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
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DEVELOPMENT CONSTRUCTION PERMITw�
APPLICATION
(1/16/06)
For City use only: Application Number: Application Date:
Permit application fee: S 400.00
INSTRUCTIONS:
1. 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
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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
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