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HomeMy WebLinkAboutPOUDRE VALLEY HOSPITAL LEMAY CAMPUS SURGERY ADDDITION - Filed DCP-DEV. CONSTRUCTION PERMIT - 2007-11-28Transpo,-_lion Services Engineering Department City of Fort Collins, Colorado DEVELOPMENT CONSTRUCTION PERMIT Permit Number: 6� 43 Issuance Date. V-9310 Project Name: _Poudre Valley Health System — Lemay Campus Expansion_ Phase I Project Location: 1024 S. Lemay Ave.,SE Comer of Lemay and Doctors U1 Permittee: Troy Martin, Poudre Valley Health System —Lem U Campus 495 7465 City and developer contacts: See attached Exhibit `A' for names and phone numbers of all contact persons for this project Fees: Permit Application Fee ($400.00) $ paid 4/6/07 Construction Inspection Fee (paid prior to issuance of this permit) $ 729.00 Total amount due $ 729.00 Development Bond or other approved security: Amount of security deposited with the City to guarantee the completion of all public i.niprovements to be constructed as shown on the approved plans for the development. .$-- $100,000.00 Form of security deposited with the City:_ Letter of Credit PERFORMANCE REQUIREMENTS OF THIS PERMIT: 1. The Permittee shall be responsible to require their Project Engineer to incorporate into all design drawings and specifications the certification of all materials testing by an Engineer. The Permittee shall have an Engineer prepare revised design drawings and secure City approval for all revisions to the Utility Plans and related documents. The Permittee shall have an Engineer represent, as required by the City in the Development Agreement, that the improvements are constructed in conformance with the approved Utility Plans and the standards and specifications of the City. The Permittee shall provide "as -constructed" plans prepared by an Engineer prior tc the City's acceptance of the constructed public improvements. (All references above to the terms "Project Engineer" and "Engineer" shall mean a Professional Engineer licensed in Colorado.) 2. All contractors who perform work on this project must be bonded and licensed in conformance with City requirements. 281 North College Avenue • P.O. Box 580 • Fort Collins, CO 80522-0580 • (970) 221-6605 • FAX (970) 221-6378 www.fcgov.com Nkj�z F W W S y LU Q wW N O V ZC Q W H z Q Q U W O R' IL c 000000 c00000 0000000000 000co 000000 f» .a w us V9 V9 m �9 V9 Vi V9 V9 vi v9 V9 060'A M00000 v> ss v9 V9 sis G W. o f J J W z Z O w w r LU m V ? LL 1. � F O O O O O O I� f� U n l n 0 0 0 O O O O o 0 0 0 0 0 f f l 0 0 0 0 0 0 0 N 0 0 0 U) O V 0 0 0 V -7 Z Z Z oM fM MM (9 V9 d) V9 O O OOCOG t")O 0'4' W, V9 tl9 V9 f� f� O m M m O� e-C . V9 Vi V9 V9 V9 J 0 w i9 V9 V9 ui V3 v9 K Ow W N wLu x f O z LU LL m Z _LL V C 0 o O o o o O o CDo 0 0 0 0 0 0 0 0 0 o O o O g 00 0 C 0 0 0 0 0 0 0 0 o O o o O o o a Z Ooc000 u9 f9 69 w 69 fn 0 000000000 f» 69 f» f» f» se 69 v9 69 6p ....... V9 fA 69 V9 69 64 U F J Q 4 OVJLLO F W= U r Q". W w Zj w x o00000 o00000 0 00000000 0�00000000 0000000 000000o `r"` T� Z f. 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Complete this form (some questions may not apply to you) and attach all necessary documents and submit to the Development Engineering Section of the City. 2. If you have any questions contact the Development Engineer, , at 221-6605. 3. Submit the Application and pay the Application Fee at the fee at the Engineering counter at 281 N. College Avenue. PROJECT INFORMATION: Project Name (as approved by the City): Poudre Valley Health System— Lemav Campus Expansion— Phase I Project A.K.A. (Marketing name if different from Project Name): Project Location: 1024 S Lemav Ave Fort Collins. CO 80524 Property Owner(At the time of this permit issuance): Individual Name: _ Troy Martin Company Name: pnnr9re da11e�z Health Cystem — T emay Cn i pnq Address: 1024 S Lemav Ave Fort Collins. CO 80524 Phone number(s): Office: 495.7465 Cellphone: Fax number: Email: teml(a,pvhs.ore Applicant/Project Manager (The primary contact person for all matters regarding this project, and the person responsible for all matters referencing "the Developer" in the Development Agreement for this project): Individual Name: Same as General Contractor Company Name: Address: Phone number(s): Office: Cellphone: - Fax number: Email: RECEIPT CITY OF FORT COLLINS NEIGHBORHOOD & BUILDING SERVICES 281 N. COLLEGE AVE. Phone:970-221-6760 Fax:970-224-6134 Application Type: Building / Misc / General / NA Application *: B0702058 Project Name: Address: Owner Name: Receipt No.: 120887 Payment Method Ref Number Amount Paid Payment Date Check Owner Info.: Work Description: 237155 $400.00 04/06/2007 12:18:11 PM �. M.A. MORTENSON�; DBELLFY #237155 PVH LEMAY CAMPUS EXPANSION PHASE I `1 DCP FOR PVH - LEMAY CAMPUS EXPANSION - PHASE I M.A. MORTENSON COMPANY $400 #237155 I6i &-D vers;or. Accela Automation: ShowPayDetai140 - T8108-D Page 1 of 1 RECEIPT CITY OF FORT COLLINS NEIGHBORHOOD & BUILDING SERVICES 281 N. COLLEGE AVE. Phone:970-221-6760 Fax:970-224-6134 Application Type: Building / Misc / General / NA Application #: B0702444 Project Name: POUDRE VALLEY HEALTH SYSTEM Address: Owner Name: Receipt No.: 121351 Payment Method Ref Number Amount Paid Payment Date Cashier ID Comments Check 9914 $729.00 04/20/2007 03:19:22 PM DBELLFY Owner Info.: Work CONSTRUCTION INSPECTION FEE FOR POUDRE VALLEY HEALTH SYSTEM - LEMAY CAMPUS Description: EXPANSION - PHASE I $729 #9914 (PERMIT APPLICATION FEE PAID 4/6/07) T�,10.-_ VeIzjor 4_1, http://dtsweb02. fcgov.conVoperations/permit/index.cfm?FUSEACTION=ShowPayDetail... 04/20/2007 3. Construction time restrictions: N/A 4. The applicant understands that additional permits may be required for this development project and the applicant shall secure those permits directly from the issuing departments. 5. This permit, along with a complete set of all approved plans and documents for this project (utility plans, site plan, landscape plan, development agreement, soils report, pavement design, traffic study, drainage report, plat easements and any other official documents), shall be kept on the development site available for use by City staff doing inspections. 6. Permit Expiration (in accordance with Section 29-12 of the Transitional Land Use Regulations or Section 2.6.3(K) of the Land Use Code, whichever is applicable): a. If construction has not begun within sixty (60) days from the date of issuance of this permit, this permit shall expire and the applicant will forfeit the permit fee paid for this permit, whereupon the applicant must re -apply for a new permit. b. In addition, this permit shall expire one year from the date of issuance. The applicant may apply for an extension by reapplication at least two weeks prior to the expiration date. Such application shall contain information sufficient to justify the granting of the extension. An extension may be granted for up to six months. 7. Building permits and certificates of occupancy will only be issued when all conditions contained in the Development Agreement and Sections 3.3.2(C) and (D) of the Land Use Code or Sections 29-678 and 29-679 of the Transitional Land Use Regulations, whichever is applicable, are met. If the Development Agreement does not specify times for completion of public improvements, or if there is no Development Agreement, then the improvement requirements specified in Section 24-95 of the City Code shall apply, which provides that construction of all improvements shall be required prior to the time of issuance of the first building permit. 8. Acceptance by the City of the public improvements shall be after (1) final inspection has been conducted by the City ; (2) punch list items from the final inspection are completed and accepted by the City; (3) required certifications from the licensed professional engineer that improvements are completed to City standards, specifications and approved Utility Plans; and (4) the `as -constructed' plans have been received and accepted by the City. 9. The warranty on street improvements is for five (5) years from the date of acceptance by the City of the completed improvements, in accordance with Sections 29-13 and 29-14 of the Transitional Land Use Regulations and/or Sections 2.2.3(C)(3)(g), 3.3.1(C)(2), and 3.3.2(C) of the Land Use Code, as applicable. 10. The City Erosion Control Inspector must be notified at least twenty four (24) hours prior to any planned construction on this project. All required perimeter silt fencing and other erosion/sediment control best management practices (BMP's) that can be installed prior to construction must be in place and inspected by the City Erosion Control Inspector before any land disturbing activity begins. 11. No work (including grading) shall be started in State Highway right-of-way until a permit is issued by the Colorado Department of Transportation to allow such work to begin. 12. Other conditions: Permittee's acknowledgment signature: By signing this permit I acknowledges that I am acting with the knowledge, consent, and authority of the owners of the property (including all owners having legal or equitable interest in the real property, as defined in Section 1-2 of the City Code; and including common areas legally connected to or associated with the property which is the subject of this application) without whose consent and authority the requested action could not lawfully be accomplished. Pursuant to said authority, I hereby permit City officials to enter upon the property for purposes of inspection and, if necessary, to enter upon such property to perform work required of the applicant if the applicant were to fail to perform the required work. I also acknowledge that I have read this permit document with all its requirements and conditions, and I agree to all of the terms and conditions so stated in this permit. Applicant/Project Manager's Signature: Dater Approval for issuance: City Engineer ��� 31f � - (Permit Issuance Date) Exhibit `A' page 3 of 5 EXHIBIT `A' DEVELOPMENT PROJECT CONTACT PERSONS Project Name: Poudre Valley Health System — Lemay Campus Project A.K.A.: Name, address and numbers City Staff Contact Persons: Development Engineer: Susan Joy 281 N. College Avenue, Fort Collins, Co 80524 (970)221-6750 x7656 Construction Inspector: Rhonda Henson 281 N. College Avenue, Fort Collins, Co 80524 (970)221-6605 Cell (970) 217-4089 Current Planner: Peter Barnes 281 N. College Avenue, Fort Collins, Co 80524 (970)416-2355 Water Utilities Engineer: Roger Buffington 700 Wood Street, Fort Collins, Co 80521 (970)221-6681 Erosion Control Inspector: 700 Wood Street, Fort Collins, Co 80521 (970)224-6063 Natural Resources: Dana Leavitt 281 N. College Avenue, Fort Collins, Co 80524 (970)221-6143 Traffic Operations: Eric Bracke 625 Ninth Street, Fort Collins, Co 80524 (970)224-6062 Street closures: Syl Mireles 625 Ninth Street, Fort Collins, Co 80524 (970)221-6815 Transportation Planning: David Averill 250 N. Mason St., Fort Collins, Co 80524 (970)416-2643 Exhibit `A' page 4 of 5 Forestry: Tim Buchanan 215 N. Mason St., Fort Collins, Co 80524 (970)221-6361 Light and Power: Doug Martine 700 Wood Street, Fort Collins, Co 80521 (970)221-6700 Developer's Contact Persons: Project Manager/Developer/Owner: Troy Martin, Poudre Valley Health System — Lemay Campus 1024 S. Lemay Ave., Fort Collins, CO 80524 (970)495-7465 temI@pvhs.org Project Engineer: Jim Allen -Morley, Stantec Consulting Inc. 209 South Meldrum Street, Fort Collins, CO 80521 (970)482-5922 Fax (970) 482-6368 iallenmorley@stantec.com Architect/Planner: Marcia Lester, Davis Partnership Architects 2301 Blake St, Suite 100, Denver, CO 80205 (303)861-8555 Cell (303) 810-2913 Fax (303) 861-3027 m l e ster(o-)davi spanner. com General Contractor: Daivid Kuntz, M.A. Mortenson Company 1217 E. Elizabeth Street, Fort Collins, Co 80524 (970) 224-0580 Cell (970) 219-4928 Fax (970) 221-0721 Dave.kuntz@mortenson.com Exhibit `A' page 5 of 5 �:,� � 1IL,BONA3,i.A3tliYldV I I � E e �pbkb R :� � i � R I iB.g���7Yg�'� a�lip!�i�� I• 5 b k� k kl k 1� j5ji iiEyybii b }I —9969—l33tll5 NIMtk 15Y3 \ e rc d e $ I h s • �g I LAIC rm•-R•••~• V --- --- b11ia�A�rNn3uofwd j �� ! I j i ! i' I 1 tl!tl! � Y Ypa 1�0�°ltlQtl�1'��lrl� oil 3 � Y III;; C II,I �R III nmm Fr , PH ! b smonr AVYfJ1 woos a F y �+r✓iw V r���wwi\+Mu/y No Text