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HomeMy WebLinkAboutApplicationGarfield County Community Development Department 108 8th Street, Suite 401 Glenwood Springs, CO 81601 (970) 945-8212 www.garfield-county.com TYPE OF CONSTRUCTION ONSITE WASTEWATER TREATMENT SYSTEM (OWTS) PERMIT APPLICATION X New Installation 0 Alteration ❑ Repair WASTE TYPE X Dwelling 0 Transient Use , 0 Comm/Industrial 0 Non -Domestic 0 Other Describe INVOLVED PARTIES Property Owner: Bureau of Land Management Phone:(970) 876-9000 Mailing Address: Colorado River Valley Field Office 2300 River Frontage Road 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: RU 21-8 - See the attached plat for description Assessor's Parcel Number: 240317100952 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 O Septic Tank ❑ Aeration Plant X Vault 0 Vault Privy 0 Composting Toilet O Recycling, Potable Use 0 Recycling 0 Pit Privy 0 Incineration Toilet O Chemical Toilet X Other Hauled to Down Valley Waste for their disposal Ground Conditions Depth to 1" Ground water table NA Percent Ground Slope NA Final Disposal by O Absorption trench, Bed or Pit 0 Underground Dispersal 0 Above Ground Dispersal O Evapotranspiration 0 Wastewater Pond 0 Sand Filter X Other Hauled to Down Valley Waste for their disposal Water Source & Type O 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 i_ _ 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 r have provided the required in and understand the Notice and Certification above as well as which is correct and accurate to the best of my knowledge. Property Owner Print and Sign /D ,/�O/f Date OFFICIAL USE ONLY Special Conditions: Permit Fee: is., /� ' Perk Fee: Tota ees:Jj� VV. Fees Paid: 6 Buildin Permit $ c 11° Septic Permit: ce r - 3'1�/ Issue ate: to 2b/i,� Balance Due: BLDG DIV:' L 0Mir APP VAL DATE+ RU 21-8 Pad Vault System Description 41. � c c73 o �o k��>80 �E �� -\��2 a o — Q ° (2v .22" oea- V t5 ® b 2 2 o' . • § a 2 0 2 E ¥ o@�gR 222- E to o 0. ▪ "13 0502/-5 g j 7 c g 0 2 a) -ca' -a • £■ c o Q c 0 Eam-0(5 §2Cc2 ®Ro22 � t�§§ =©o.m o/ U)•c) �-a 0 o@lc■a (52L§ E a mWT 9- Ew -- a �. 2 ,072 eEs® 0£@CTm 2 2Ik 222-.0 t2 °— ■®a g3 ca to -N . §o -c o00.��-- 2�@ a) o k�\•CD oa) • ai222� 1D (5 -CNA 0 §ID> ± k >, E (5. o •. = a�/2mu) / ■ ' 7 /0000 § c2 221)22 2 � . § 2�§kc 0k�2k ) 0 2 eta©2 §o -c rE£§S 0I11IF&I'P11,4111111#11,1■fQ114l4ia wIr 111 141. III 01111 Reccptlanli: 815094 0212712012 12 1O.?0i P11 Joan 1llberaco 1 or 7 Rap F40;f16 CO Dao FooTO 00 GARFIF_1.D COUNTY 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 with the ful: 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 nr 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 casements, 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; S. 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 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 ail services or the provision of other utility services utilized by Company's facilities; 11. Agreements modifying, amending, renewing, extending, ratifying forfeiting, canceling and terminating arty 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 Iimited liability company presence and it hereby ratifies whatsoever Attorney -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. Q111I'.11i4 01111 RecaptIcnN: at5004 8212712012 12.18.10 P11 Joan Pib 2 of 2 Ree Fee:$18.00 Doc Fee:D.00 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 f° day of January, 2012. WPX r RO ., AIN, LLC By. D. es Its:/ ice Pr 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. Barites 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, thein ! day of-Januarp2012. velar taxY Notary Public My Commission Expires: 2, -2.5 2 0124 KIMBERLY J. new Wary y.ei.rmod wr.w r,ruMDrrrwr After Recordation Please Return To: WPX Energy Rocky Mountian, LLC Attn: Land Dept. PO Box 370 Parachute, CC) 81635 Section 8 T. 7S., R. 93 W rr r r r r r r rr / / • r' / / r' / rr s r/ ` / / / /' r y Proposed // / / Acre/ f�oad / / 1 / / // / rrr / / // / / / r` / r • / r r r '0 ff / T �t2 F 3.1' T F 0.1, / / r T C11 proposed /7, } VOC Unjt Daylight Line•- s 11° / Ed§e o1 /Proposed Pad / 0 100 GRAPHIC 8CALE IN FEET 1 INCH=100FEET �T� / ' per • AC / Z.tf, a y/ /".- - ' Cut/Fit!Line / • . Liner 0•r` •� / r Od r' ''nnh / l� / 50� /// /! / / o / / /)#' // // /f/ / r/ .'.Goya'' .04� $ / / / <1/4:.Z: Q- , / yrr 0 p r` •¢C r sro ri`� 427 - / 'Zo / / / / / r / s6 / ' r r �r /rr r r /r ei's s.�,.1- go.,P / r. t 19 • ,,,��a�G ,,., ; / �,P'PGL�' L `P' r / ; rPGSy?�� / // j$ / // / r / /p / ///�(�15 °� //' // 1(i r% r' r ESTIMATED EARTHWORK QUANTITIES (cy) ITEM CUT FILL TOPSOIL EXCESS PAD 23950 16940 7500 -490 PIT 19300 19300 TOTALS 43250 16940 7500 18810 C� F' // • / / i/ // / // r f r /` r / / f/ / r / r'. f'r i �S / / �- D• ay• light/line ine / / • / ` / / / / / / / / iF "NOTE 1.) Topsoil Volume Based on 12" Soil Depth. / n // , 2,) 10% Swell Factor Applied 10 Earthwork Cul Volume. / r / 3.) Total Disturbed Area = ±7.74 ac. ✓ / REVISED: 6/2/75 Construction Plan Prepared for: WPXENERGY WPX Energy Rocky Mountain, LLC — yr ▪ / r 136 Errs1 Third Street Rjtie, Colorado $1650 Ph. 1970) 625.2720 Fax (970) 625.2773 Sttt'trc')+ St',-trices, Inc. SCALE: r - I00° DATE: 10/ 15/14 PLAT: 24)1'7 PROJECT: Valleu DFT: curs RU 21-8 Drill Pad - Plat 2 CONSTRUCTION LAYOUT Section 8 T. 7 5, R. 93 W Jr A A ( 1004 2000 ����a�r GRAPHIC SCALE IN FEET (INCH = 2000 FEET ACCESS DESCRIPTION: FROM THE INTERSECTION OF STATE HIGHWAY 6 AND COUNTY ROAD 323 (RULISON ROAD) NORTH OF RULISON, PROCEED SOUTHERLY ALONG COUNTY ROAD 323 (RULISON ROAD) .11.1 MILES TO THE INTERSECTION WITH COUNTY ROAD 309 (RULISON PARACHUTE ROAD), PROCEED LEFT IN AN EASTERLY DIRECTION 32.3 MILES TO THE INTERSECTION WITH COUNTY ROAD 320 (RIFLE RULISON ROAD), PROCEED RIGHT IN AN EASTERLY DIRECTION 16.2 MILES TO THE INTERSECTION WITH COUNTY ROAD 317 (BEAVER CREEK ROAD), PROCEED RIGHT IN A SOUTHERLY DIRECTION 33.6 MILES TO AN INTERSECTION WITH A DIRT/GRAVEL ROAD, PROCEED LEFT IN AN EASTERLY TO NORTHEASTERLY DIRECTION *2.7 MILES TO AN INTERSECTION WITH A DIRT/GRAVEL ROAD, PROCEED RIGHT IN A SOUTHRLY DIRECTION ±0.2 MILES TO THE RU 21-6 DRILL PAD LOCATION, AS SHOWN HEREON. f1:36 East T1 -4&,e ROle, Lbl6rad3 81650 }Ph. r9 70 6242 720 Paz (970) 625-2 773 .4.40 BOOKCLIFF LS'U1'VC)1 SerlriC 1 ! e. SCALE. 1" 2000' DATE 10/ 15/ 19 PLAT. 5 nil PROJECT: Valle DF7' Construction Plan Prepared for: �7 WPX Energy Rocky Mountain, LLC RU 21-8 Drill Pad - Plat 5 ACCESS ROAD & TOPO MAP WPXENERGY WPX ENERGY ROCKY MOUNTAIN, LLC "UrT PO BOX 21358 TULSA, OK 74121-1358 PAY DATE Sep 30, 2015 Invoice Date Sep 29, 2015 SUPPLIER NO. 527487 Inv Num: 29 -SEP -2015 Inv Desc: RU 21•B PAD OTWS PERMIT FEE SUPPLIER NAME GARFIELD COUNTY BUILDING & PLANNING Invoice / Credit Memo Invoice Description Supplier Support 1-866-581-4981 COMPANY NUMBER: 3057 CHECK NUMBER: 3057300034 Gross 575.00 Page Totals Discount 50.00 50.00 CHECK TOTAL $75.00 Net 575.00 575.00 VERIFY THE AUTHENTICITY OF THIS MULTI -TONE SECURITY DOCUMENT. pi CHECK BACKGROUND AREA CHANGES COLOR GRADUALLY FROM TOP TO BOTTOM. E) WPX ENERGY ROCKY MOUNTAIN, LLC JPMorganChase'Bank,NA. ' : 70:2322/419 PO BOX 21358 cnlcage, IL TULSA, OK 74121-1358 Company Number: 3057 WPXENERGY Seventy -Five Dollars And Zero Cents Pay To The Order Of GARFIELD COUNTY BUILDING & PLANNING ATTN: BROOKE WEINING 108 8TH ST, STE 401 GLENWOOD SPRINGS, CO 81601 US 00000000000000920850 Check Number: 3057300034 Check Date: Sep 30, 2015 PAY (USD) 1 $75.00 Authorized Signature "30 5 73000340 4:0 7 19 23 2 261: 0009 20850v