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HomeMy WebLinkAboutDRB16-0447 Submittal.pdf Department of Community Development 75 South Frontage Road TOWN OF VA1L Vail, CO 81657 Tel: 970-479-2138 www.vailgov.com Application for Design Review Exterior Alteration General Information: This application is required for all proposals involving minor changes to buildings and site improve- ments, such as roofing, painting, window additions, landscaping, fences, retaining walls, etc. Applicable Vail Town Code sections can be found at www.vailgov.com under Vail Information —Town Code Online. All projects requiring de- sign review must receive approval prior to submitting a building permit application. An application for Design Review cannot be accepted until all required information is received by the Community Development Department, as outlined in the submittal requirements. The project may also need to be reviewed by the Town Council and/or the Planning and Environmental Commission. Design review approval expires one year from the date of approval, unless a building per- mit is issued and construction commences. Fee: $250—Multi-Family/Commercial $20—Single Family/Duplex Single Family Duplex i Multi-Family ✓ Commercial Description of the Request: Replace existing emergency generator at the Vail Transportation Center Physical Address: 241 S Frontage Rd E, Vail, CO 81657 Parcel Number: 070 Frontage at MM 176.4 (Contact Eagle Co. Assessor at 970-328-8640 for parcel no.) Property Owner: Colorado Department of Transportation Mailing Address: 222 S 6th Street, Room 100, Grand Junction, CO 81501 Phone: (970)445-8132 Owner's Signature: S A TlrtG/1 arirft,„/ Primary Contact/ Owner Representative: Dave Kuhn Mailing Address: 222 S 6th Street, Room 100, Grand Junction, CO 81501 Phone: (970)445-8132 E-Mail: Fax: (970) 683-6290 For Office Use Only: Cash CC: Visa/ MC Last 4 CC# Exp. Date: Auth # Check# Fee Paid: Received From: Meeting Date: DRB No.: Planner: Project No: Zoning: Land Use: Location of the Proposal: Lot: Block: Subdivision: Dec 2015 COLORADO DEPARTMENT OF TRANSPORTATION UTILITY PERMIT PERMITTEE DEPARTMENT USE ONLY Name: TOWN OF VAIL Date Issued 11/11/2015 Chad Salli Permit# 3150365-U Milepost Address: 1309 Elkhorn Dr S.x.# 070 A 176.40 Vail, CO 81657 Region 03 Section 02 Telephone: (970) 479-2169 Patrol 19-2 Fred Etter NOTICE TO PERMITTEE:For underground facility location information,contact the Utility Notification Center of Colorado(UNCC).Pursuant to 9-1.5-103 C.R.S.you shall not make or begin excavation without first notifying the UNCC and if necessary,then notifying the tier two members having underground facilities in the area of such excavation.Notification shall also be given to the CDOT regional permitting office,or as otherwise directed by this Permit's Special Provisions. Notice of the commencement,extent and duration of the excavation work shall be given at least two business days prior thereto,not including the day of actual notice. The UNCC may be called at 1-800-922-1987. CDOT shall be called at(970)683-6271. ACTIVITY DESCRIPTION(Furnished by Permittee) PURPOSE 7 Installation 7 Adjustment fl Removal p Maintenance of existing Facility FACILITY (Type,size,class of transmittant,design pressure or etc.) Backup generator in CDOT ROW DESCRIPTION OF WORK Replace existing backup generator for the Vail Village Transportation Center NATURE OF INSTALLATION ❑Longitudinal(Parallel) ❑ Transverse(Crossing) E Buried 17 Aerial/Ground-mounted MAttach.To Hwy.Str.No. LOCATION:_070 Frontage at MM 176.4,475'east of Village Center Dr. County: Fagle City/Town: Vail Project Info: n/a ADDITIONAL REMARKS Work to comence after the 2015-2016 ski season in the spring. Lane closures will be in place for equipment and construction activities. SPECIAL PROVISIONS(completed by the Department) The Special Provisions are terms and conditions of this permit. Any work shall only be in accordance with the approved plans and special provisions as set forth in this permit and its attachments. The CDOT inspector is Dave Kuhn 2M5 Telephone: (970)445-8132 Work is to be completed on or before: 11/11/2016 or within days,(as applicable) david.kuhn@state.co.us Work time restrictions: Daylight hours only. No weekends, holidays,or during special events Designated minimum cover is N/A Designated overhead clearance is_N/A (ALSO SEE ATTACHED STANDARD PROVISIONS,AND ADDITIONAL SPECIAL PROVISIONS), (TRAFFIC CONTROL MUST CONFORM TO THE MUTCD) Other: FIELD INSPECTOR SHALL BE NOTIFIED 48 HOURS PRIOR TO BEGINNING WORK OR PERMIT IS VOID UNLESS PRIOR APPROVAL IS OBTAINED, UNLESS AN EMERGENCY THEN AS SOON AS POSSIBLE. Permittee is prohibited from commencing any work within highway ROW prior to issuance of a fully endorsed and validated permit. Permit, plan exhibit,insurance certificate(s),and traffic control plan must be available on site during work. High visibility vests are required at all times during working hours. 1. Your request to use and/or occupy state highway system rights of way as described above is granted subject to the terms and conditions of this permit, including the Standard and Special Provisions as shown on the permit and all attachments hereto. 2. To the extent authorized by law,Permittee hereby assumes,releases and agrees to indemnify,defend,protect,and save the State of Colorado harmless from and against any loss and/or damages to the property of the State of Colorado,third parties or the Permittee's facilities,and all loss and/or damage on account of injury to or death of any person whomsoever,arising at any time,caused by or growing out of the occupation of Colorado State Highway rights of way by Permittee's facilities or any part thereof,including but not limited to installation,adjustment,relocation,maintenance or operation,or removal of existing facilities,unless such loss and/or damage arises from the sole negligence or willful conduct of the State of Colorado or its employees or agents. 3. Failure by the Permittee to comply with any of the included terms or conditions may subject this permit to suspension or cancellation,at the discretion of the Department of Transportation. 4. THIS PERMIT IS NOT VALID UNTIL FULLY ENDORSED BY ALL PARTIES, WITH DATE OF ISSUE AFFIXED BY AN AUTHORIZED REPRESENTATIVE OF THE DEPARTMENT. A FULLY EXECUTED COPY OF THIS PERMIT MUST BE ON FILE AT THE TRANSPORTATION REGION OFFICE. 5. In accepting this permit the undersigned,representing the Permittee,verifies that he or she has the authority to sign for and bind the Permittee,and that he or she has read,understands and accepts all the included conditions. Attested Date I Signature Date Title Title I Print Name: (Print Name: COLORADO DEPARTMENT OF TRANSPORTATION I By Date Chief Engineer Regional Transportation Director or Designee Distribution: Region File(Original) Mtce Landscaping Supvr Permittee/Applicant Inspector Dave Kuhn 2M5 CDOT Form#0333 01/09 Mtce Patrol Supvr. 19-2 Fred Etter Previous versions are obsolete and should not be used. CDOT UTILITY/RELOCATION/SPECIAL USE PERMIT STANDARD PROVISIONS The following Standard Provisions are terms and site restoration,Completed Operations coverage shall be conditions of this permit: provided for a minimum period of one year following final acceptance of work. Effective January 1,2008 If anyaggregate limit is reduced below 1,000,000 Utility work authorized under this permit shall comply with the requirements of because of claims made or paid,the Permittee,or the State Highway Utility Accommodation Code,and applicable federal,state, as applicable-their Contractor,shall immediately local,and industry codes and regulations. obtain additional insurance to restore the full aggregate limit and furnish to CDOT a certificate Construction of any portion of the highway facility,including the pavement or other document satisfactory to CDOT showing structure,subsurface support,drainage,landscaping elements and all compliance with this provision. appurtenant features,shall comply with the provisions of the CDOT Standard 3) Automobile Liability Insurance covering any auto(including Specifications for Road and Bridge Construction,and with the Colorado owned,hired and non-owned autos)with a minimum limit as Standard Plans(M&S Standards). follows:$1,000,000 each accident combined single limit. 1. COMMENCEMENT AND COMPLETION 4) For any:a)engineering design;b)construction inspection;or,c) Work on highway Right of Way(ROW)shall not commence prior to issuance traffic control plans approved by a Traffic Control Supervisor; of a fully endorsed and validated permit. done in association with the operations or installations authorized by this permit,Professional Liability Insurance with minimum Permittee shall notify the CDOT inspector: limits of liability of not less than$1,000,000 Each Claim and a. At least 2 working days prior to commencing work,or resuming $1,000,000 Annual Aggregate. If the policy is written on a operations which have been suspended for five or more consecutive Claims Made form,the Permittee,or,as applicable—their working days Consultant or Contractor,shall renew and maintain Professional b. When suspending operations for 5 or more working days Liability Insurance for a minimum of two years following final c. Upon completion of work. acceptance of the work,or provide a project specific Policy with a two year extended reporting provision. Work shall not proceed beyond a completion date specified in the Special Provisions without written approval of the Department. 5) Pollution Legal Liability Insurance with minimum limits of liability of$1,000,000 Each Claim and$1,000,000 Annual 2. PLANS,PLAN REVISIONS,ALTERED WORK Aggregate. CDOT shall be named as an additional insured to the Pollution Legal Liability policy. If the Policy is a component of Plans or work sketch(EXHIBIT A)are subject to CDOT approval.A copy of the Professional Liability Policy,the Additional Insured the approved plans or sketch must be available on site during work.Plan requirement is waived,and the Policy shall be written on a revisions or altered work differing in scope or nature from that authorized Claims Made form,with an extended reporting period of at least under this permit,are subject to CDOT prior approval.Permittee shall two year following final acceptance of the work. promptly notify the CDOT inspector of changed or unforeseen conditions, which may occur on the job. 6) Umbrella or Excess Liability Insurance with minimum limits of $1,000,000. This policy shall become primary(drop down)in 3. INSURANCE the event the primary Liability Policy limits are impaired or exhausted. The Policy shall be written on an Occurrence form Insurance Requirements for Utility and Special-Use Permits(Revised 7-05 per and shall be following form of the primary. The following form State Requirements) Excess Liability shall include CDOT as an additional insured. A. The Permittee shall obtain,and maintain at all times during the B. CDOT shall be named as additional insured on the Commercial performance of work authorized by this Permit,insurance in the General Liability and Automobile Liability Insurance policies. following kinds and amounts. The Permittee shall require any Completed operations additional insured coverage shall be on Contractor working for them within the State Highway Right of endorsements CG 2010 11/85,CG 2037,or equivalent. Coverage Way to obtain like coverage.The Permittee shall also require any required by the Permit will be primary over any insurance or self- Contractor or Consultant performing work described in sub- insurance program carried by the State of Colorado. paragraph 4)below,to obtain Professional Liability Insurance. C. The Insurance shall include provisions preventing cancellation or 1) Workers'Compensation Insurance as required by state statute, non-renewal without at least 30 days prior notice to CDOT by and Employer's Liability Insurance covering all employees certified mail. acting within the course and scope of their employment and work on the activities authorized by this Permit. D. The Permittee,or,as applicable—their Contractor or Consultant, will require all insurance policies in any way related to the Permit 2) Commercial General Liability Insurance written on ISO and secured and maintained by the Permittee,Contractor or occurrence form CG 00 01 10/93 or equivalent,covering Consultant,to include clauses stating that each carrier will waive all premises operations,fire damage,independent Consultants, rights of recovery,under subrogation or otherwise,against CDOT, products and completed operations,blanket contractual liability, its agencies,institutions,organizations,officers,agents,employees personal injury,and advertising liability with minimum limits and volunteers. as follows: E. All policies evidencing the insurance coverages required hereunder a. $1,000,000 each occurrence; shall be issued by insurance companies satisfactory to CDOT. b. $2,000,000 general aggregate; F. The Permittee,or as applicable-their Contractor or Consultant, c. $2,000,000 products and completed operations aggregate; shall provide certificates showing insurance coverage required by and this Permit to CDOT prior to commencing work. No later than 15 d. $50,000 any one fire. days prior to the expiration date of any such coverage,the Permittee,Contractor or Consultant,shall deliver CDOT certificates e. For any permanent Permittee-owned installations located of insurance evidencing renewals thereof. At any time during the within the State Highway Right of Way,highway repairs,or term of this contract,CDOT may request in writing,and the 02/06 CDOT Permit Form 333 and Standard Provisions Page 2 of 5 CDOT UTILITY/RELOCATION/SPECIAL USE PERMIT STANDARD PROVISIONS Permittee,Contractor or Consultant,shall thereupon within 10 days vehicles through the work zone,and shall conform to the supply to CDOT,evidence satisfactory to CDOT of compliance requirements of the Americans with Disabilities Act. The TCP and with the provisions of this section. MHT's shall contain sufficient detail to demonstrate conformity with all applicable requirements. G. Notwithstanding subsection A of this section,if the Permittee is a "public entity"within the meaning of the Colorado Governmental c. The Permittee shall have a competent person at the work site at all Immunity Act CRS 24-10-101,et seq.,as amended("Act'),the times in responsible charge of temporary traffic control. In Permittee shall at all times during the term of this permit maintain situations where the TCP goes beyond any Typical Application only such liability insurance,by commercial policy or self- shown in the MUTCD,or particularly dangerous roadway or traffic insurance,as is necessary to meet its liabilities under the Act. Upon conditions exist,the Department may require the Permittee to have request by CDOT,the Permittee shall show proof of such insurance a Traffic Control Supervisor(TCS)develop or approve the TCP or satisfactory to CDOT. Public entity Permittees are not required to to have a TCS on-site during work. The TCS shall be certified as a name CDOT as an Additional Insured. worksite traffic supervisor by either the American Traffic Safety Services Association(ATSSA)or the Colorado Contractors H. If the Permittee engages a Contractor and/or Consultant to act Association(CCA),and shall have a current CDOT flaggers' independently from the Permittee on the permitted work,that certification card. The TCS shall be responsible for the planning, Contractor and/or Consultant shall be required to provide an preparation,coordination,implementation,and inspection of the endorsement naming CDOT as an Additional Insured on their TCP. Commercial General Liability,Auto Liability,Pollution Legal d. The Permittee shall not start the permitted work before the Liability and Umbrella or Excess Liability policies. Department accepts the TCP. 4. WORK WHERE DEPARTMENT LACKS AUTHORITY e. The Department may review and order changes to the TCP and Utility work within municipal boundaries(pursuant to 43-2-135 CRS),on MHT's during performance of the work,as required. certain public lands,or on private property,may require separate approval of f. The Permittee shall comply with the TCP at all times during the appropriate jurisdictional agency or property owner. performance of the work. 5. INSTALLATIONS ON FREEWAYS g. The Permittee shall keep a copy of the TCP at the work site at all CDOT may permit utility accommodations on freeways,including but not times during performance of the work for inspection. limited to the Interstate System,only in accordance with Utility h. The TCP shall ensure that closure of intersecting streets,road Accommodation Code provisions.Special case exceptions as defined therein may be permitted only in accordance with FHWA-approved Departmental approaches and other access points is minimized. On heavily policy. traveled highways,the Department will not permit operations that interfere with traffic during periods of peak traffic flow. 6. JOINT USE ALTERNATIVES i. When Permittee operations coincide with highway construction or As directed or approved by CDOT,if necessary for the safe and efficient use of maintenance operations,the Permittee shall develop and implement the ROW,Permittee shall utilize joint use facilities such as the placement of the TCP in cooperation and coordination with the highway agency two or more separate lines in a common trench,or attachment to the same and/or its contractors and as otherwise directed by the Department overhead support.The Permittee will be responsible for proper coordination in the permit. with other affected utilities. j. All flaggers shall have a current CDOT flagger certification card 7. ATTACHMENT TO HIGHWAY STRUCTURES and shall be capable of communicating with the traveling public and others at the work site. Permittee is responsible for designing structure attachments,subject to the 10. NCHRP 350 CRASHWORTHINESS REQUIREMENTS FOR approval of the CDOT Staff Bridge Design Engineer. WORK ZONE TRAFFIC CONTROL DEVICES 8. DRAINAGEWAYS AND WATERCOURSES Work zone devices designated by FHWA as:Category I,including but not The flow of water shall not ever be impaired or interrupted.Where possible, limited to single-piece drums,tubes,cones and delineators;Category II, crossings of ditches,canals or water-carrying structures shall be bored or including but not limited to barricades,vertical panels with light,drums or jacked beneath.Irrigation ditch or canal crossings require approval of the ditch cones with light,portable sign supports,intrusion detectors and type III company or owner.Permittee shall repair damage to any drainage facility to the barricades;or as Category III,including but not limited to concrete barriers, satisfaction of the owner. fixed sign supports,crash cushions,and other work zone devices not meeting the definitions of Category I or II;shall meet NCHRP 350 crash test 9. TRAFFIC CONTROL PLAN requirements. The Permittee,or their contractor shall obtain and make available upon request,the manufacturer's written NCHRP 350 certification,or a. Prior to commencing work,the Permittee shall develop and submit as applicable,the FHWA Acceptance Letter,for each type of device. FHWA to the Department for acceptance,a Traffic Control Plan(TCP)for Acceptance Letters for Category II or Category III Work Zone Devices may be any accommodation work that will affect traffic movement or accessed through the FHWA website at safety. The Permittee shall implement the TCP and utilize traffic http://safety.thwa.dot.gov/roadway_dept/road_hardware/wzd.htm control devices as necessary to ensure the safe and expeditious 11. WORKER SAFETY AND HEALTH movement of traffic around and through the work site. b. The Permittee shall develop the TCP,and Methods of Handling a. All workers within the State Highway right of way shall comply with Traffic(MHT's)included therein,in conformance with the Manual their employer's safety and health policies/procedures and all on Uniform Traffic Control Devices(MUTCD),the Colorado applicable U.S.Occupational Safety and Health Administration Supplement thereto adopted by the Commission pursuant to sections (OSHA)regulations-including,but not limited to the applicable 42-4-104 and 42-4-105 CRS,the Department's standard sections of 29 CFR Part 1910-Occupational Safety and Health specifications for temporary traffic control and the Department's Standards and 29 CFR Part 1926 -Safety and Health Regulations standard plans for signing-Standard Plans S 630-1 and S 630-2. for Construction. The TCP shall include provisions for the passage of emergency 02/06 CDOT Permit Form 333 and Standard Provisions Page 3 of 5 CDOT UTILITY/RELOCATION/SPECIAL USE PERMIT STANDARD PROVISIONS b. Personal protective equipment(PPE)(e.g.head protection, footwear,high visibility apparel,safety glasses,hearing protection, e. Thrust blocks are required on all vertical and horizontal bends in respirators,gloves,etc.)shall be worn as appropriate for the work pressure pipes. being performed,and as specified in regulation. At a minimum,all workers in the SH ROW,except when in their vehicles,shall wear f. Meters shall not be placed on highway ROW except within the following personal protective equipment: corporate limits where municipal regulations allow such use. 1) Head protection that complies with the ANSI Z89.lstandard; 15. ALIGNMENT,COVER,CLEARANCE 2) At all construction sites or whenever there is danger of injury a. Location and alignment of Permittee's facilities shall only be as to feet,workers shall comply with OSHA's PPE requirements specified in this permit or as otherwise indicated in the approved for foot protection per 29 CFR 1910.136,1926.95,and plans or work sketch(EXHIBIT A). 1926.96. If required,such footwear shall meet the requirements of ANSI Z41; b. Parallel installations will not be permitted under roadways (including curbing and/or shoulders)or median areas,except within 3) High visibility apparel,which shall,at a minimum comply corporate boundaries,subject to municipal regulations. with the Class 2 specifications of the ANSI/ISEA 107standard. Class 3 apparel shall be considered for use at night or in c. Parallel installations should be located as near as practicable to the particularly hazardous situations. ROW line. Crossings shall be as nearly perpendicular to the highway as feasible. 4) The most recent version of the ANSI standards listed above shall apply. d. Where no feasible alternate locations exist,the Department may permit parallel installations along roadside areas within 15 feet from 12. ADA REQUIREMENTS edge of shoulder or back of curb. In these cases,the facility must be so located and safeguarded as to avoid potential conflict with The Permittee shall comply with the applicable provisions of the Americans necessary highway appurtenances(signs,guard rail,delineators, With Disabilities Act,with respect to both permanent facilities installations and etc.). Specific safeguards such as increasing depth of cover to 60 temporary work zones. inches,capping,or encasement,shall be specified in this permit's Special Provisions. 13. CLEAR ROADSIDE CONSIDERATIONS e. Parallel installations shall follow a uniform alignment,wherever a. CDOT is committed to provide a roadside area that is as free as practical.Due consideration must be given to conserving space practical from nontraverseable hazards and fixed objects("clear available for future utility accommodations.The standard allowable zone").New above ground installations may be permitted within the deviation from the approved horizontal alignment is±18 inches. clear zone only upon a showing that no feasible alternate locations exist.Permittee must utilize appropriate countermeasures to f. Minimum cover shall conform to the Special Provisions.Normal minimize hazards. specified cover will be 48 inches or greater;reduced cover may be approved where site conditions warrant,subject to other safeguards b. Permittee shall remove materials and equipment from the highway as may be specified or approved in the permit. Minimum overhead ROW at the close of daily operations. The traffic control plan must clearance shall conform to the Special Provisions,consistent with include protective measures where materials and equipment may be Utility Accommodation Code criteria. stored on ROW. Protection of open trenches and other excavations within highway ROW shall be addressed in the Permittee's traffic 16. PAVEMENT CUTS AND REPAIRS control plan. All excavations shall be closed at the end of daily operations,and no open excavation will be allowed in the clear zone Paved surfaces shall not be cut unless otherwise specified in this permit.No after dark. The Permittee agrees to promptly undertake mitigating more than one half the width of the roadbed may be opened at a time,when or corrective actions acceptable to the Department upon notification otherwise permitted.Pavement shall be sawed or wheel-cut to a neat line. by CDOT that the installation permitted herein has resulted in a Pavement shall be replaced to a design equal to or greater than that of the hazardous situation for highway users. surrounding undisturbed pavement structure.Pavement repair shall conform to the Special Provisions or the approved plans. 14. GENERAL CONSTRUCTION REQUIREMENTS 17. BORING,JACKING,ENCASEMENT a. Work shall not be performed at night or on Saturdays,Sundays,or holidays without prior authorization or unless otherwise specified in Unless otherwise specified,buried crossings shall be bored or jacked beneath this permit.CDOT may restrict work on ROW during adverse the roadway,at least from toe of slope to toe of opposite slope. Portals for weather conditions or during periods of high traffic volume. untrenched crossings more than 5 feet in depth shall be bulk headed in conformance with OSHA construction and safety standards. Portal limits of b. Those areas within ROW,which must be disturbed by permit untrenched crossings shall be established safely beyond the highway surface operations,shall be kept to a practical minimum.Permittee shall not and clear zone and in no case shall the lateral distance from the surfaced area of spray,cut,or trim trees or other landscaping elements within the highway to the boring or jacking pit be less than the vertical difference in highway ROW,unless such work is otherwise specified in this elevation between such surface and the bottom of the pit. Water jetting or permit,or clearly indicated on the approved plans. Cleated or tunneling is not permitted.Water assisted boring may be permitted as tracked equipment shall not work on or move over paved surfaces determined by the CDOT Inspector.Boring hole shall be oversized to the without mats,or pads on tracks. minimum amount required to allow pull-through of the conduit being installed. Resultant voids shall be grouted or otherwise backfilled,subject to CDOT c. Material removed from any portion of the roadway prism must be approval.Ends of bored sections shall not be covered before being inspected. replaced in like kind with equal or better compaction.Segregation Encasement shall be consistent with Utility Accommodation Code provisions. of material is not permitted. The permitted facility shall be of CDOT may require protective casing for shallow installations or certain durable materials in conformity with accepted practice or industry conduit materials. Encased crossings shall extend at least from toe of slope to standards,designed for long service life,and relatively free from toe of slope,or the full width between access-control lines on freeways, routine servicing or maintenance. including the Interstate System. d. Construction or compaction by means of jetting,puddling,or water 18. INSPECTION AND ACCEPTANCE flooding is prohibited within all highway ROW. 02/06 CDOT Permit Form 333 and Standard Provisions Page 4 of 5 CDOT UTILITY/RELOCATION/SPECIAL USE PERMIT STANDARD PROVISIONS a. CDOT will determine the extent of inspection services necessary for a given installation.Permittee shall attend final inspection as may g. If pre-existing solid waste or hazardous materials contamination be required. If the initial performance of permitted work was (including oil or gasoline contaminated soil,asbestos,chemicals, unacceptable,as determined by the Department,the Permittee shall mine tailings,etc.)are encountered during the performance of work, perform any reconstruction or improvement of that work as ordered the Permittee shall halt work in the affected area and immediately by the Department,in a timely manner and prior to any further contact the CDOT regional permitting office for direction as to how construction. If permitted operations are not being carried out in to proceed. compliance with the terms and conditions of this permit,the Department may order the Permittee to perform whatever corrective h. Spills shall be reported immediately using the CDOT Illicit measures are necessary to attain compliance with the permit. If Discharge Hotline(303)512-4446.Spills on the highway,into there is an immediate danger to the public's health,safety or waterways,or that may otherwise present an immediate danger to welfare,the Department may order the Permittee to cease all the public,shall be reported by calling 911 or the Colorado State operations and if necessary,to remove all equipment and facilities Patrol at(303)239-4501,and the Colorado Department of Public from the SHROW. Health and Environment at 1-(877)518-5608. b. Final acceptance does not relieve Permittee of maintenance 20. RESTORATION OF RIGHT OF WAY obligations toward those elements of the highway facility constructed under this permit. Final acceptance begins the two-year Prior to final acceptance,all disturbed portions of highway right of way shall warranty period(see requirement under"Operation and be cleaned up and restored to their original condition,subject to CDOT Maintenance"below). approval. Seeding,sodding,and planting shall be as specified,or otherwise approved by CDOT.Construction,maintenance and watering requirements 19. ENVIRONMENTAL CLEARANCES/PERMITS shall conform to the CDOT Standard Specifications.Where landscape restoration must be delayed due to seasonal requirements,such work may be a. It is the responsibility of the Permittee to determine which authorized by separate permit. Permittee shall use only certified weed-free environmental clearances and/or regulations apply to their activities seed and mulch.Permittee shall clean equipment before transporting it into or and to obtain any clearances that are required directly from the out of the state to prevent the migration of noxious weeds. appropriate regulatory agency prior to commencing work. Please refer to or request a copy of the"CDOT Environmental Clearance 21. OPERATION AND MAINTENANCE Information Summary"(ECIS)for details. The ECIS may be obtained from CDOT Permitting Offices or may be accessed via the a. Permittee agrees to own and maintain the installation permitted CDOT webpage at herein.The facility shall be kept in an adequate state of repair and http://www.dot.state.co.us/UtilityProgram/Forms.cfm. Failure to maintained in such a manner as to cause the least interference with comply with regulatory requirements may result in suspension or the normal operation and maintenance of the highway. revocation of your CDOT permit,or enforcement actions by other agencies. b. If any element of the transportation facility,constructed or replaced as a condition of this permit,fails within 24 months due to improper b. The Special Provisions of this permit shall list any specific construction or materials,Permittee shall make all repairs environmental clearances or permits that the Department has been immediately as notified in writing by CDOT. notified by the Permittee or by the administering regulatory agency apply to the operations authorized by this permit. The Special c. Routine,periodic maintenance and emergency repairs may be Provisions shall require the Permittee obtain the listed performed under the general terms and conditions of this permit. environmental clearances/permits prior to beginning work. CDOT shall be given proper advance notice whenever maintenance work will affect the movement or safety of traffic.In an emergency, c. The Permittee shall comply with all requirements described in the the CDOT Region office and the State Patrol shall immediately be CDOT Environmental Clearances Information Summary,including notified of possible traffic hazards.Emergency procedures shall be those pertaining to: coordinated beforehand,where possible. 1) Ecological Resources d. Maintenance activities requiring new excavation or other 2) Cultural Resources disturbance within highway ROW may require separate permit. 3) Discharges of Stormwater or Process Water Where highway construction or maintenance operations so require, 4) Hazardous Materials Permittee will shut off lines,remove all combustible materials from 5) Discharges of Dredged or Fill Material the highway right of way,or provide other temporary safeguards. 6) Erosion and Sediment Control 7) Disposal of Drilling Fluids 22. MARKERS,LOCATION AIDS,LOCATION ASSISTANCE 8) Concrete Washout 9) Spill Reporting a. The utility shall take all practical measures to ensure that buried 10) Transportation of Hazardous Materials utility facilities are surface-detectable by standard geophysical methods. Where the utility facilities,by the nature of their material d. Disturbance of any wildlife shall be avoided to the maximum extent properties,burial depth or other factors,may by themselves not be practicable. If threatened or endangered species or archeological or surface-detectable,the utility shall,where feasible,incorporate historical artifacts are encountered during the progress of a project, detection wire or other detection aids in the installation of those work in the subject area shall be halted and the CDOT regional facilities. In instances where detection aids are not feasible or permitting office shall be contacted immediately for direction as to would be ineffective and surface-detectability cannot be ensured, how to proceed. surface markers shall be installed as directed by the Department and as-constructed plans and showing the accurate horizontal and e. All discharges of stormwater or process water are subject to the vertical location of the buried facilities shall be provided to the applicable provisions of the Colorado Water Quality Control Act Department. and the Colorado Discharge Permit Regulations. b. All plowed or trenched installations must include color-coded f. There shall be no disposal of hazardous materials in the state (using the American Public Works Association color coding highway right of way. Solid waste shall be removed from the state system)warning tape placed not less than 12 inches vertically above highway right of way and disposed of at a permitted facility or the top of the line. The warning tape shall be surface-detectable if designated collection point(such as the Permittee's own dumpster). needed to facilitate detection of the line. Drilling fluids must be disposed of as described in the ECIS. 02/06 CDOT Permit Form 333 and Standard Provisions Page 5 of 5 CDOT UTILITY/RELOCATION/SPECIAL USE PERMIT STANDARD PROVISIONS c. The utility shall place readily identifiable markers at the right of c. The Permittee shall promptly remove all abandoned facilities from way line where it is crossed by pipelines carrying transmittants the SH ROW and promptly restore the SH ROW to pre-existing or which are flammable,corrosive,expansive,energized,or unstable, other conditions prescribed by the Department unless the particularly if carried at high pressure or potential,except where a Department in writing expressly allows the facility to remain in vent will serve as a marker. place. Written notice from the Department,allowing an abandoned d. The utility shall place markers for longitudinal underground facility to remain in place,may include special conditions. facilities vertically above the facilities or at a known horizontal offset,unless otherwise approved in writing by the Department. d. If utility facilities are retired or abandoned in place,the utility shall Each marker shall provide a fore-and backsight to succeeding and comply with that decision if directed by the Department: preceding markers. Markers shall be installed at suitable intervals along tangent sections,at angle points or points of curvature and at 1) cap,plug or fill lines, reasonable intervals along curves. 2) furnish suitable location records for any such buried facilities, 3) maintain its own records of such facilities and respond to e. The utility shall maintain any markers required by this Code for the locate notices/requests from the UNCC and/or excavators, In life of the installation. providing such locates,the utility will indicate to the requesting entity whether or not the subject facilities are f. The Department may require the utility to submit"as-constructed" retired or abandoned. plans. The Department may enter into an agreement with the utility 4) perform any other actions as deemed necessary by the whereby the Department can rely on those plans for the exact Department to protect the transportation facility and/or the location of the utility for any future excavations,and need not give traveling public. notice to the utility under Article 1.5 of Title 9,C.R.S. e. If the ownership of utility facilities is transferred,both the original g. The utility will comply with the applicable requirements of Article Permittee and the new owner shall notify the Department in writing 1.5 of Title 9 C.R.S.,including any requirement to participate in the prior to the change in ownership,and such notice shall state the State's Notification Association pursuant to 9-1.5-105 C.R.S.. All planned date of change in ownership. The notice from the new owners of underground utilities within the SHROW,with the owner shall include a written statement accepting all terms and exception of the Department itself,must become members of the conditions of the existing permit,effective upon the planned date of UNCC Notification Association. the change in ownership. h. In addition to complying with the provisions of Article 1.5 of Title 9 C.R.S(One-Call Statute)in response to the Department's f. Utility facilities containing asbestos may not be abandoned in-place. notification of planned excavations,utility owners shall surface- Ordinarily,such facilities must be removed from the SHROW when mark their buried utility facilities that are located within the take out of service. On a case-by-case basis,the Department may SHROW in order to facilitate Departmental engineering and design allow such facilities to be retired in-place,with the owner retaining activities,upon reasonable request from the Department,and at no full legal ownership and responsibility for the facilities. cost to the Department. The Permittee shall respond to such request within a reasonable timeframe acceptable to the Department,but no 25. SUSPENSION AND CANCELLATION longer than 14 calendar days from the date of request,and the accuracy of the surface marking shall be within 18 inches of either a. The CDOT inspector may suspend operation due to: side of the actual location of the buried facility. 1) Non compliance with the provisions of this permit 23. ADJUSTMENTS DUE TO HIGHWAY CONSTRUCTION 2) Adverse weather or traffic conditions 3) Concurrent transportation construction or maintenance If for any transportation purpose it becomes necessary to remove,adjust,or operations in conflict with the permitted work. relocate this facility,Permittee will do so promptly,at no cost to the CDOT 4) Any condition deemed unsafe for workers or for the general except as provided by law,upon written notice from CDOT and in accordance public. with the utility relocation permit issued to cover the necessary work. The utility shall perform the relocation at or within a time convenient to and in b. Work may resume when grounds for suspension no longer exist. proper coordination with the project or transportation-related activity,to minimize public inconvenience and cost,as directed by the Department in the This permit is subject to cancellation due to: permit authorizing the relocation. The utility company shall pay for damages 1) Persistent noncompliance with permit provisions caused by the company's delay in the performance of utility relocation work or 2) Abandonment or transfer of ownership interference with the performance of transportation project work done by 3) Superseded by new permit covering the same installation others. Such damages include,but are not limited to,payments made by the 4) Conflict with necessary planned transportation construction. Department to any third party based on a claim that performance of the transportation project work was delayed or interfered with as a direct result of c. Permittee must promptly terminate occupancy upon notice of the utility company's failure to timely perform the utility relocation work. cancellation of permit,unless a new permit is applied for and Damages resulting from delays in the performance of the utility relocation granted. work or interference with the transportation project work that are caused by events beyond the utility company's ability to reasonably foresee or control(a d. Where Permittee does not fulfill an obligation to repair or maintain force majeure)shall not be charged to the utility company. any portion of the highway facility,or control and safely maintain the flow of traffic thereon,CDOT reserves the right,in lieu of 24. ABANDONMENT,RETIREMENT,CHANGE IN OWNERSHIP canceling this permit,to accomplish the required work by any other appropriate means,and Permittee shall be liable for the actual costs a. The Permittee shall notify the Department in writing of the planned thereof. retirement or abandonment of its facility or any portion thereof. The Department will notify the Permittee in writing if it determines that the facilities may be retired or abandoned in place,along with any special conditions that may apply. b. Retired facilities shall remain the Permittee's sole responsibility, subject to all provisions of the Utility Accommodation Code and all of the terms and conditions of the permit issued for that facility, including maintenance and relocation requirements. 02/06 CDOT Permit Form 333 and Standard Provisions Page 6 of 5 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 http://www.cdphe.state.co.us/permits.asp. • CDOT Water Quality Program Manager: Rick Willard (303)757-9343 http://www.coloradodot.info/programs/environmental/water- quality • CDOT Asbestos Project Manager:Theresa Santangelo-Dreiling, (303)512-5524 • Colorado Office of Archaeology and Historic Preservation: (303)866-3395 • U.S.Army Corps of Engineers, District Regulatory Offices: Omaha District(NE Colorado), Denver Office(303)979-4120 http://www.nwo.usace.army.mil/html/od-tl/tri-lakes.html Sacramento Dist. (Western CO), Grand Junction Office (970)243-1199 http://www.spk.usace.army.mil/cespk-co/regulatory/ Albuquerque District(SE Colorado), Pueblo Reg. Office(719)-543-6915 http://www.spa.usace.army.mil/reg/ • CDOT Utilities, Special Use and Access Permitting: (303)757-9654 http://www.dot.state.co.us/Permits/ Ecological 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, http://coloradodot.info/programs/environmental/wildlife/guidelines, or the Colorado Division of Wildlife website http://wildlife.state.co.us/WildlifeSpecies/SpeciesOfConcern/. Additional guidance may be provided by the appropriate Region Planning 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 sites/artifacts 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 search at(303)866-3395. Paleontological 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, et 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 et 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 Containing 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. Additional information concerning clearance on CDOT projects is available from the CDOT Asbestos Project Manager(303)512- 5519, or Theresa Santangelo-Dreiling, Property Management Supervisor(303)512-5524. Environmental Clearances Information Summary Page 1 of 3 Colorado Department of Transportation December'10 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 Engineers,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). However, 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)692-3500. Working 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. The Colorado Division of Wildlife (CDOW) application, as per guidelines agreed upon by CDOT and CDOW, can be accessed at http://www.coloradodot.info/programs/environ mental/wildlife/guidelines. Stormwater Construction Permit(SCP)and Stormwater Discharge 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:For Utility/Special Use activities being performed in conjunction and coordination with a CDOT highway construction contract, please contact the CDOT Water Quality Program Manager at(303)757- 9343. Otherwise, contact the CDPHE Water Quality Control Division at(303)692-3500. Website: http://www.cdphe.state.co.us/wq/PermitsUnit/index.html. Construction Dewatering(Discharge 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: http://www.cdphe.state.co.us/wq/PermitsU nit/FORMSandApplications/Appsandformsnewpage.html Municipal Separate Storm Sewer System(MS4) Discharge 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/environmental/water-quality/documents/CDOT%20MS4%20Permit.doc/view)and COR-030000(http://www.cdphe.state.co.us/wq/PermitsUnit/PERMITs/SWpermitsrats/SWConstructionPErmit.pdf). 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 go to http://www.cdphe.state.co.us/wq/permitsunit/MS4/MS4Permittees.pdf. 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 http://www.coloradodot.info/programs/environmental/water-quality/glossary.html#AllowableDischarge. Contact Information: Contact the CDOT Water Quality Program Manager at(303)757-9343, or 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 fire fighting activities. Contact Information: The CDOT Water Quality Program Manager or the CDPHE Water Quality Control Division (telephone#'s listed above). Erosion and 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 208 specifications. In either case,the CDOT 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: http://www.dot.state.co.us/environmental/envWaterQual/wgms4.asp 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'10 separated from fluids or after infiltration of the water, provided: 1)the drilling fluid consists of only water and bentonite clay, 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 Information: Contact the CDOT/CDPHE Liaison or CDOT Water Quality Program Manager. 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 the CDOT Water Quality Program Manager at(303)757-9343. Website: http://www.coloradodot.info/programs/environmental/water- quality/revised-m-standards; refer to the link Revision of Sections 101, 107, 208, 213 and 620 Water Quality Control One or More Acres of Disturbance for additional guidance. 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(4H20), 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.karami@dot.state.co.us. Environmental Clearances Information Summary Page 3 of 3 Colorado Department of Transportation December'10 4 CDOT COLORADO cool COLORADO CO 'lk Department of CO Transportation `-.F.' Department of Transportation What is stormwater runoff? Water Quality IDrcuram Tips for Reporting an Illicit Discharge Stormwater runoff occurs when precipitation from rain or snowmelt Industrial Facilities flows over the ground.Impervious surfaces like roads and sidewalks Call the illicit discharge hotline at(303)512-4426 IDroQram prevent stormwater from naturally soaking into the ground From a safe distance try to estimate the amount of the discharge. CDOT has a Municipal Separate Storm Sewer System permit, Identify characteristics of the discharge(color,odor, otherwise known as(MS4)from the Colorado Department of Why is stormwater runoff a problem? algae,etc.). Public Health and Environment. The permit states that only Obtain information on the vehicle dumping the stormwater can be discharged from CDOT's storm drain system Stormwater can pick up debris,chemicals,dirt and other waste (if applicable). pollutants and flow into CDOT's storm drain system or directly Do not approach! into a stream,river,lake,wetland or reservoir.Anything that Call*CSP for illicit dumping. enters CDOT's storm drain system is discharged untreated into If possible,take a photo,record a license plate. the waterways we use for fishing,swimming,and providing REMEMBER: telthbasln drinking water. Never get too close to the illicit discharge,it may be dangerous!!! wee pip*—.~ ffr El' . ..s. , ' p'P r' m drain • { ry kt ''t For more information on CDOT Utility TOTHEWASTEWATER TOME LOCAL c•` TREATMENT PLANT WATERS ODY Permits: https://www.codot.gov/business/permits/utilitie • ' • _ w ';_ sspecialuse For more information on CDOT Access As part of the permit, CDOT has several different Permits: programs to prevent pollutants from entering into the storm drain system: https://www.codot.gov/business/permits/access permits Construction Site Program New Development Redevelopment Program Dredged spoil,dirt,slurry,solid waste,incinerator For more information on CDOT Water Quality Illicit Discharge Program Program: residue,sewage,sewage sludge,garbage,trash, Industrial Facilities Program chemical waste,biological nutrient,biological Water Quality Program Manager Public Education and Outreach Program material,radioactive material,heat,pH,wrecked or 4201 E.Arkansas Ave. discarded equipment,rock,sand,any industrial, Pollution Prevention and Good Housekeeping municipal,or agricultural waste. Shumate Building Program Denver,Colorado 80222 303-757-9343 Wet Weather Monitoring Program 4 CDOT COLORADO COOT COLORADOCO - Department of CO Transportation `= Department of • Transportation CDOT defines a utility,or utility facility as any Industrial Facilities Program Elements: Control Measures privately, publicly,or cooperatively owned 1. Educate and outreach to owners for Industrial line,facility,or system producing,transmitting or distributing the following: or operators that have potential to Facilities contribute substantial pollutant to ✓ Communications ✓ Cable television water. Industrial facilities can use control measures(CM) ✓ Power otherwise known as Best Management Practices 2. Report and include information on ✓ Electricity p (BMP)during the construction of a facility and when ✓ Light operating the facility.Control measures are schedules discharge and water quality s( Heat Gas of activities,maintenance procedures,and other ✓ Oil concerns. Provide written management practices to prevent and reduce ✓ Crude Products notification within 15 days of pollution entering into CDOT's storm drain system. ✓ Water Control Measures also include treatment,operating ✓ Stream discovery to CDPHE. procedures,and practices to control site run off ✓ Waste 3. Submit an annual report to CDPHE which can include structural and non-structural ✓ Stormwater not connected with highway drainage controls. ✓ Similar Commodity containing the number of informational brochures THE GAUNTLET distributed; name and title of each -, J individual trained. p GREAT! POLLUTANT S? _ Education • I• ' ff There are instances when a utility I: i,,.. IS THEREABMP �r� -Y..414. L� company or other entity doing work in the �✓ FINDING! • •y�/iap—.,. R~ , PRESENT? }tf! state highway right-of-way will require some type of environmental permit or V V clearance for that work. CDOT has put IS THIS THE .1 FINDING! PROPER BMP FOR � together an Environmental Clearances THE POLLUTANT? 4 - -. _Imo Information Summary for those applying • for a CDOT Utility and Special Use Permit (I5THEBM _ _i„. or Access Permit to obtain all required PROPERLY MAINTAINED? ii, or This fact sheet is given to each r permittee and is available at: https://www.codot.gov/programs/enviro C In compliance!! i nmental/resources/guidance- i ire .L ILstandards/Environmental%20Clearances% �p .. '+`�4 + la 20Info%20Summary.pdf 'fir ., - � ._ STATE OF COLORADO DEPARTMENT OF TRANSPORTATION V. I OT Region 3 Traffic&Safety Utility Permit Section 222 South 6th Street, Room 100 ..���� Grand Junction,Colorado 81501 - (970)683-6271 LATE FALL, WINTER AND SPRING SPECIAL PROVISIONS FOR WORK WITHIN CDOT ROW It's that time of year again when work within the Right of Way (ROW) becomes a special concern. Due to Northwest Colorado's unpredictable weather, work in the ROW can create several types of hazards for the traveling public, contractors, and their personnel. The condition of the highway can change quickly. Mud tracked onto the highway by equipment, or ice and snowpack are just a few of the conditions that make the roadway more hazardous for all concerned. The terrain within the ROW must be kept clear of hazards as well. Holes, trenches, equipment and materials can make the terrain "unrecoverable" for a driver should his/her vehicle leave the highway. Activities must be shut down when the roadway is other than dry. The use of frozen materials for backfilling will only lead to settlement. The contractor must make extra effort to compact the excavation. In the spring, any settlement of backfill shall be repaired. The re-vegetation shall take place yet this fall or early next spring. toI 4, ` T COLORADO CO `! Department of Transportation Region 3 Traffic Section 222 South 6th Street Room 100 Grand Junction, Colorado 81501 (970)683-6288 Fax: (970)683-6290 3150365-U Permit No 070A Frontage Highway No 176.4 Mile Marker 3219 Patrol No SPECIAL PROVISIONS FOR SPECIAL USE PERMIT—WORK/CONSTRUCTION IN ROW THE SPECIAL PROVSIONS ARE TERMS AND CONDTIONS OF THIS PERMIT CDOT IS NOT A UNCC MEMBER AND UNCC WILL NOT LOCATE CDOT FACILITIES. PERMITTED WORK REQUIRES PERMITTEE OR CONTRACTORS TO CONTACT CDOT(970) 384-3354, FOR LOCATES IF ANY CDOT SIGNALS, FLASHING BEACONS, ELECTICAL SIGNS, LUMINARIES, AND WEATHER STATIONS ARE LOCATED WITHIN 3000 FEET OF CONSTRUCTION AREA NOTICE-NO UNDERGROUND INSTALLATIONS SHALL BE PERFORMED FROM 15 NOVEMBER TO 15 APRIL, UNLESS THE CDOT INSPECTOR ON THE PERMIT HAS APPROVED OF THE INSTALLATION DURING THIS TIME FRAME. REVIEW & COMPLY WITH THE ATTACHED "SPECIAL PROVISIONS FOR LATE FALL,WINTER AND SPRING". TRAFFIC CONTROL 5. Advanced warning and construction signs, flashers, barricades and flag people must conform to the Manual on Uniform Traffic Control Devices and, Colorado 1. The complete permit for this work, including approved Supplements,and must be in place before work starts each Colorado Department of Transportation (to be known as day. CDOT or the Department)permit, construction and traffic control plans,will be kept at the work site at all times. The 6. Any advance warning signs not in use for a particular permittee is responsible for providing traffic control plans activity shall be removed,placed outside of the clear zone, that conforms to and meets the requirements of the Manual or laid flat at least 4' from the edge of the shoulder and not on Uniform Traffic Control Devices (MUTCD) and the on landscaped areas or sidewalks. This applies to both Colorado supplements. signs and structures. 2. To meet conditions encountered in the field,minor changes 7. All flagging personnel must be certified and have their or additions may be ordered and approved by the CDOT certification cards available for inspection at any time. Field Inspector. 8. Lane closures must be as short as possible and as per the 3. All CDOT employees shall be considered as inspectors MUTCD. Flaggers are required for each lane closure. when the safety of the traveling public, safety of Advance warning signs must be placed as per MUTCD. contractors, employees, or integrity of the property of All temporary traffic control signs shall be removed, CDOT is at risk. covered or laid on the ground during non-working hours. 4. All work shall cease when weather creates a safety hazard 9. Two-way traffic shall be maintained at all times in the for the traveling public and/or barrow ditch is wet enough construction area in accordance with the M.U.T.C.D. and to leave tire or cleat marks. Colorado Supplements. S4.OF GOlO 222 South 6th Street, Room 100, Grand Junction, CO 81501-2769 P 970.683.6284 F 970.683.6290 www.coloradodot.lnfo I *71 ` N* */876* WORKER SAFETY AND HEALTH 13. No work shall proceed beyond the expiration date specified on the permit without written approval of the Department. 10. All workers within the State Highway right of way shall comply with their employer's safety and health 14. No work shall be permitted at night or on Saturday, policies/procedures, and all applicable U.S. Occupational Sunday, or holidays without prior authorization or unless Safety and Health Administration (OSHA) regulations- otherwise specified in this permit. including, but not limited to the applicable sections of 29 CFR Part 1910- Occupation Safety and Health Standards 15. On three(3)day weekend holidays,the project shall be shut and 29 CFR Part 1926-Safety and Health Regulations for down by 12:00 Noon on Friday,and not resume prior to the Construction. following Tuesday morning. Personal protective equipment (e.g. head protection, 16. Work hours for this permit are from one hour after sunrise footwear, high visibility apparel, safety glasses, hearing to one hour before sunset, unless otherwise stated in the protection, respirators, gloves, etc.) shall be worn as permit. appropriate for the work being performed,and as specified in regulation. At a minimum, all workers in the State 17. Permittee is responsible for the safety of the traveling Highway right of way,except when in their vehicles,shall public at all times when work is being done. wear the following personal protective equipment: 18. Forty-eight (48) hour notification must be given for the • Head protection, that complies with the ANSI underground location of CDOT owned facilities. Phone Z89.11997 standard; 970.384.3354 • At all construction sites or whenever there is 19. Any damage to highway facilities, such as traffic lights, danger of injury to feet, workers shall comply streetlights, concrete walkways, bike paths, asphalt, with OSHA's PPE requirements for foot signing, etc., shall be repaired and reported immediately protection per 29 CFR 1910.136, 1926.95, and and notification must be given to the CDOT Inspector or 1926.96. If required,such footwear shall meet the contact CSP Dispatch 970.824.6501 Craig&970.249.4392 requirements of ANSIZ41-1999; Montrose. • High visibility apparel as specified in the Traffic 20. Should any excavation encounter plant or animal fossils, Control provisions of this permit(at a minimum, the remains of historic or prehistoric structures,historic or ANSI/ISEA 107-1999,Class 2). prehistoric artifacts (bottle dumps, charcoal from subsurface hearths, pottery, potsherds, stone tools, Where any of the above-reference ANSI standards arrowheads,etc.),the operation shall cease at once and the have been revised, the most recent version of the permittee shall contact the CDOT Environmental Office standard shall apply. 970.683.6251 for guidance. CONSTRUCTION 21. Permittee assumes all responsibility for any and all land survey monuments within the permitted area of the right-of-way.If disturbed or destroyed,the permittee bears 11. The permittee must notify the CDOT inspector no less than full cost for replacement. Construction may need to be two (2) days prior to any work on highway right-of-way. re-routed to avoid disturbing High Accuracy Reference The CDOT Inspector's name, phone number, and email is Network Survey Land Markers Direct any questions within on the permit.If a break in work exceeds 7 days,the CDOT five (5) days prior to construction to: Region Survey inspector shall be notified of the changed work schedule. Coordinator at 970.683.6231. Notification may be given by phone or email. 22. If petroleum or other potentially hazardous material is 12. The CDOT inspector may suspend operations due to (1) encountered during excavation, work shall cease non-compliance with the provisions of this permit, (2) immediately and the permittee shall contact the CDOT adverse weather or traffic conditions, (3) concurrent Environmental Office 970.683.6251 for guidance. The highway construction or maintenance in conflict with the proper disposal of any soils or other material determined to permitted work,or(4)any condition deemed unsafe for the be hazardous and/or contaminated by fugitive petroleum workers or for the general public.Work may resume upon uncovered or excavated during the performance of utility disposal of grounds for suspension. construction shall be the sole responsibility of the Utility S4.OF GOlO 222 South 6th Street, Room 100, Grand Junction, CO 81501-2769 P 970.683.6284 F 970.683.6290 www.coloradodot.Info *�1 N* */876* and shall be accomplished in accordance with all 32. Unacceptable work shall be promptly removed and applicable Federal, State and Local laws and regulations. replaced in an acceptable manner. Final acceptance does Such clean up and disposal shall be at no cost to CDOT. not relieve permittee of maintenance obligations toward those elements of the highway facility constructed under 23. All construction vehicles, delivery vehicles and traffic this permit. control vehicles shall be equipped with flashing amber/yellow beacons, which are visible from all 33. All procedures and work are subject to CDOT approval. directions. Only construction vehicles involved in the construction are to be at the work site. It is important to 34. All work to be as per permit and submitted plans. limit the number of extraneous vehicles at each work site. Staging areas shall be pre-approved. MISCELLANEOUS 24. Staging and material storage areas,within the right of way 35. The permittee hereby assumes, releases and agrees to must be pre-approved and beyond the clear zone. indemnify, defend, protect and save the State of Colorado Employee parking within the right of way shall be harmless from and against any loss of and/or damage to the restricted and shall not be allowed,except in pre-approved property of the State of Colorado, third parties or the contractor staging areas and beyond the clear zone. The permittee's facilities including loss of services,loss and/or only vehicles allowed within the highway clear zone are damage on account of injury to or death of any person, the construction vehicles necessary for the operation. whosoever, arising at any time, caused by or growing out Parking along the shoulder of the highway is not allowed. of the occupation of Colorado State Transportation rights-of-way the permittee's facilities or any part thereof, 25. All backfill is subject to AASHTO standard compaction unless such loss and/or damage is the direct result of any T-99 or T-180 as appropriate. Compaction and materials willful and wanton act of the State of Colorado or its testing may be required at the discretion of the Department employees. of Transportation. Flow fill shall be used for all parallel installations within 6 feet of the asphalt. 36. Permittee is prohibited from any illicit or non-storm water discharges that are prohibited by State Water Quality laws. 26. No open cut allowed inside the toe of fill slopes or barrow If further information is necessary, CDOT shall provide a ditch line or within 15 feet of the paved shoulder or curb copy of the Environmental Clearances Summary. line,whichever is further from the centerline. Permittee agrees that it shall be responsible for obtaining all necessary environmental clearances and permits from 27. Material removed from any portion of the roadway must be all agencies (U.S. Army Corps of Engineers, Colorado replaced in like kind with equal or better compaction. No Divisions of Wildlife,U.S.Forrest Service,U.S.Bureau of segregation of materials will be permitted. Land Management, Colorado Department of Health & Environment, county health department, etc.) before 28. All pavement markings removed or damaged during the commencing any work under this permit. Without these utility installation will be replaced. clearances&permits,this permit shall be not in effect. Permittee also agrees to assume all responsibility and 29. Areas of roadway and right-of-way disturbed during this liability in connection with potential environmental work will be restored to the original contour and condition hazards encountered in connection with its work under this by grading to drain, top soiled, fertilized, mulched and permit.The permittee must show all environmental permits reseeded with approved material at specified proportions. and clearances to CDOT (Utility Inspector or Mulch, fertilizer and seed shall be "certified weed free". Environmental Officer) on request and prior to Refer to Section 212&213 of the"Colorado Department construction. of Transportation Standard Specifications for Road and Bridge Construction". 37. If any element of the highway facility, constructed or replaced as a condition of this permit fails within two years 30. Highway right of way fences shall not be cut. due to improper construction, installation or materials, permittee will be responsible for making all repairs 31. All work and materials to meet or exceed the most current immediately as notified. issue of the "Colorado Department of Transportation Standard Specifications for Road and Bridge 38. In the event of extreme fire danger and/or fire bans in Construction" &"Colorado Department of Colorado Counties, permittee shall develop a fire plan. Transportation Standard Plans-M&S Standards". 4;oF G ol0 0 222 South 6th Street, Room 100, Grand Junction, CO 81501-2769 P 970.683.6284 F 970.683.6290 www.coloradodot.Info I *�1 ` t* */876* Plan shall include fire protection/prevention equipment at the work site&the accountability of personnel. S4,oFGolO 222 South 6th Street, Room 100, Grand Junction, CO 81501-2769 P 970.683.6284 F 970.683.6290 www.coloradodot.Info I *�� t* */876* `yT COLORADO CO � Department of Transportation r. Region 3 Traffic Section 222 South 6th Street, Room 100 Grand Junction, Colorado 81501 (970)683-6288 Fax: (970)683-6290 PERMIT FINAL INSPECTION INSPECTION AND ACCEPTANCE Final acceptance begins the two-year warranty period I, David Kuhn, have inspected the area regarding Permit 3150365-U for the Colorado Department of Transportation. I find the area to be in satisfactory condition. CDOT INSPECTOR: DATE: PHONE: 970-445-8132 EMAIL: david.kuhn@state.co.us PERMITTEE: Town of Vail PERMITTEE REPRESENTATIVE: RETURN THIS PERMIT FINAL INSPECTION TO THE ADDRESS LISTED ABOVE 4:'4oF•COOO F 222 South 6th Street, Room 100, Grand Junction, CO 81501 P 970.683.6288 F 970.683.6290 www.coloradodot.lnfo `%i" ' * */876* •ACORD,,, CERTIFICATE OF LIABILITY INSURANCE DATE(MOONY) 12/22/2014 PRODUCER LIC 6N/A 1-303-757-5475 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION CIRSA ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 3665 Cherry Creek North Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 'Denver, co 60209 INSURERS AFFORDING COVERAGE • INSURED INSURER A.CIRSA Town of Vail INSURER B _ 175 South Frontage Road INSURERC Vail, CO 81657 INSURER Q -•— INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INTSRA POLICY EFFECTIVE 'POLICY EXPIRATION' TYPE OF INSURANCE POLICY NUMBER I DATE lMMIDDIYYI DATE IMMIODIVY LIMITS A GENERAL LIABILITY LIAR 01-2015 01/01/15 01/01/16 I EACH OCCURRENCE 5 5,000,000 © COMMERCIAL GENERAL LIABILITY FIRE DAMAGE An one fire 5 5,000,000 ■© CLAIMS MADE OCCUR MED EXP An one.-rson) 5 0 ©$lOm POL H&O Aggregate PERSONALSADVINJURY 55,000,000 ■ , GENERAL AGGREGATE 5 GEN L AGGREGATE LIMIT APPLIES�''" PER: PRODUCTS-COMP/OP AGG 5 9,000,000 POLICY pi 711::,i I Itoc A AUTOMOBILE LIABILITY LIAR 01-2015 01/01/15 01/01/16 D COMBINESINGLE LIMIT COMBINED 5 5,000,000 X ANY AUTO ALL OWNED AUTOS BODILY INJURY 5 (Per person) SCHEDULED AUTOS - HIRED AUTOS BODILY INJURY 5 (Per accident) NON-OWNED AUTOS PROPERTY DAMAGE 5 (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT 15 1 ANY AUTOOTHER THAN EA ACC I S AUTO ONLY: AGG 15 EXCESS LIABILITY EACH OCCURRENCE S OCCUR CLAIMS MADE AGGREGATE 5 5 DEDUCTIBLE S RETENTION 5 S I WC Sia- IOTH- WORKERS COMPENSATION AND I �R EMPLOYERS'LIABILITY E EACH ACCIDENT 5 E.L.DISEASE-EA EMPLOYEE 5 IIII E.L.DISEASE-POLICY LIMIT 15 OTHER 1 s s s DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Certificate Holder is Additional Insured on Liability Policies if required by contract. Constructing road improvements within the CDOT right-of-way. CERTIFICATE HOLDER Y 'ADDITIONAL INSURED;INSURER LETTER: A CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Colorado Department of Transportation-Region 3 DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.BUT FAILURE TO DO 5O SHALL Mike Verketie IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 222 Sc. 6th Street, Roam 100 REPRESENTATIVES. Grand Junction, CO 81501-2769 AUTHORIZED REPRESENTATIVE 7.c`. Y/.f'� USA / u ACORD 25-5(7197) AmandaR GACORD CORPORATION 1988 42458260