HomeMy WebLinkAboutApplicationCommunity Development Department
108 8th Street, Suite 401
Glenwood Springs, CO 81501
leTole4s-82L2
www. garfield-countv.com
X New lnstallation tr Alteration tr Repair
X Dwelline lETransientUse lO Comm/lndustrial ln Non-Domestic
E Other Describe
PropertyOwner: YoubereBeaverCreekRanch Phone: (.77216624212
Mailing Address: 215 S 10th Street Sac Citv. lA 50583-2137
Contractor: TEP Rockv Mountain LLC Phone: (.9TOI 285-9377
Mailing Address:PO Box 370. Parachute. CO 81535
Engineer:David Fox Phone:@
Mailing Address: PO Box 370, Parachute, CO 81635
Job Address: RU 22-7 Pad
Assessor's Parcel Number: 240307300001 Sub.Lot Block
Building or Service Type: Temporary office & house #Bedrooms:2 GarbageGrinderS
Distance to Nearest Community Sewer System: NA
Was an effort made to connect to the Community Sewer System: NA
E,$sRttc.ffik i:B:Aalillott?lrlt]r,l,x!,fiq8 , [ 'g vadtprlw ',rE1l r :TiiffiFi
E Becyelin$ Potable Use EI Rccycli4g'l tr nitnnry I El lndneratlonToilet
B Chemical Toilet X Other Hauled bv HB Rentals to Garfield Countv La.ndfill
Disoosal Site
Ground Conditions D€pth to lst Ground water table NA I Percent Ground Slope NA
Final Disposal by E Absorption trench, Bed or Pit I E Underground Dispersal I E Above Ground Dispersal
E Evapotranspiration E Wasteweter Pond I E Sand Fiher
X Other t{arrlad hv HB Rentals ta Garfield lnrrntv I andfill Di<nncel Sit.
Water Source & Type tr well E Spring E Stream orCreek E Cistern
X Community Water System Name Citv of Rifle Bulk fi2 - Hauled bv HB Rentals
Effluent uWlEffluent be discharted directly into waters of the State?Yes XNo
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
eva luation of the application; and the issuance of the permit is subject to such terms and conditlons
as deemed necessary to insure compliance with rules bnd rigulatiSns 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 t'he permit applied forherein. 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 and understand the
have provided the required information which
Property Owner Prlnt and Slgn
7.AS-L(o 875.
Certlfication above as wel! as
and to the best of my knowledge.
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-Redeption$: 879851
@7t1d12@16 E2:,l8:46 Pl.l Jean Albericoof 2 Rec Fee:$16.@@ Doc Fee'0.0@ GARFIELD COUNTY C0
POWER OF ATTORNEY
KNOW ALL PERSONS BY TI{ESE PR.ESENTS:
SCIT{FORffiED
eopv
TIIAT TEP ROCIil MOIJNTAIN T.r.C, a Delaware limited liability company, hereby nominates,
constitutes, and appoints Bryen S. Hotard, as its true and lawful Attomey-in-Fact to execute and deliver
in the name and on b€half of IEP ROCIff MOITNTAIN LI,C ("Principal') any of the following
desipated instruments or documents in connection with the Principal's opemtions in eryloring for and
producing oil, gas, or oth€r minerals ftom landg or interests in lands, owned, held, or claimed by the
United States, any stde or political zuMivision thereof, any person, corporation, partnership or other legal
entity:
A. (l) Applioations for permits or leases; (2) consbnts, stipulatims, or.agreemcnts in connection with
the issuance of permits or leases; (3) accephnces of leases, zubleaseq or permib; (4) acceptances of all
instruments tansferring leases, offers to lease, pennits, applications for permitg on subleaseq or an interest
in any ofthese (including 6signmmts of working or royalty intercsts) to principal.
B. Applications fore:rtensions or renewals of leases and permits.
C. (1) Prospecting; seismic, or ercplordion permits; (2) insnuments in connection with the acquisifion
or maintenance of prospecting seismic, or exploration permits.
D. Instuments withdrawing applications for leases or permits.
E. (l) Requese for rights-of-way anil surface use permits; (2) acceptanoe of grurts of rigfttsof-way
and surface use perrrie, including any stipulation or condition in the granb; (3) any stEtements that may be
required in connection with applications for riglts-of-way urd surface use permits.
F. Requests for e:rtension oftime in which to drill wells.
Principal agrees to be bound by all representations the Attorney-in-Fact may make in any insffumert or
dccument he or she is authorized to execute and deliver under this Power of Attorney. Principal hereby
waives any defenses available to it to contest, negate, or disaffirrr tbe actions of its Attorney-in-Fact under
this Powerof Afrorney.
This Power of Attomey is effective July l, ZbtO, ana shall continue in full force and effect until rpvokEd in
writing, and has the same force and effect as if the Principal granted separate special autrority to the
nmed Attomey-in-Fact to execute and deliver each such insfiument or documelrt seeardety for eaoh and
every such instrument or document so executed and delivsed.
EXECUTED by Principal on this 13ft day ofJuly, 2016.
Terra Energl Pertuers IJ,C as sole member of
TEPRocky Mountain LLC
AGREEDTOAIID ACCEPTED
BY:
2
Attomey-in-FactITS: Presid€Nrtmd CEO
ACKNOWLEDGEMENT
State ofTexas
Countyofllanis
corporation.
(Notary SeaI)
3-2016[ Michael s. Lm4 known to
LI,C.,aDelaware corporation, on behalf of the
nFrAr{Y cEtEr,t Pot tocr(
Nofory Pub,lE Srole of lexos
My Cornmlcslon Expltes
Aprll 26, 20I9
Section 7
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GMPHIC SCALE IN FEET
1 INCH = 80 FEET
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ESTIMATED EARTHWORK QUANTITIES (cy)
EI{Iffv wPX Enersy Rocg Mountain, LLCSCALE:
DATE:
PI,AT:
PRA]ECT:
DFT:
RU22-TDrillPad - Plat2
CONS?RUCYION I,AYOUT
Sedion 7r.7s.,R9sw
ACCESS DESCRIPTION:
FROM THE INTERSECTION OF STATE HTGHWAY 6 AND COUNTY ROAD 323 (RUL|SON ROAD) NORTH OF RUL|SON, PROCEED SOUTHERLY
ALONG COUNTY ROAD 323 (RULISON ROAD) 11.1 MILES TO THE INTERSECTION WITH COUNTY ROAD 309 (RULISON PARACHUTE ROAD),
PROCEED LEFT lN AN EASTERLY D|RECT|ON r2.3 MTLES TO THE TNTERSECTTON WITH COUNTY ROAD 320 (R|FLE RULTSON ROAD),
PROCEED RIGHT lN AN EASTERLY DIRECTION 16.2 MILES TO THE INTERSECTION WITH COUNW ROAD 317 (BEAVER CREEK ROAD),
PROCEED LEFT ALONG COUNry ROAD 317 IN A SOUTHERLY DIRECTION 13.6 MILES TO AN INTERSECTION WITH A DIRT/GRAVEL ROAD,
PROCEED LEFT IN AN EASTERLY DIRECTION 11.2 MILES TO THE ?U 22:7 DRILL PAD LOCATION, AS SHOWN HEREON.
WW wPX Energy Rocky Mountain, LLCSCALE:
DATE:
PLAT:
PRA]ECT:
DFT:
RU22-TDillPad - Plat 5
ACCESS ROAD & ?Orc ]WAP