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HARRISONS ADDITION BLOCK 116 633-639 SOUTH COLLEGE AVENUE - Filed OA-OTHER AGREEMENTS - 2015-09-09
COLORADO DEPARTMENT OF TRANSPORTATION CDOT Permit No. 415015 STATE HIGHWAY ACCESS CODE SH/S/MP 287 C / 346.043 / L NOTICE TO PROCEED Local Jurisdiction Fort Collins Permittee(s): Applicant: Bohemian Companies Russell + Mills Studios Mary Taylor 262 E. Mountain Avenue 141 S. College Avenue, Suite 104 Fort Collins, CO 80524 Fort Collins, CO 80521 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 tX j, �C'x,_ Title 1��l�i I t Date 3/16/2015) .,� G0py 1 disiilution: Required: Region (original) Applicant -! Staff Access Section Make copies as necessary for: Local Authority Inspector Bruce Barnett MTCE Patrol Traffic Engineer 4-Fort Collins Form 1266 8/98, 6/99 State Highway Access Permit Attachment to Pennit No. 415015 - 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. 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 Highway right-of- way. All workers within the State Highway right-of-way shall comply with their employer's safety and health policies/procedures, and 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. 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 a danger of injury to feet, protective footwear that complies with the ANSI Z41-1999 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 upon notice of cancellation of the permit from the Department, unless a new permit is applied for and granted. State Hiahway Access Permit 2 Attachment to Permit No. 415015 - Additional Terns and Conditions 8. Reconstruction and improvements to the access may be required when the Permittee has failed to meet the required design and/or material specifications. If any construction element fails within two years due to improper construction or material specifications, 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 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. 11. The Permittee is responsible for obtaining any necessary additional federal, state, andlor City/County permits or clearances required for construction of the access. Approval of this access permit does not constitute verification of this action by the Permittee. 12. 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. 13. 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. 14. The access shall be maintained as per Exhibit "A". 15. 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. 16. The maintenance of the access and/or 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. 17. 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 State Highway Access Permit 3 Attachment to Permit No. 415015 - Additional Terns and Conditions 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 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 Pen -nit: 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. COLORADO DEPARTMENT OF TRANSPORTATION Issuing authority application STATE HIGHWAY ACCESS PERMIT APPLICATION acceptance date: 12-3 J 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 CDOT's Access Management website at http:ltwww.dot.state.co.us/AccessPermitsrindex.htm 1)Property owner (Permittee) 2) Applicant or Agent for permitter (if different from property owner) Bohemian Companies Mary Taylor, Russell+Mills Studios Street address Mailing address 262 E Mountain Ave 141 S College Ave, Suite 104 City, state & zip Phone # City, state & zip Phone Of (required) Fort Collins, CO 80524 970-221-2636 Fort Collins, CO 80521 970-484-8855 E-mail address E-mail address if available rileygbohemianfoundation.org mtaylor@russellmillsstudios.com 3) Address of property to be served by permit (required) 633.5 & 639 S College Ave, Fort Collins, CO 80525 4) Legal description of property: If within jurisdictional limits of Municipality, city and/or County, which one? county subdivision block lot section township range Larimer 1 1 116 1 2,3,4 1 14 1 7 North 69 West 5) What State Highway are you requesting access from? 6) What side of the highway? E W College Ave ON S 7) How marry feet is the proposed access from the nearest mile post? How many feet is the proposed access from the nearest cross street? feet N S E from: feet (N S E UT from: 8) What is the approximate date you intend to begin construction? 9 Check here if you are requesting a: new access (temporary access (duration anticipated: ) ./ improvement to existing access change In use of access of an existing access (provide detail) access ❑removal 0docation 10) Provide existing property use Community Commercial 11) Do you have knowledge of any State Highway access permits serving this property, or adjacent properties in which you have a property interest? Mno [3yes, 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? ©no [3yes, if yes - please describe: 13) Are there other existing or dedicated public streets, roads, highways or access easements bordering or within the property? Q 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 actress serve? 15) It you are requesting commercial or industrial access please indicate the types and number of businesses and provide the floor area square footage of each. businessAand use square footage business square footage Multi —Purpose Music Facility 6,048 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. if your counts are M of passenger cars and light trucks at peak hour volumes a cc mum unit trucks at peak hour volumes oak hour volumes or (average daily volumes. FIndicale cingte unit veMdes Ine><ness of 30 ft. tr of farm vehicles (held equipment) Total Count of all vehicles 0 Previous editions are obsolete and may not be used Page 1 of 2 C00T Form 11137 01110 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 httls://www.dot.state.co.us/environmental/Forms.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 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, ANSVISEA 107-1999, class 2); head protection that complies with the ANSI Z89.1-1997 standard; and at all construction riles 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: -chttp://www.dot.state.co.us/DesignSuRRgrtl>, 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 appplicant 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 or Agent for Permittee signature Print name Date �:�wn*�7bt0.ua Mary Taylor �"�"T mwnnglawmtM uweal.co.+. au9 Mary Taylor 02/05/2015 0,117XI MDS1037l10r00 If the 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 If is issued, the owner, in most with this application by all owners -of -interest unless stated in writing. a permit property cases, will be listed as the permittee. Prop it wriersignature ;fintname PAo— Date :�/ , -0 1 rLd Previous editions are obsolete and may not be used Page 2 of 2 CDOT Form N131 01110 . } M MO9 O3 *SN111031aOJ ' 3AV 3O311O0 'S SEP 19'CC9 iouLsia oisnw ,s § §� a� e H�� N : Pfill, oil i4il %ip4I: t. IT EXHIBIT X-' 'Rr+�.m�a';uRvec3kM �e+�eRrh�.'ro4'Ic .a +Kt. .r rro:� 71 �. ®�d gown-rw-est x f - -, C�.Idk1 U rt i ve rsi ty rth-tY�-t�f. r. �, . •� - � ° . � � _ � ... , � � - asap. � � � � t -�. f I t < 1 Y 3 4 t` CJ f tiE"� Dec' S �m ► p F E l r^ .O W"M a') t`l`D :i s S Q i r E P I�tY1�St ? a, t COLORADO DEPARTMENT OF TRANSPORTATION STATE HIGHWAY ACCESS PERMIT lee 100.00 4 / 01 / 4-Fort Collins 415015 State Highway NorMp/Side 287 C ( 346.043 / L Local Jurisdiction 'ort Collins The Permittee(s); Boheinian Contl)atties applicant: Ref No.: Russell + Mills Studios 262 E. Mountain Avenue Mary Taylor 141 S. College Avenue, Suite 104 Fort Collins, CO 80524 Fort Collins, CO 80521 970-221-2636 970-484-8855 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 in accordance with this permit, including the State Highway Access Code and any attachments, terms, conditions and exhibits. This permit may be revoked by the issuing authority if at any time the permitted access and its use violate any parts of this permit. The issuing authority, the Department an tl 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 227 feet north of Mile Post 346 on the west/left side. Access to Provide tu. (Land Use Codc ) Multi -purpose Music Facility %S corCo 0 (L(Units) 6,048 SQ FT The Permittee will be allowed to "close" the access at their discretion by placing bollards adjacent to the west side of the sidewalk and then again at the property line. MUNICIPALITY OR COUNTY APPROVAL Required only when the appropriate local authority retains Issuing authority. or —-- Upon the signing of this permit the permittee agrees to the terms and conditions and referenced attachments contained herein. All construction 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 aemittee shall notify Bruce Barnett with the Colorado Department of Transportation in Greeley, Colorado at (970) 381-1742, at least 48 hours prior to commencing construction within the State Highway right -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 to accept the permit and its terms and conditions. Pei This permit is not valid until signed by a duly authorized representative of the Department. COLORADO DEPARTMENT OF TRANSPORTATION Sig a4rre ( P t Name I Title ; } Date (of issu ) et I .~ 1 L'. l Cody Ois butlon: Required t Region 3 SiaMAaess Sect on Mahecep.es as necessary for Previous editions Obsolete obsolete rid ma not be used Local Auftnty Inspecrcr 2 App�icsnl 4 Certrai Files MTCE Patrol Tratric Engineer fag t of COOT Form M101 5ro7 State Highway Access Permit Form 101, Page 2 The following paragraphs are excerpts of the State Highway Access Code. These are provided for your convenience but do not alleviate compliance with all sections of the Access Code. A copy of the State Highway Access Code is available from your local issuing authority (local government) or the Colorado Department of Transportation (Department). When this permit was issued, the issuing authority made its decision based in part on information submitted by the applicant, on the access category which is assigned to the highway, what alternative access to other public roads and streets is available, and safety and design standards. Changes in use or design not approved by the permit or the issuing authority may cause the revocation or suspension of the permit. APPEALS 1. Should the permittee or applicant object to the denial of a permit application by the Department or object to any of the terms or conditions of a permit placed there by the Department, the applicant and permittee (appellant) have a right to appeal the decision to the [Transportation] Commission [of Colorado]. To appeal a decision, submit a request for administrative hearing to the Transportation Commission of Colorado within 60 days of transmittal of notice of denial or transmittal of the permit for signature. Submit the request to the Transportation Commission of Colorado, 4201 East Arkansas Avenue, Denver, Colorado 80222-3400. The request shall include reasons for the appeal and may include changes, revisions, or conditions that would be acceptable to the permittee or applicant. 2. Any appeal by the applicant or permittee of action by a local issuing authority shall be filed with the local authority and be consistent with the appeal procedures of the local authority. 3. In submitting the request for administrative hearing, the appellant has the option of including within the appeal a request for a review by the Department's internal administrative review committee pursuant to [Code] subsection 2.10. When such committee review is requested, processing of the appeal for formal administrative hearing, 2.9(5) and (6), shall be suspended until the appellant notifies the Commission to proceed with the administrative hearing, or the appellant submits a request to the Commission or the administrative law judge to withdraw the appeal. The two administrative processes, the internal administrative review committee, and the administrative hearing, may not run concurrently. 4. Regardless of any communications, meetings, administrative reviews or negotiations with the Department or the internal administrative review Committee regarding revisions or objections to the permit or a denial, if the permittee or applicant wishes to appeal the Department's decision to the Commission for a hearing, the appeal must be brought to the Commission within 60 days of transmittal of notice of denial or transmittal of the permit. PERMIT EXPIRATION 1. A permit shall be considered expired if the access is not under construction within one year of the permit issue date or before the expiration of any authorized extension. When the permittee is unable to commence construction within one year after the permit issue date, the permittee may request a one year extension from the issuing authority. No more than two one-year extensions may be granted under any circumstances. If the access is not under construction within three years from date of issue the permit will be considered expired. Any request for an extension must be in writing and submitted to the issuing authority before the permit expires. The request should state the reasons why the extension is necessary, when construction is anticipated, and include a copy of page 1 (face of permit) of the access permit. Extension approvals shall be in writing. The local issuing authority shall obtain the concurrence of the Department prior to the approval of an extension, and shall notify the Department of all denied extensions within ten days. Any person wishing to reestablish an access permit that has expired may begin again with the application procedures. An approved Notice to Proceed, automatically renews the access permit for the period of the Notice to Proceed. CONSTRUCTION 1. Construction may not begin until a Notice to Proceed is approved. (Code subsection 2.41 2. The construction of the access and its appurtenances as required by the terms and conditions of the permit shall be completed at the expense of the permittee except as provided in subsection 2.14. All materials used in the construction of the access within the highway right-of-way or on permanent easements, become public property. Any materials removed from the highway right-of-way will be disposed of only as directed by the Department. All fencing, guard rail, traffic control devices and other equipment and materials removed in the course of access construction shall be given to the Department unless otherwise instructed by the permit or the Department inspector. 3. The permittee shall notify the individual or the office specified on the permit or Notice to Proceed at least two working days prior to any construction within state highway right-of-way. Construction of the access shall not proceed until both the access permit and the Notice to Proceed are issued. The access shall be completed in an expeditious and safe manner and shall be finished within 45 days from initiation of construction within the highway right-of-way. A construction time extension not to exceed 30 working days may be requested from the individual or office specified on the permit. 4. The issuing authority and the Department may inspect the access during construction and upon completion of the access to ensure that all terms and conditions of the permit are met. inspectors are authorized to enforce the conditions of the permit during construction and to halt any activities within state right-of-way that do not comply with the provisions of the permit, that conflict with concurrent highway construction or maintenance work, that endanger highway property, natural or cultural resources protected by law, or the health and safety of workers or the public. 5. Prior to using the access, the permittee is required to complete the construction according to the terms and conditions of the permit. Failure by the permittee to abide by all permit terms and conditions shall be sufficient cause for the Department or issuing authority to initiate action to suspend or revoke the permit and close the access. If in the determination of the Department or issuing authority the failure to comply with or complete the construction requirements of the permit create a highway safety hazard, such shall be sufficient cause for the summary suspension of the permit. If the permittee wishes to use the access prior to completion, arrangements must be approved by the issuing authority and Department and included in the permit. The Department or issuing authority may order a halt to any unauthorized use of the access pursuant to statutory and regulatory powers. Reconstruction or improvement of the access may be required when the permittee has failed to meet required specifications of design or materials. If any construction element fails within two years due to improper construction or material specifications, the permittee shall be responsible for all repairs. Failure to make such repairs may result in suspension of the permit and closure of the access. 6. The permittee shall provide construction traffic control devices at all times during access construction, in conformance with the M.U.T.C.D. as required by section 42- 4-104, C.R.S., as amended. 7. A utility permit shall be obtained for any utility work within highway right-of-way. Where necessary to remove, relocate, or repair a traffic control device or public or private utilities for the construction of a permitted access, the relocation, removal or repair shall be accomplished by the permittee without cost to the Department or issuing authority, and at the direction of the Department or utility company. Any damage to the state highway or other public right-of-way beyond that which is allowed in the permit shall be repaired immediately. The permittee is responsible for the repair of any utility damaged in the course of access construction, reconstruction or repair. 8. In the event it becomes necessary to remove any right- of-way fence, the posts on either side of the access shall be securely braced with an approved end post before the fence is cut to prevent any slacking of the remaining fence. All posts and wire removed are Department property and shall be turned over to a representative of the Department. 9. The permittee shall ensure that a copy of the permit is available for review at the construction site at all times. The permit may require the contractor to notify the individual or office specified on the permit at any specified phases in construction to allow the field inspector to inspect various aspects of construction such as concrete forms, subbase, base course compaction, and materials specifications. Minor changes and additions may be ordered by the Department or local authority field inspector to meet unanticipated site conditions. 10. Each access shall be constructed in a manner that shall not cause water to enter onto the roadway or shoulder, and shall not interfere with the existing drainage system on the right-of-way or any adopted municipal system and drainage plan. 11. By accepting the permit, permittee agrees to save, indemnify, and hold harmless to the extent allowed by law, the issuing authority, the Department, its officers, and employees from suits, actions, claims of any type or character brought because of injuries or damage sustained by any person resulting from the permittee's use of the access permit during the construction of the access. CHANGES IN ACCESS USE AND PERMIT VIOLATIONS 1. It is the responsibility of the property owner and permittee to ensure that the use of the access to the property is not in violation of the Code, permit terms and conditions or the Act. The terms and conditions of any permit are binding upon all assigns, successors -in -interest, heirs and occupants. If any significant changes are made or will be made in the use of the property which will affect access operation, traffic volume and or vehicle type, the permittee or property owner shall contact the local issuing authority or the Department to determine if a new access permit and modifications to the access are required. 2. When an access is constructed or used in violation of the Code, section 43-2-147(5)(c), C.R.S., of the Act applies. The Department or issuing authority may summarily suspend an access permit and immediately order closure of the access when its continued use presents an immediate threat to public health, welfare or safety. Summary suspension shall comply with article 4 of title 24, C.R.S. MAINTENANCE 1. The permittee, his or her heirs, successors -in -interest, assigns, and occupants of the property serviced by the access shall be responsible for meeting the terms and conditions of the permit, the repair and maintenance of the access beyond the edge of the roadway including any cattle guard and gate, and the removal or clearance of snow or ice upon the access even though deposited on the access in the course of Department snow removal operations. Within unincorporated areas the Department will keep access culverts clean as part of maintenance of the highway drainage system. However, the permittee is responsible for the repair and replacement of any access -related culverts within the right-of-way. Within incorporated areas, drainage responsibilities for municipalities are determined by statute and local ordinance. The Department will maintain the roadway including auxiliary lanes and shoulders, except in those cases where the access installation has failed due tc improper access construction and/or failure to follow permit requirements and specifications in which case the permittee shall be responsible for such repair. Any significant repairs such as culvert replacement, resurfacing, or changes in design or specifications, requires authorization from the Department. Form 101, Page 3 COLORADO DEPARTMENT OF TRANSPORTATION Environmental Clearances Information Summary PURPOSE - This summary is intended to inform entities external to CDOT that may be entering the state highway right-of-way to perform work related to their own facilities (such as Utility, Special Use or Access Permittees), about some of the more commonly encountered environmental permits/clearances that may apply to their activities. This listing is not all-inclusive - additional environmental or cultural resource permits/clearances may be required in certain instances. Appropriate local, state and federal agencies should be contacted for additional information if there is any uncertainty about what permits/clearances are required for a specific activity. IMPORTANT — Please Review The Following Information Carefully — Failure to Comply With Regulatory Requirements May Result In Suspension or Revocation of Your CDOT Permit Or Enforcement Actions By Other Agencies CLEARANCE CONTACTS - As indicated in the permit/clearance descriptions listed below, the following individuals or agencies may be contacted for additional information: • Colorado Department of Public Health and Environment (CDPHE): General Information — (303) 692-2035 Water Quality Control Division (WQCD): (303) 692-3500 Environmental Permitting Website hops://www.colorado.aov/pacificLd-ahe/all-permits CDOT Water Quality Program Manager. (303) 757-9343 htto://www.coloradodot.info/pro rams/environmental/water-quality • CDOT Asbestos Project Manager. Theresa Santangelo-Dreiling, (303) 512-6524 • Colorado Office of Archaeology and Historic Preservation: (303) 666-3395 • U.S. Army Corps of Engineers, District Regulatory Offices: Omaha District (NE CO), Denver Office (303) 979-4120 http:/Iwww.nm.usace.army.m€VM€ssions/Reaulatorerogram/Colorado asgx Sacramento Dist. (Western CO), Grand Junction Office (970) 243-1199 http://www.sok.usace.armv.m€VMissions/Regulat2ry aspx Albuquerque District (SE CO), Pueblo Office (719) 543-9459 http://www.spa.usace.armv mil/Missions/ReyuletorvProaramandPermits aspx • CDOT Utilities Special Use and Access Permitting: 303 757-9654 http://www.coloradodot.info/business/t)ermits Egoloalcai Resources - Disturbance of wildlife shall be avoided to the maximum extent practicable. Entry Into areas of known or suspected threatened or endangered species habitat will require special authorization from the CDOT permitting office. If any threatened or endangered species are encountered during the progress of the permitted work, work in the subject area shall be halted and the CDOT Regional Permitting Office and Region Planning and Environmental Manager shall be contacted immediately. Authorization must be provided by CDOT prior to the continuation of work. information about threatened or endangered species may be obtained from the CDOT website, httpl/www coloradodot info/proaramslenvironmental/w€idlifetau€delines, or the Colorado Parks and Wildlife (CPW) website, http:/Iwww.cpw.state.co.us4eam/PaciWSOC-ThreatenedEndangeredL€st aspx. Additional guidance may be provided by the appropriate Region Plannin and Environmental Manager RPEM . Cultural Resources - The applicant must request a file search of the permit area through the Colorado Office of Archaeology and Historic Preservation (OAHP), Denver, to ascertain If historic or archaeological resources have previously been identified. Inventory of the permit area by a qualified cultural resources specialist may be necessary, per the recommendation of CDOT. If archaeological sitaWartifects or historic resources are known to exist prior to the initiation of the permitted work or are encountered as the project progresses, all work in the subject area shall be halted and the CDOT Regional Permitting Office and Region Planning and Environmental Manager shall be contacted immediately. Authorization must be provided by CDOT prior to the continuation of work. Additional guidance may be provided by the Regional Permitting Office and RPEM. Contact Information: Contact the OAHP for file searches at 303 866.3395. Paleontoloaical Resources - The applicant must request a fossil locality file search through the University of Colorado Museum, Boulder, and the Denver Museum of Nature and Science to ascertain if paleontological resources have been previously identified. Inventory of the permit area by a qualified paleontologist may be necessary, per the recommendation of CDOT. If fossils are encountered during the permitted work, all work in the subject area shall be halted and the CDOT Regional Permitting Office and Region Planning and Environmental Manager shall be contacted immediately. Authorization must be provided by CDOT prior to the continuation of work. Additional guidance may be provided by the Regional Permitting Office in the Permit Special Provisions. Contact information: Contact the CDOT Paleontologist at 303 757-9632. Hazardous Materials, Solid Waste - The Solid Wastes Disposal Sites and Facilities Act C.R.S. 30-20-100, at al, and Regulations Pertaining to Solid Waste Disposal Sites and Facilities (6 CCR 1007-2), prohibit solid waste disposal without an approved Certificate of Designation (a landfill permit). The Colorado Hazardous Waste Act C.R.S. 25-15-301 at al, and the Colorado Hazardous Waste Regulations (6 CCR 1007-3) prohibit the transfer, storage or disposal (TSD) of hazardous waste except at permitted TSD sites. There are no permitted landfills or TSD sites within the State Highway Right of Way. Therefore, all solid or hazardous wastes that might be generated by the activities of entities entering the State Highway Right of Way must be removed from the ROW and disposed of at a permitted facility or designated collection point (e.g., for solid waste, a utility or construction company's own dumpster). If pre-existing solid waste or hazardous materials contamination (including oil or petroleum contaminated soil, asbestos, chemicals, mine tailings, etc.) is encountered during the performance of work, the permittee shall halt work in the affected area and immediately contact the CDOT Regional Permitting Office for direction as to how to proceed. Contact Info: Andy Flurkey, CDOT Hazardous Materials Project Manager, 303 512-5520. Asbestos Contalnina Materials. Asbestos Contaminated Soil - All work on asbestos containing materials (ACM) must comply with the applicable requirements of the CDPHE Air Pollution Control Division's (APCD) Regulation 8. Disposal of ACM, and work done in asbestos -contaminated soil, must comply with the CDPHE Hazardous Materials and Waste Management Division's (HMWMD) Solid Waste Regulations. The application for any CDOT permit must specifically identify any ACM involved in the work for which authorization is being requested. Additional guidance or requirements may be specified in the permit special provisions. Contact info: CDPHE APCD and HMWMD Regulations can be accessed via the CDPHE Environmental Permitting Website listed above. Environmental Clearances Information Summary Pagel of 3 Colorado Department of Transportation December'14 Additional information concerning clearance on CDOT Projects is available from the CDOT Asbestos Project Manager (303) 512- 5519, or Theresa Santan elo-Dreilin , Property Management Supervisor 303 512-5524. Transportation of Hazardous Materials - No person may offer or accept a hazardous material for transportation in commerce unless that person is registered in conformance with the United States Department of Transportation regulations at 49 CFR, Part 171. The hazardous material must be properly classed, described, packaged, marked, labeled, and in condition for shipment as required or authorized by applicable requirements, or an exemption, approval or registration has been issued. Vehicles requiring a placard, must obtain authorization and a State HAZMAT Permit from the Colorado Public Utilities Commission. Contact Information: For authorization and more info call the Federal Motor Safety Carrier Administration, US DOT for inter- and intra-state HAZMAT Registration 303 969-6748. Colorado Public Utilities Commission: 303 894-2868. Discharge of Dredged or Fill Material 404 Permits Administered By the U.S. Army Corps of Enaineers and Section 401 Water Quality Certifications Issued by the CDPHE WQCD - Corps of Engineers 404 permits are required for the discharge of dredged or fill materials into waters of the United States, Including wetlands. There are various types of 404 permits, including nationwide permits, which are issued for activities with relatively minor impacts. For example, there is a nationwide permit for utility line activities (nwp #12). Depending upon the specific circumstances, it is possible that either a "general" or "individual" 404 permit would be required. If an individual 404 permit Is required, section 401 water quality certification from the CDPHE WQCD is also required. Contact the appropriate Corps District Regulatory Office for Information about what type of 404 permit may be required contact information above). Contact the CDPHE Water Quality Control Division at 303 692-3600. Workina on or in any stream or Its bank - In order to protect and preserve the state's fish and wildlife resources from actions that may obstruct, diminish, destroy, change, modify, or vary a natural existing stream or its banks or tributaries, it may be necessary to obtain a Senate Bill 40 certification from the Colorado Department of Natural Resources. A stream is defined as 1) represented by a solid blue line on USGS 7.5' quadrangle maps; and/or 2) intermittent streams providing live water beneficial to fish and wildlife; and/or 3) segments of streams supporting 25% or more cover within 100 yards upstream or downstream of the project; and/or 4) segments of streams having wetlands present within 200 yards upstream or downstream of the project measured by valley length. The CPW application, as per guidelines agreed upon by CDOT and CPW, can be accessed at h :I/ .00loradodot.info/ ro r mstenvironmental wildlife/ uidelines. Stormwater Construction Permit (SCP) and Stormwater Discharae From Industrial Facilities - Discharges of Stormwater runoff from construction sites disturbing one acre or more - or certain types of industrial facilities, such as concrete batch plants - requires a CDPS Stormwater Construction Permit. Contact Information: Contact the CDPHE Water Quality Control Division at (303) 692-3500. Website: h s:/Avww lorado. ov/ acifcicd hetw -co struction- eneral- its. Construction Dewaterina (Discharae or Infiltration) - Discharges of water encountered during excavation or work in wet areas may require a Construction Dewatering Discharge Permit. Contact information: For Construction Dewatering Discharge Permits, contact the CDPHE WQCD at (303) 692-3500. For Dewatering Application and instructions, see Section 3 at the CDPHE website: httS://www.colorado. ovJ acific/cd he/w-constru lion- neral ermits. Municipal Separate Storm Sewer System (1101154) Discharae Permit - Discharges from the storm sewer systems of larger municipalities, and from the CDOT highway drainage system that lies within those municipalities, are subject to MS4 Permits issued by the CDPHE WQCD. For facilities that lie within the boundaries of a municipality that Is subject to an MS4 permit, the owner of such facility should contact the municipality regarding stormwater related clearances that may have been established under that municipality's MS4 permit. All discharges to the CDOT highway drainage system or within the Right of Way (ROW) must comply with the applicable provisions of the Colorado Water Quality Control Act and the Colorado Discharge Permit Regulations Permit # COS- 000005 (http://www.coloradodot.info/programs/environmentaUwater-quality/documents/ms4 program area maps) and COR-030000 (hops://www.colorado aov/pacific/cdphe/wa-municipal-ms4-permits). Discharges are subject to inspection by CDOT and CDHPE. Contact the CDPHE Water Quality Control Division at (303) 692.3500 for a listing of municipalities required to obtain MS4 Permits, or o to :/ .colorado. ov/ aciifcJcd hefw-munici al-ms4- ermits. General Prohibition — Discharges - All discharges are subject to the provisions of the Colorado Water Quality Control Act and the Colorado Discharge Permit Regulations. Prohibited discharges include, but are not limited to, substances such as wash water, paint, automotive fluids, solvents, oils or soaps and sediment. Allowable non-stormwater discharges can be found at htLo://www.coloradodot info/programs/environmentaltwater-quality/glossaryhtml. Contact information: Contact the Colorado Department of Public Health and Environment, Water Quality Control Division at 303 692-3500. General Authorization Allowable Non-Stormwater Discharges -Unless otherwise Identified by CDOT or the WQCD as significant sources of pollutants to the waters of the State, the following discharges to stormwater 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 conditioning condensation, irrigation water, uncontaminated springs, footing drains; water line flushing, flows from riparian habitats and wetlands, and flow from firefighting activities. Contact information: The CDPHE Water Quality Control Division (telephone #'s listed above). Erosion Snd Sediment Control Practices - For activities requiring a Stormwater Construction Permit, erosion control requirements will be specified through that permit. In those situations where a stormwater permit is not required, all reasonable measures should be taken in order to minimize erosion and sedimentation according to CDOT Standard Specifications 107.25 and 208. All disturbances require a stabilization plan, native seeding or landscape design plan. In any case, the COOT Erosion Control and Stormwater Quality Guide (most recent version) should be used to design erosion controls and to restore disturbed vegetation. Contact Information: The CDOT Erosion Control and Stormwater Quality Guide may be obtained from the Bid Plans Office at (303) 757-9313 or from: htt ://www.colorad dot.infol ro rams/environmen lAandsca a-ar hitecture/eros1 n-storm uali Disposal of Drilling Fluids - Drilling fluids used in operations such as Horizontal Directional Drilling may be classified as "discharges" or "solid wastes", and in general, should be pumped or vacuumed from the construction area, removed from the State Highway Right of Way, and disposed of at permitted facilities that specifically accept such wastes. Disposal of drilling fluids into storm drains, storm sewers, roadside ditches or any other type of man-made or natural waterway is prohibited by Water Quality Control and/or Solid Waste regulations. Small quantities of drilling fluid solids less than 1 cubic yard of solids may be left on -site after either being Environmental Clearances Information Summary, Page 2 of 3 Colorado Department of Transportation December'14 separated from fluids or after infiltration of the water, provided: 1) the drilling fluid consists of only water and bentonite day, or, if required for proper drilling properties, small quantities of polymer additives that are approved for use in drinking water well drilling; 2) the solids are fully contained in a pit, and are not likely to pose a nuisance to future work In the area, 3) the solids are covered and the area restored as required by CDOT permit requirements (Utility, Special Use, or Access Permits, etc.). Contact lntormadon: Contact CDPHE (telephone 99 listed above). Noxious Weeds and Invasive Species Management Plan — Noxious Weeds and Invasive Species guidance can be found by contacting the Colorado Department of Agriculture (https://www.colomdo.gov/pacificla(iconservation/noxiousweeds) and the Colorado Division of Parks and Wildlife (tg2:/-/cnw-state.co.us/aboutus/Paces/RS-NoxiousWeeds.aspx). In either case, management fans involving the control of noxious weeds associated with the permitted acUvIty and cleaning of equipment will be required. Concrete Washout - Waste generated from concrete activities shall NOT be allowed to flow Into the drainage ways, inlets, receiving waters, or in the CDOT ROW. Concrete waste shall be placed in a temporary concrete washout facility and must be located a minimum of 50 feet from state waters, drainageways, and Inlets. Concrete washout shall only be performed as specified by the CDOT Environmental Program and shall be in accordance to CDOT specifications and guidelines. Contact information: Contact CDPHE or find additional information on the CDOT website: Revision of Sections 101. 107 208 213 and 620 Water Quafifv Control One or More Acres of Disturbance. Spill Reporting Spills shall be contained and cleaned up as soon as possible. Spills shall NOT be washed down into the storm drain or buried. All spills shall be reported to the CDOT Illicit Discharge Hotline at (303) 512-4446 (4H2O), as well as the Regional Permitting Office and Regional Maintenance Supervisor. Spills on highways, into waterways, any spill in the highway right-of-way exceeding 25 gallons, or that may otherwise present an immediate danger to the public shall be reported by calling 911, and shall also be reported to the CDPHE at 1-877-518.5608. About This Form - Questions or comments about this Information Summary may be directed to Alex Karami, CDOT Safety & Traffic Engineering, Utilities Unit, at 303 757-9841, alex.karam[Ostate.co.us. 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