Loading...
HomeMy WebLinkAboutApplication11 Viii A11 1 0 Repair Garfield County 1 Community Development Department 108 8th Street, Suite 401 Glenwood Springs, CO 81601 (970) 945-8212 www.garfield-county.com ONSITE WASTEWATER SYSTEM (OWTS) PERMIT APPLICATION TYPE OF CONSTRUCTION X New Installation L❑ Alteration WASTE TYPE X Dwelling 0 Other Describe ❑ Transient Use 1 ❑ Comm/Industrial ❑ Non -Domestic INVOLVED PARTIES Property Owner: BLM Phone:( Mailing Address: 2300 River Frontage Rd, Silt, CO 81652 Contractor: WPX Energy Mailing Address: PO Box 370, Parachute, CO 81635 Engineer: David Fox Phone: (970) 285-9377 Mailing Address: PO Box 370, Parachute, CO 81635 Phone: (970) 250-5505 PROJECT NAME AND LOCATION Job Address: GM 32-4 - See the attached plat for description Assessor's Parcel Number: 240921200952 Sub. Lot Block Building or Service Type: Temporary office & house #Bedrooms: 2 Garbage Grinder No Distance to Nearest Community Sewer System: NA Was an effort made to connect to the Community Sewer System: NA Type of OWTS 0 Septic Tank j 0 Aeration Plant X Vault • 0 Vault Privy 1 0 Composting Toilet ❑ Recycling, Potable Use 0 Recycling 0 Pit Privy 0 Incineration Toilet 0 Chemical Toilet X Other Hauled to Down Valley Waste for their disposal _ Ground Conditions Depth to if` Ground water table NA Percent Ground Slope NA Final Disposal by 0 Absorption trench, Bed or Pit 0 Underground Dispersal '; 0 Above Ground Dispersal 0 Evapotranspiration I 0 Wastewater Pond 0 Sand Filter X Other Hauled to Down Valley Waste for their disposal —I Water Source & Type 0 well f 0 Spring 0 Stream or Geek 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 1 have have provided the required inf• m 10 Property Owner Print and Sign and understand the Notice and Certification above as well as which is correct and accurate to the best of my knowledge. .4;16// rim/9" Da OFFICIAL USE ONLY Special Conditions: Permit Fee: oas Perk Fee: MIA Total Fees: ° pA ca- Fees Paid: co 7Ia 2 Buildin Permit 'lq•Alli Septic Permit: LIEW- Issue ate: 19-i -fr2-040 (4 Balance Due: ri SP 7 BLDG DIV: -� 12-` -Z"2 .- APPROVAL DATE ki ‘2-E0r1/9 1/R3 - GM 32-4 Pad Vault System Description �[-a kaf$CO 03@§ecmm8uao-0 §\�/ �7)� �0al oas E kED©��25 01 k2 c/��co /\ v�sij 00) 0@.�%22 >,�a $ %§22�ac k/IEk S 2 B� A2 k f £@ fes 70.10 a", g. b_��e .c■x%Eu-0 ��2=-c $22©�"R. CL X51 %£®g0 =7 o■ �22mzi o�=I>S± %22�� 777■asuu k�\@2�2 16§$�E t03C$ o "- ci) 03 k0�w CLk ,0 %0.2=2£ 200 , '§ 22$2222 §011X§& fa%Sk $2�E�&_/ o2��iE u)§u,c2 2 E cm° 2 2 > o 3 P iv, 2 2 x§ 2 222��27 k��kR° °&a2§ .in ■ �. 2�©2�2/ 0=�� � us _� c o=o■£ »_ � — 73 �� � u@=== -0■—■2�� ..,-9 °2 22 raI�22 03>2Cou= CLZ.■2co§ �2=�2 22a�g�2 c��c§gk §222§ OREan=ca 0o_5�-a@12 CCE£>o WPX Energy Rocky Mountain, LLC wtina8 PLAT #2- AS -BUILT SITE PLAN FOR GM 32-4 SEC11ON 4, T7S, R96W, 6th P.M. SCALE: 1" = 80' DATE: 11-27-13 DRAWN BY: M.D. REV.: 03-30-14 REV.: 04-15-14 owl c Z5NRE r • Top of Berm Toe of Fill I0 Existing +36- CMP Existing Drainage Existing Road Existin Road Overflow Tank Water Tank ssj2 Flare Tank Production Units } Soles Line Existing Valve Set APPROXIMATE PAD FINISHED GRADE ELEV. = 5532 4' Top of Berm Toe of Fi// Edge of Existing Pad Existing 3S" CMP NOTE.• 2' Contour Interval. UINTAH ENGINEERING & LAND SURVEYING BS So. 200 lost • Verna; MA 84078 • (NW 789-10f7 LEGEND: PROPOSED ACCESS ROAD EXISTING ROAD Uintah Engineering & Land Surveying 85 South 200 East Vernal, Utah 84078 (435) 789-1017'" FAX (435) 789-1813 WPX ENERGY ROCKY MOUNTAIN, LLC GM 32-4 SECTION 4, T7S, R96W, 6th P.M. ACCESS ROAD & TO PO M A P 03 mom 27 DAY 13 YEAR 5 SCALE: 1"=2000'1 DRAWN BY: MG IREV:04-07-14.1.M.F PLAT EiRcc�e4k illl4KbW1�i ® T70„Jam'e�0i 1 7R* Fe0;71600Do Fst00GARFIELD COWRY CO LIMITED POWER OF ATTORNEY WPX 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 witli 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 es more specifically set forth below: : L 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 casements; 6. Agreements subordinating mortgage rights to casement 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 bad 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. 1 0111K11111841MINCRItliV114CINCIIVI 01111 Rae.,tlonP : 610004 02/2712012 ¶2t*a110 PI1 Joan PLbsrleo 2 or 2 P.a FeeSSi0.00 dee F.e:e.e0 GARFIELD COUNTY Co IN WITNESS WHEREOF, WPX Energy Rocky Mountain, 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 1" day of January, 2012. X By. n4 Jts ice P ROAIN, LLC es ident STATE OF OKLAHOMA ) ) ss. COUNTY OF TULSA ) ACKNOWLEDGMENT 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 Iimited 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, the day of -I ary; 2012. cry Notary Public My Commission Expires: 2.. - 23 - 2 OIL-/ NIMIERLYIOE71r ,w,pars battler w, nr.eewrr CMN IMIMI ►yorrilmrmpilla 4�oM After Recordation Please Return To: WPX Energy Rocky Mounlian, LLC Attn: Land Dept PO Box 370 Parachute, CO 81635 7