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Home My WebLink AboutBLOCK 113 LOTS 6 AND 7 TAP AND HANDLE 307 SOUTH COLLEGE AVENUE - Filed OA-OTHER AGREEMENTS - 2012-01-05COLORADO DEPARTMENT OF TRANSPORTATION CDOT Permit No. 411075 STATE HIGHWAY ACCESS CODE SH/S/MP 287 C / 346.387 / L NOTICE TO PROCEED Local Jurisdiction Fort Collins Permittee(s): Applicant: XYZ Corporation Tap & Handle Donald James Jeff Willis 1750 14th Street, Suite 101 307 South College Avenue Boulder, CO 80302 Fort Collins, CO 80524 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(11)(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) By Title Date (X) This Notice is not valid until signed by a duly authorized representative of the Department Colorado Department of Transportation By (X)%,�' �a I Title -P�M (� I4 Date 11/14/2011 _ coibution: Required: Region (original) Applicant Staff Access Section Make copies as necessary for: Local Authority Inspector Lee e MTCE Patrol Traffic Engineerton 4-Fort Collins Form 1265 8/98, 6199 COLORADO DEPARTMENT OF TRANSPORT STATE HIGHWAY ACCESS PERMIT 01 / 4-Fort Collins 411075 State Highway NoNp/Side 287 C / 346.387 / L I.ocal Jurisdiction Fort Collins The Permitt*s); Applicant: Ref No.: XYZ Corporation Tap & Handle Donald James Jeff Willis 175014th Street, Suite 101 307 South College Avenue Boulder, CO 80302 Fort Collins, CO 80524 303-449-2700 512-796-6345 is hereby granted permission to have an access to the state highway at the location rnoted below. The access shall be constructed, maintained and used in accordance with this permit, inducting the State Highway Access Code and any attachments, terms, conditions and exhibits. This permit may be revoked by the issuing authority if at any tine the permitted access and its use violate any parts of this permit. The issuing authority, the Department and their 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 Location: The access is located on State Highway 287, a distance of 2,043 feet north of Mile Post 346 on the westAeft side. Access to Provide Service to: (Land Use code:) (Size or mot) (Units) Restaurant/Bar 2,590 SQ FT Office (existing) 1,400 SQ FT Additional Information: MUNICIPALITY OR COUNTY APPROVAL Required only when the appropriate local authority retains issuing authority. s Print Name I Title Date Upon the signing of this permit the permittee agrees to the terms and conditions and referenced attachments contained herein. All constnx lion shall be completed in an expeditious and safe manner and shall be finished within 45 days from initiation. The permitted access shall be completed in accordance with the terms and conditions of the permit prior to being used. The permitlee shall notify Lee Ireton with the Colorado Department of TlansoottaWn In Greeley, Colorado at (970) 350-2147, at least 48 hours prior to commencing construction within the State Highway right-d-way. The person signing as the permitiee must be the owner or legal representative of the property served by the permitted access and have full authority to accept the permit and its temis and conditions. Permitbes Sig Print Name �% ��n� 1 oE' � : Jay►-�-�s Data it o//z vii This permit is not valid until signed by a duly authorized representative of the Department. COLORADO DEPARTMENT OF TRANSPORTATION Sign re Prinki , Title Date I ( Copybist button: Required: Make copies as necessary nor Previous w o m a�w mappw� ov uses (\%" 1.Region 3.Staff Access section Local Authority inspector age of 3 CDOT Form IM01 5X7 2.Applicant 4.Central Files MICE Patrol Traffic Engineer State Highway Access Permit Attachment to Permit No. 411075 - 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"- Access Plan "B"- Vicinity Map 4. This permit is issued in accordance with the State Highway Access Code (2 CCR 601-1), 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. The Department retains the right to perform any necessary maintenance work in this area. 6. 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 be considered a violation of the terms and conditions of this access permit and may result in revocation of the permit by the Department and/or the issuing authority. 7. 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 of features within the right-of-way may require the Permittee to install a subsurface drain in accordance with CDOT Standard M-605-1 or other approved system. The Permittee shall contact Gloria Hice-Idler at the Greeley Traffic Office, (970) 350-2148, to obtain the Landscaping Permit. 8. Routine, periodic maintenance and emergency repairs may be performed within the State Highway right- of-way, under the general terms and conditions of the permit. Any significant repairs such as culvert replacement, resurfacing, or changes in design or specifications, will require written authorization from the Department. The Department shall be given proper advance notice whenever maintenance work will affect the movement or safety of traffic on the State Highway. In an emergency, the Department Region Office and the State Patrol shall immediately be notified of possible hazards. 9. The access shall be maintained as per Exhibit "A" 10. The access shall be maintained in a manner that will not cause water to enter onto the roadway, 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. 11. The development of this property shall not negatively impact adjacent nearby properties. Correction of the problem and cost resulting from damages shall be borne by the Permittee. State Highway Access Permit 2 Attachment to Permit No. 411075 - Additional Terms and Conditions 12. It is the responsibility of the Permittee to determine which environmental clearances and/or regulations apply to the project, and to obtain any clearances that are required directly for the appropriate agency prior to commencing work. Please refer to or request a copy of the "CDOT Environmental Clearance Information Summary" (ECIS) for details. The ECIS may be obtained CDOT Permitting Offices or may be accessed via the CDOT Planning/Construction-Environmental Guidance webpage at http://www.dot.state.co.us/environmental/Fonns/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 Colorado Discharge Permit Regulations. 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 the State, the following discharges to storm water systems are allowed without a Colorado Discharge Permit System Permit: landscape irrigation, diverted stream flows, uncontaminated ground water infiltration to separate storm sewers, discharges from potable water sources, foundation drains, air condition condensation, irrigation water, springs, footing drains, waterline flushing, flows from riparian habitats and wetlands, and flow from fire fighting activities. ANY OTHER DISCHARGES, including storm water discharges from industrial facility or construction sites, may require Colorado Discharge Permit System permits from CDPHE before work begins. For additional information and forms, go to the CDPHE website at: http://cdphe.state.co.us/wq/PermitsUnit/wqu. 71 N I C nl%m '1vvN Tf NV%ocoo 1"CRlvll 1 mirri-nom 1 IVIV 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 tyke - If you have any questions contact the issuing authority. - For additional information see CDOT's Access Management website at hitcJ/www dot atrAte.co.us/AccessPermitslindox.htm 11 Donald B. James, XYZ Co poration Street address 1750 14th Street, Suite 100 City, state & zip Phone # Booulder, CO 80302 E-mail address [3) Address of property to be served by permit (required) Applicant or Agern Jeff Willis 307 South Coll ,y, state —& Zip Fort Collins, mail address if available ttee (if different from property & Handle Avenue CO 80524 1512-786-6345 307 South Colle a Avenue, Fort Collins, CO 80524 4) Legal description of property: If within jurisdictional limits of Municipality, city and/or County, which one? county subdivision block lot section township Larimer 5) What State Highway are you requesting access from? 6) What side of the hi hway? US 287 ❑N LJS E 0 W 7) How many feet is the proposed access from the nearest mile post? How many feet is the proposed access from the nearest cross 2000 feet ON S E rJM from: 346.0 1 130 feet 8) What is the approximate date you intend to begin construction? 9/10/11 9) Check here if you are requesting a: El new access Demporary access (duration anticipated: Mchange in access use ❑removal of access 10) Provide existing property use range Olive Street Qimprovement to existing access Relocation of an existing access (provide detail) Travel agency and office building 11) Do you have knowledge of any State Highway access permits serving this property, or adjacent properties in which you have a property interest? Elno []yes, 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? Elno yes, if yes - please describe: 13) Are there other existing or dedicated public streets, roads, highways or access easements bordering or within the property? Ono E] 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? No indicate the types and number of businesses and provide the floor area square foota�ge�oeefoaco� 15) If you are requesting commercial or industrial access please ge business/land use square footage business Restaurant/Bar 2590 Office (existing) 1400 16) If you are requesting residential developement access, what is the type (single family, apartment, townhouse) and number of units? number of units number of units type 17) Provide the following vehicle count estimates for vehicles that will use the access. Leaving the property then returning is two counts. # of passenger cars and light bucks at peak tour volumes # of mum unit tricks at peak hour N Indicate if your counts are 0 :]peak hour volumes or Qaverage daily volumes. 24 6 # of single unit vehicles in excess of 30 it. # of farm vehicles (field equipment) Total count of all vehicles 0 246 0 18) Check with the issuing authority to determine which of the following documents are required to complete the review of your application. a) Property map indicating other access, bordering roads and streets. e) Subdivision, zoning, or development plan. b) Highway and driveway plan profile. f) 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 apply to their activities. Such clearances may include Corps of Engineers 404 Permits or Colorado Discharge Permit System permits, or ecological, archeological, historical or cultural resource clearances. The CDOT Environmental Clearances Information Summary presents contact information for agencies administering certain clearances, information about prohibited discharges, and may be obtained from Regional CDOT Utility/Special Use Permit offices or accessed via the CDOT Planning/Construction-Environmental-Guidance webpage http://www.dot.state.co.us/environmental/Forms.asy. 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 not limited to the applicable sections of 29 CFR Part 1910 - 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 a minimum, all workers in the State Highway right of way, except when in their vehicles, shall wear the following personal protective equipment: High visibility apparel as specified in the Traffic Control provisions of the documentation accompanying the Notice to Proceed related to this permit (at a minimum, ANSI/ISEA 107-1999, class 2); head protection that complies with the ANSI Z89.1-1997 standard; and at all construction sites or whenever there is danger of injury to feet, workers shall comply with OSHA's PPE requirements for foot protection per 29 CFR 1910.136, 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 shall apply. 3- The Permittee is responsible for complying with the Revised Guidelines that have been adopted by the Access Board under the American Disabilities Act (ADA). These guidelines define traversable slope requirements and prescribe the use of a defined pattern of truncated domes as detectable warnings at street crossings. The new Standards Plans and can be found on the Design and Construction Project Support web page at: <httR://www.dot.state-co.us/DesianSupport/>, 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 the permitted access not consistent with the terms and conditions listed on the permit may be considered a violation of the permit. The applicant declares under penalty of perjury In the second degree, and any other applicable state or federal laws, that all Information provided on this form and submitted attachments are to the best of their knowledge true and complete. I understand receipt of an access permit does not constitute permission to start access construction work. Applicant A e for Permittee signature Print name Date «� c,..c f e applicant is not the owner of the property, we require this application also to be signed by the property owner or their legally authorized representative (or other acceptable written evidence). This signature shall constitute agreement with this application by all owners -of -interest unless stated in writing. If a permit is issued, the property owner, in most cases, will be listed as the permittee. owner ' nature X GI Print name Date LJbqa'4 #eJWet 600 i 4") �Z_3 4co Previous editions are obsolete and may not be used Page 2 of 2 CDOT Form #137 01/10 FPROPOSED CLEANOUT Afl-N INSTALL 6" 1% SEND 'T.B. I el 4110 r-S INSTALL a" 45* BEND VATH T.B. 10.304 v 61 M NUM'On F SERV 7.29d LF 6* J.K SERVICE WI :3 z INSTALL 6 W BEND Wm T.B. H IINSTALL 6' 45* BEND WITH T.B. Ell m m < m z c m MAIN INSTALL 6" WET TAP AND G. V. N=11 'E 6* ME SIRKE 307 S. College Avenue, Fort Collins, CO - Google Map GSjAddress 307 S College Ave o.� J e Fort Collins, CO 80624 ■ Andre's jay's Simm 11 Ballroom Danee Page 1 of I Notes PERMIT #411075 VI E Oak St C Fmi C 6) PAIS. 0Ace ■ Partners 3E Mor.1104an Gfill W Olive St E Olive St E DMA PIAZA Cn Perkins 3 QA as tCu NO :,on W Magnolia St to E Magnolia St M287 E Magnolia St 200 Z WeJK Faign au U 61 0 fn = 0 (D Artarm-na Slarhtxk-i 0 t a r, t t, e r,,-. 0h Family to 0 1E Vim n n C. n I c > q0wade0q Sheri sh-11 Staton 7 Eleven 250 Mulberry St VV Mulberry St E Mulberry St Good Timas FynL?ti C.mid Big Rtwritn Fort CaUm Ta+ Chik.adenly 287 80201111 Google - Map data 02011 Google - all, J I� EXHIBIT http://maps.google.com/maps?f=q&source=s_q&hl=en&geocode=&q=307+S.+College+A... 10/5/2011