Conflict with necessary
planned highway construction and/or improvements.The Permittee shall promptly terminate occupancy
State I-Iighway Access Permit 2AttachmenttoPermitNo.410037-Additional Terms and Conditions
upon notice of cancellation of the permit from the Department,unless a new permit is applied for andgranted.
8.Reconstruction and improvements to the access closure may be required when the Permittee has failed tomeettherequireddesignand/or material specifications.If any construction element fails within two yearsduetoimproperconstructionormaterialspecifications,the Permittee is responsible for all such repairs.
9.The Department retains the right to perform any necessary maintenance work in this area.
10.Backing maneuvers within and into the State Highway right-of-way are strictly prohibited.All vehicles
shall enter and exit the highway right-of-way in forward movement.Backing into the right-of-way shall beconsideredaviolationofthetermsandconditionsofthisaccesspermitandmayresultinrevocationofthepermitbytheDepartmentand/or the issuing authority.
11.All existing accesses to the property shall be removed immediately.Removal shall include,but notlimitedto,the return of the highway right-of-way side slopes,ditches,and fences to match existing adjacentconditions,INCLUDING REMOVAL OF ASPHALT APRONS.Any asphalt removed from the highwayshallresultinasmoothfinishededge.
12.The Permittee is responsible for obtaining any necessary additional federal,state,and/or City/County
permits or clearances required for construction of the access.Approval of this access permit does notconstituteverificationofthisactionbythePermittee.
13.All costs associated with the closure of this access are the responsibility of the Permittee.This includes
design,construction,signing and striping,utility relocation,testing of materials,and inspections.
14.No work will be allowed at night,or on Saturdays,Sundays,and legal holidays without priorauthorizationfromtheDepartment.The Department may also restrict work within the State Highwayright-of-way during adverse weather conditions.
15.Traffic detours or lane closures will not be allowed,unless pre-approved by the Department.
16.Two-way traffic shall be maintained throughout the work area at all times unless specific writtenauthorizationisobtainedfromtheDepartment
17.No construction vehicles shall be parked,or construction materials/equipment stored,on the StateHighwayright-of-way overnight.
18.No work shall be performed near a Department electronic traffic control device without coordination
with Cobie Garbiso at (970)350-2137.
19.Landscaping and site construction shall not obstruct sight distance at any State Highway access point.Landscaping within the State Highway right-of-way requires the Permittee to obtain a CDOT Landscaping
Permit from the Traffic/Access Section.The access permit does not authorize that activity.Irrigation offeatureswithintheright-of-way may require the Permittee to install a subsurface drain in accordance withCDOTStandardM-605-l or other approved system.The Permittee shall contact Gloria I-lice-Idler at theGreeleyTrafficOffice,(970)350-2147,to obtain the Landscaping Permit.
State Highway Access Permit
Attachment to Permit No.410037 -Additional Terms and Conditions
20.Routine,periodic maintenance and emergency repairs may be performed within the State Highwayright-of-way,under the general terms and conditions of the permit.Any significant repairs such as culvertreplacement,resurfacing,or changes in design or specifications,will require written authorization from theDepartment.The Department shall be given proper advance notice whenever maintenance work will affectthemovementorsafetyoftrafficontheStateHighway.In an emergency,the Department Region OfficeandtheStatePatrolshallimmediatelybenotifiedofpossiblehazards.
21.All work is to conform to the plans referenced by this permit on file with the Department or as modifiedbythispermit.(If discrepancies arise,this permit shall take precedence over the plans.)The DepartmentplanreviewisonlyforthegeneralconformancewiththeDepartment’s design and code requirements.TheDepartmentisnotresponsiblefortheaccuracyandadequacyofthedesign,dimensions,elevations,and anyotherelementswhichshallbeconfirmedandcorrelatedattheworksite.The Department through theapprovalofthisdocument,assumes no responsibility for the completeness and/or accuracy of the plans.
22.The State requires a Certificate of Insurance prior to commencing any work on the State Highway right-of-way.Policies shall name the State of Colorado as additional insured party.All vendors,contractors,and utility companies shall procure,at their own expense,and maintain for the duration of the work period,the following minimum insurance coverages:
A.Standard workman’s compensation and employer’s liability,including occupational disease,covering allemployeesengagedinperformanceoftheworkatthesite,in the amount required by State Statutes.B.Comprehensive general liability in the amount of $1,000,000 combined single limit bodily injury andpropertydamage,each occurrence and $2,000,000 annual aggregate.
C.Automobile liability in the amount of $1,000,000 combined single limit bodily injury and propertydamage,for each accident.
Certificates of insurance showing compliance with these provisions shall be attached to and made a part ofthispermitandbeavailableonthesiteduringconstruction.
23.Survey markers or monuments must be preserved in their original positions.Notify the Department at(970)350-2173 immediately upon damage to or discovery of any such markers or monuments at the worksite.Any survey markers or monuments disturbed during the permitted work shall be repaired and/orreplacedimmediatelyattheexpenseofthePermittee.
24.Should any excavation encounter plant or animal fossils,the remains of historic or prehistoricstructures,artifacts,(pottery,stone tools,arrowheads,etc.),the work shall be stopped and the PermitteeshallnotifytheDepartmentinspector.
25.The Permittee or the contractor shall notify Lee Ireton at (970)350-2147 or (970)590-7155 at leasttwoworkingdayspriortobeginninganyaccessimprovementsorconstructionofanykindwithintheStatel-lighway right-of-way.Failure to comply with this requirement may result in revocation of this permit.
26.The Department inspector may suspend any work due to:1)Noncompliance with the provisions of thispermit;2)Adverse weather or traffic conditions;3)Concurrent highway construction or maintenance inconflictwithpermitwork;4)Any condition deemed unsafe for workers or the general public.The workmayberesumeduponnoticefromtheDepartmentinspector.
State I-Tighway Access Permit 4AttachmenttoPermitNo.410037 -Additional Terms and Conditions
27.Construction traffic devices,when not in use,shall be removed or turned away from traffic.
28.No paved surface shall be cut unless specified in this permit.Asphalt removal shall be saw cut toassureastraightedgeforpatching.
29.The removed access shall be constructed and maintained in a manner that will not cause water to enterontotheroadway,and will not interfere with the existing drainage system within the State Highway right-of-way.Drainage to the State Highway right-of-way shall not exceed historical rate of flow.
30.All existing drainage structures shall be extended,modified,or upgraded as necessary,to accommodate
all new construction and safety standards,in accordance to the Department’s standard specifications.
31.The Permittee shall request final inspection by Lee Ireton at (970)350-2147,within 10 days followingcompletionofaccessconstruction,and prior to authorized use.The Permittee or their representative shallbepresent.
32.A ftilly executed complete copy of this permit must be on the job site with the contractor at all timesduringconstruction.Failure to comply with this or any other construction requirement may result in theimmediatesuspensionofworkbyorderoftheDepartmentinspectorortheissuingauthority.
33.The design and closure of the access andlor development of this property shall not negatively impactadjacentnearbyproperties.Correction of the problem and cost resulting from damages shall be borne bythePermittee.
34.It is the responsibility of the Permittee to determine which environmental clearances andlor regulations
apply to the project,and to obtain any clearances that are required directly for the appropriate agency priortocommencingwork.Please refer to or request a copy of the “CDOT Environmental ClearanceInformationSummary”(ECIS)for details.The ECIS may be obtained CDOT Permitting Offices or may beaccessedviatheCDOTPlanning/Construction-Environmental Guidance webpage at
http://www.dot.state.co.us/environmental/Forms/asp.FAILURE TO COMPLY WITH REGULATORY
REQUIREMENTS MAY RESULT IN SUSPENSION OR REVOCATION OF YOUR CDOT PERMIT,OR ENFORCEMENT ACTIONS BY OTHER AGENCIES.
ALL discharges are subject to the provisions of the Colorado Water Quality Act and the ColoradoDischargePermitRegulations.Prohibited discharges include substance such as:wash water,paint,automotive fluids,solvents,oils or soaps.
Unless otherwise identified by CDOT or the Colorado Department of Public Health and Environmental
(CDPHE)Water Quality Control Division (WQCD)as significant sources of pollutants to the waters of theState,the following discharges to storm water systems are allowed without a Colorado Discharge PermitSystemPermit:landscape irrigation,diverted stream flows,uncontaminated ground water infiltration toseparatestormsewers,discharges from potable water sources,foundation drains,air conditioncondensation,irrigation water,springs,footing drains,waterline flushing,flows from riparian habitats andwetlands,and flow from fire fighting activities.
State Highway Access Permit
Attachment to Permit No.410037 -Additional Terms and Conditions
ANY OTT-IER DISCHARGES,including storm water discharges from industrial facility or constructionsites,may require Colorado Discharge Permit System permits from CDPHE before work begins.Foradditionalinformationandforms,go to the CDPHE website at:
http :/Jcdphe.state.co .us/wq/PermitsUnit/wqu.
U
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Not to Scale
Krager and Associates II °034
Safeway Fueling Store #920 1-h O 35 Figure 1
Estes Park,Colorado oo3
905flg-sLOC