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HomeMy WebLinkAboutApplication.pdfRECE Garfield County SEP 19 2014Community Development Department 108 8t" Street, Suite 401 GARFIE=L.r) COUNTY Glenwood Springs, CO 81601 -)MMIUNITY DEVELOPME:NI (970) 945-8212 www.garfield-county.com ONSITE WASTEWATER TREATMENT SYSTEM (OWTS) PERMIT APPLICATION TYPE OF CONSTRUCTION X New Installation 0 Alteration WASTE TYPE X Dwelling 0 Repair 0 Transient Use 0 Comm/Industrial Non -Domestic 0 Other Describe INVOLVED PARTIES Phone: (970) Property Owner: WPX Energy 285-9733 Mailing Address: PO Box 370, Parachute, CO 81635 Contractor: WPX Energy Phone: (970) 285-9377 Mailing Address: PO Box 370, Parachute, CO 81635 Engineer: David Fox Phone: (970) 250-5505 Mailing Address: PO Box 370, Parachute, CO 81635 PROJECT NAME AND LOCATION Job Address: GM 13-33 - See the attached plat for description Assessor's Parcel Number: Building or Service Type: Distance to Nearest Community Was an effort made to 217133200019 Sub. house Lot Block Temporary office & #Bedrooms: 2 Garbage Grinder No Sewer System: connect to the Community NA Sewer System: NA Type of OWTS ❑ Septic Tank 0 Aeration Plant X Vault 0 Vault Privy 0 Composting Toilet ❑ Recycling, Potable Use 0 Recycling 0 Pit Privy 0 Incineration Toilet ❑ Chemical Toilet X Other Hauled to Down Valley Waste for their disposal Ground Conditions Depth to 15t Ground water table NA Percent Ground Slope NA Final Disposal by 0 Absorption trench, Bed or Pit 0 Underground Dispersal 0 Above Ground Dispersal ❑ Evapotranspiration 0 Wastewater Pond 0 Sand Filter X Other Hauled to Down Valley Waste for their disposal Water Source & Type 0 Well 0 Spring 0 Stream or Creek 0 Cistern X Community Water System Name Down Valley Septic and Waste Effluent Will Effluent be discharged directly into waters of the State? 0 Yes X No CERTIFICATION Applicant acknowledges that the completeness of the application is conditional upon such further mandatory and additional test and reports as may be required by the local health department to be made and furnished by the applicant or by the local health department for purposed of the evaluation of the application; and the issuance of the permit is subject to such terms and conditions as deemed necessary to insure compliance with rules and regulations made, information and reports submitted herewith and required to be submitted by the applicant are or will be represented to be true and correct to the best of my knowledge and belief and are designed to be relied on by the local department of health in evaluating the same for purposes of issuing the permit applied for herein. I further understand that any falsification or misrepresentation may result in the denial of the application or revocation of any permit granted based upon said application and legal action for perjury as provided by law. I hereby acknowledge that I have read a und- stand the Notice and Certification above as well as have provided the required informati whi is orrect and accurate to the best of my knowledge. Property wner Print and Sign 9-16-0 Date OFFICIAL USE ONLY Special Conditions: Permit Fee: 123 •DO Perk Fee:Total 0 Fees: 123.OD Fees Paid: 123.00 Building Permit Septic Permit: . , gg IssuAp ate: I -01 --1(-1 Balance Due: �- BLDG DIV: %.. '` ci, 2 7- 2")1 40 APPROVA DATE fa. 4 123.00) ✓* 3os121 2141 U C C a 0 •- oi•2 EL .> O �-U • (0 0 O a) L- "O E O - (0 moo a)_o-o •O a);>_U U -o a) Ea).c > °' Or a(f) > -00- 0C30 CO Ca U CO O a) O N 0 > O U a)�nU ca U O) -p a U(13 a) O a)� a a) 0E =C L 0 p 00 O U a) .c 43 - N o) to >.N'( a) N O I- (6 o r 2 J N N c`,E a) •T a6 a) O C ,U o _ U O p f, CE O (6 •V O .U1 2 (U6 O a) O) E a) "'' -Q Q 'a a C) (13 j p 0OCO(CV O 0p a O_ O a) U (n O n O 'tn2_UO ,'sO(n� = O) a) U -OO OU p a) CC d 1 L a a) E (6 L N o .V Lf) a) x a..' .N ' a) .5 N a) U 0 (a F- ( 4 4- (4 >, O c 4) E 'O co Y O p—+ -4--'C a) C S "O O O a) ...� a4--' "O a) -13 O O j N U C O, CC (d 0).O "O E N O ("6 C C .0 xx a) '- 0 L O 3 "O Q -d Laso(n , 00. a) co 0 r > ,aa) O a) _0 o a) 0 0 0 (n .c "J -0 -(Pr). I- o. .0 0 +, C C o •a c o w o CD 0.) T(6-0 p 0 ._ .1 O O a . N N (6 E >,= c E a) N - Q 3 c (d 2 �cr)M O Q O > 0)(f.)_ a) - a) > n C -C O 0 a) O - — _0 CO a)(6 a c U r a) a)-- - 0.5 O Eco0 o(a D. (6 A - O ° U (n C C L OL U C a+ L a) C 0 ) a) .c O a >, ca c a0) -0 Q7 0 U C 'J 0 (0 "° 0) 2 Q E > OU O O � C O 6 iu Section 33 T. 6 S, R. 96 W I l \ % .) 9 / 1 / / / °/ // / <';' / //, / / / 7 / 5Q 0/S.O PNT. Dayliccpit Ljne -�/ yA!°-. —✓ F 15.5 __.50' / /A soy • A= \\ GRAP IC $GALE IN FEET 1It1CH80,FEET NE # O sri F 18.1' `-- % \ \ .` F20.7' �- _,Y_iandt ' ��s S'aub esan 57433 rI i �irbed &-iv \ Gaf/Fiiliine Fo, - �Elev. _ N.__`Pam,` -..^' _ _ - �"– — b(owdow4-Tank ' -----:.:e20-1540.:- _`,la -X o� - / // r �~ :2— X Ex \ \II�t - ` ,\ \ -`I` \ 1 ist. Prod ion ` \ 1 pment C 12' v NAz 12519° \ SE#6 \ \ .\ I Pro p. GM 51333` y Q B L1 \ 90 Prop. GM 413-33 150' / C 0.2' 1J • \ 1 Prop. GM 313-33 , Prop. GM 41433 I WM.xis. GM 13-33 1 _ \ / / / /J,; \ A\\ \fiEF PVT- •- / /NExisqimih. / - - \ f [llsiprbaRce ESTIMATED EARTHWORK QUANTITIES (cy) ITEM CUT FILL TOPSOIL EXCESS PAD 28150 24150 4000 0 PIT 0 0 TOTALS 28150 24150 4000 0 \ Edge se _ _ _ _ ._ Exist. Pad Separator Units '0054-09- i i \. '\ \? 1. 71s I 0 i 1 640 48.- ^ ` — 150— — — , - S #7 , w ,-#8A " — 020.1' „.....'" / "C-17Or- OaylighiLine- / I 7 \Y/ / / 7 \ /1 / // //i 5ry �" // IPz! i // C\ 5770 �/ / i/ // /p / / / :.\` \ \. / / / / / \ ; ) i./., / REVISED: 6/24/14 136 East Third Street Rifle, Colorado 81650 Ph. (970) 625-2720 Fax (970)625:7.7 3 di BDOKCLIFF Surve Services, Inc. SCALE: 1 " = 80' DATE: 6/11/14 PLAT: 2 of 7 L *NOTE: 1.) 10% Swell Factor Applied to Earthwork Cut Volume. 2.) Topsoil Volume Based on 12" Soil Depth. 3.) Total Disturbed Area = ±4.24 ac. Construction Plan Prepared for: WPXENERGY_ WPX Energy Rocky Mountain, LLC PROJECT: Vallee DFT:: as GM 13-33 Drill Pad - Plat 2 CONSTRUCTION LAYOUT GM 13-3344 6111/2019 1:11:14 PM Section 33 T. 6 S., R. 96 W. 0 1000 2000 =II UN NMI GRAPHIC SCALE IN FEET 1 INCH= 2000 FEET ACCESS DESCRIPTION: FROM THE INTERSECTION OF STATE HIGHWAY 6 AND COUNTY ROAD 215 AT PARACHUTE, PROCEED NORTHERLY ALONG COUNTY ROAD 215 ±3.9 MILES TO AN INTERSECTION WITH A DIRT/GRAVEL ROAD, PROCEED LEFT IN A SOUTHWESTERLY DIRECTION ±0.6 MILES TO AN INTERSECTION WITH A DIRT/GRAVEL ROAD, PROCEED RIGHT IN A SOUTHWESTERLY DIRECTION ±0.5 MILES TO THE EXISTING GM 13-33 LOCATION, AS SHOWN HEREON. 136 Bost Third Street Rifle, Colorado 81650 Ph (970) 625-2720 Fax (970)625-277_Am3 BOOKCLIFF SCALE: 1 " = 2000' DATE: 6/ 11/ 14 PLAT: 5 of 7 PROJECT: Valleil UFT: CS Construction Plan Prepared for: WpXNfGY WPX Energy Rocky Mountain, LLC GM 13-33 Drill Pad - Plat 5 ACCESS ROAD & TOPO MAP 1111FYr�I'IAIU4h� llii'�Nldrlit'h 41�'Ml+nWkilli11111 Reeep2ronI: 515004 02127/2012 12:10:10 PM Jean 0tb0 loo I 01 2 Rao Fe0:510.00 Dee FeatO.00 GARFIELD COUNTY CO LTMTTED POWER OF ATTORNEY RTX ENERGY ROCKY MOUNTAIN, LLC ("Company") a Delaware limited liability company, having its principal place of business in the City of Tulsa, County of Tulsa, State of Oklahoma, does hereby make, constitute and appoint Bryan S. Hotard with the full authority hereinafter provided, the true and lawful Attorney -in -Fact of the Company, authorized and empowered on behalf of the Company and in the Company's name, and for the sole and exclusive benefit of the Company and not on behalf of any other person, corporation or association, in whole or in part, to enter into, execute, deliver, file and accept all instruments and documents affecting the real property or real estate rights of the Company as more specifically set forth below; : I. Applications and documentation associated with Garfield County or Rio Blanco permitting requirements for including, but not limited to, Independent Sewage Disposal Systems, Small Temporary Employee Housing, Major Impact Reviews, Limited Impact Reviews, Oil and Gas well permitting, Driveway Access, County Road Maintenance, Temporary Living Quarters, Temporary Use Permits, Surface Use Permits, Surface Use Licenses, Utilities, Snow Removal and Private Construction of County Roads; 2. Agreements and other documentation that grant easements, rights of way, licenses, or permits to Company and also instruments where the Company grants such rights to others; 3. Agreements that assign easements, rights of way, licenses, permits or surface leases in connection with the Company's operations; 4. Releases and Partial Releases of easements and rights of way; 5. Agreements allowing encroachments onto easements and rights of way owned by Company and landowner instruments and conveyances on others easements; 6. Agreements subordinating mortgage rights to easement or lease ; 7. Agreements relating to the modification and relocation of Company facilities; 8. Rental or lease agreements for surface use or other surface use agreements and all notices related to the pipeline agreements; 9. Agreements for the purchase or sale of real property and for the lease of real property for residential or commercial purposes or otherwise in connection with the Company's operations; 10. Agreements to obtain water services, electrical, gas or oil services or the provision of other utility services utilized by Company's facilities; 11. Agreements modifying, amending, renewing, extending, ratifying forfeiting, canceling and terminating any and all of the aforementioned types of instruments and documents. WPX ENERGY ROCKY MOUNTAIN, LLC hereby declares that each and every act, matter and thing which shall be given, made and done by Bryan S. Hotard in connection with the exercise of any or all of the aforesaid powers shall be as good, valid and effectual to all intents and purposes as if the same had been given, made and done by WPX Energy Rocky Mountain, LLC in its limited liability company presence and it hereby ratifies whatsoever Attomey-in-Fact shall lawfully do or cause to be done by virtue hereof. This Limited Power of Attorney shall remain in full force and effect until terminated by Company. v 1111EA111111/411111 Nt 141KIdP'RIMrth 140.111411111 Receptions: 816009 02/27/2012 12:18110 PR Jean Rlaarleo 2 of 2 Roo Foe:016.00 Doe Fee:0.00 OPRFIELD COUNTY CO IN WITNESS WHEREOF, WPX Energy Rocky Motuttain, LLC has caused this Limited Power of Attorney to be signed by one of its Vice Presidents, duly authorized by its Management Committee to grant powers of attorney this l" day of January, 2012. WPX _.. ttA, RO F. TAIN, LLC By. rnes Its:/ ice Pr • Meat ACKNOWLEDGMENT STATE OF OKLAHOMA ) ) ss. COUNTY OF TULSA BEFORE ME, the undersigned authority, a Notary Public in and for said County and State, on this day personally appeared, Jerry D. Barnes personally known to me to be the Vice President of WPX Energy Rocky Mountain, LLC a Delaware limited liability company, who acknowledged to me that he has executed the above LIMITED POWER OF ATTORNEY authorized by Company's Management Committee. IN WITNESS WHEREOF, I have hereunto set my hand and affixed my notary seal, theGC 4 1 day oft 2012. February My Commission Expires: 2, 23-2©114 Aker Recordation Please Return To: WPX Energy Rocky Mountian, LLC Attn: Land Dept. PO Box 370 Parachute, CO 81635 2