HomeMy WebLinkAboutApplicationGarfield County
Community Development Department
108 81h Street, Suite 401
Glenwood Springs, CO 81601
(970) 945-8212
www.garfield-county.com
TYPE OF CONSTRUCTION
X New Installation ❑ Alteration ❑ Repair
WASTE TYPE
X Dwelling ❑ Transient Use ❑ Comm/Industrial ❑ Non -Domestic
❑ Other Describe
INVOLVED PARTIES
Property Owner: Chevron USA INC Phone:(
Mailing Address: PO Box 285 Houston, TX 77001
Contractor: TEP Rocky Mountain LLC 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: TR 44-27-597 Pad - See the attached plat for description
Assessor's Parcel Number: 213722300003 Sub. Lot Block
Building or Service Type: TemporarV 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
❑ Septic Tank
❑ Aeration Plant
X Vault
❑ Vault Privy
I ❑ Composting Toilet
—ff Recycling, Potable Use
❑ Recycling
❑ Pit Privy
❑ Incineration Toilet
❑ Chemical Toilet
X Other Hauled by HB Rgntals to Garfield Caunty Landfill
Disposal Site
Ground Conditions
I Depth to ls' Ground water table NA
Percent Ground Slope NA
Final Disposal by
❑ Absorption trench, Bed or Pit ❑ Underground Dispersal I ❑ Above Ground Dispersal
❑ Evapotranspiration ❑ Wastewater Pond ❑ Sand Filter
X Other Hauled by HB Rentals to Garfield County Landfill Disposal Site
Water Source & Type
❑ well
❑ Spring
❑ Stream or Creek
❑ Cistern
X Community Water System Name City of Rifle Bulk q2— Hauled by HB Rentafs
Effluent
Will Effluent be discharged directly into waters of the State? 11 Yes X No
CERTIFICATION
Applicant acknowledges that the completeness of the application is conditional upon such turther
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.
hereby acknowledge that I have read andwyerstand the Notice and Certification above as well as
have provided the required information ch s correct and accurate to the best of my knowledge.
p? �7
Property Owner Print and Sign Date
OFFICIAL USE ONLY
Special Conditions:
Permit 7Fee: O
T5 •
Perk Fee:
TotalFees:
Ya
Fe_Te�jPaid:
00
Building Permit
Septic Pemit:
Issue Date:
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BalanFe DuD
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BLDG DIV:
APPRo !J—
DATE
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mill kF AIM Phy-d M11 ANUMS YN 9 11&11 11111
—Rel6epticn#: 87985I
07/18/2016 02:10;46 PSI Jean Rlberico
1 of 2 Rec Fee:$16.00 Doc Fee 6.00 GPRFFELD CQVNTY CO
POWER OF ATTORNEY CONFORMED
KNOW ALL PERSONS BY THESE PRESENTS: COPY
THAT TEP ROCKY MOUNTAIN LLC, a Delaware limited liability company, hereby nominates,
constitutes, and appoints Bryan S. Hotard, as its true and lawful Attorney -in -Fact to execute and deliver
in the name and on behalf of TEP ROCKY MOUNTAIN LLC ("Principal") any of the following
designated instruments or documents in connection with the Principal's operations in exploring for and
producing oil, gas, or other minerals from lands, or interests in lands, owned, held, or claimed by the
United States, any state or political subdivision thereof, any person, corporation, partnership or other legal
entity:
A. (1) Applications for permits or leases; (2) consents, stipulations, or.agreements in connection with
the issuance of permits or leases; (3) acceptances of leases, subleases, or permits; (4) acceptances of all
instruments transferring leases, offers to lease, permits, applications for permits, or subleases, or an interest
in any of these (including assignments of working or royalty interests) to Principal.
B. Applications for extensions or renewals of leases and permits.
C. (1) Prospecting, seismic, or exploration permits; (2) instruments in connection with the acquisition
or maintenance of prospecting, seismic, or exploration permits.
D. Instruments withdrawing applications for leases or permits.
E. (1) Requests for rights-of-way and surface use permits; (2) acceptance of grants of rights-of-way
and surface use permits, including any stipulation or condition in the grants; (3) any statements that may be
required in connection with applications for rights-of-way and surface use permits.
F. Requests for extension of time in which to drill wells.
Principal agrees to be bound by all representations the Attorney -in -Fact may make in any instrument or
document 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 disaffirm the actions of its Attorney -in -Fact under
this Power of Attorney.
This Power of Attorney is effective July 1, 2016, and shall continue in full force and effect until revoked in
writing, and has the same force and effect as if the Principal granted separate special authority to the
named Attorney -in -Fact to execute and deliver each such instrument or document separately for each and
every such instrument or document so executed and delivered.
EXECUTED by Principal on this 13a' day of July, 2016.
Terra Energy Partners LLC as sole member of
TEP Rocky Mountain LLC
AGREED TO AND ACCEPTED
BY:
BY: Michael S. Land
ITS: President and CEO
Attorney -in -Fact
2
ACKNOWLEDGEMENT
State of Texas
County of Harris
This instrument was acknowledged before me on 2016 by Michael S. Land, known to
me to be the President and CEO of Terra Energy Partnefs LLC, a Delaware corporation, on behalf of the
corporation.
(Notary Seal)
a'a TIFFANY CEBELL POLiOCK
_?'' � z Notary Public, State of Texos NW48ublic
My Comminion Expires
April 26, 2019
Section 27 8470-
T. 5S, R. 97 W
e0
W I m ,, GRAPHIC SCALE IN FEET
��� 11NCW=89 FEET
—
O
Exist. Limit ��Existr�ei
of Disturbance
50'01S
EF. PNT. 1 �l
A F 0.1' C 0.2 C 0.8' l� AA
�40'R 110' 61' E#1B
Ill
Exist. VOC Unit O � C 5.8'
N#7A- m a
h� ` / e
a 1 C1.6m
�I �� rn It" I
i
tn
LU
! 1
D m
m
j M
SeparatorRrea � ��QP
1 (70'x30) c
IIII Ex. TR 513-2b-,5 101* rpp. TR 43-27-597 J
l IB1❑ Prop. TR 343-27-597
111 Ex. TR 543.2��97 * Prop. TR 443-27-597
B Nw 0- #6" as As NAz. 130.97° 90' SE 0- #2 _ D
fx. TR 344.27. 97 A7 r B $
F23' 140' Prop. TR 533-2797 Prop, TR 433-27-597 C 0. 1'
' l Prop. TR 334.27-597 A5
i Ex. TR 41.34.15 B3 A3 TR 544-27-597
Ex. TR 441-34-697* Prop. TR 534-27-597 AP #1
EE c. TR 42-34-597 . C 0.0
1
I N sr. AP #2 y
C 17.0' o
Clio n0 M 4�'
-411
at�5
fa%L��
Z Daylight Llne
a
Daylight Line
Edge of
Exist. Pad o
W #5 150' 47' . . S #3 CC
C F 1.8' Sw o- #4 C 17.5
C 0.1 i / $ of
50'o/S �l
REF.
PVT* l�
Exist. Trail _f
ESTIMATED EARTHWORK QUANTITIES (cy)
ITEM
CUT
FILL
TOPSOIL
EXCESS
PAD
4440
1240
0
3200
PIT
1400
1400
TOTAL
5840
1240
0
4600
736 E'rm t Mril a rine l
Rifles, Ll�iarodo 51656
Ph 1970) 625.2720
rax (9701625.2773
REVISED: 8/16/16
SCALE.
I" = 80'
DATE:
a 7 9! I.4
PLAT:
2 of 10
PROJECT: Trail Ridge
DFT:
Cs
*NOTE:
1.) Topsoil Volume Based on 12" Soil Depth.
2.) 10% Swell Factor Applied to Earthwork Cut Volume
3.) Total Disturbed Area = t9.42 ac.
Construction Plan Prepared for:
TERFji► TEP Rocky Mountain LLC
TR 44-27-597Drill Pad - Plat 2
CONSTRUCTIONLAYOUT
Section 27
T. 5 S., R. 97 W. p f
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ACCESS DESCRIPTION:
FROM THE INTERSECTION OF THE 1-70 FRONTAGE ROAD AND COUNTY ROAD 215 AT PARACHUTE, PROCEED IN A
NORTHERLY DIRECTION ALONG COUNTY ROAD 215 ±7.2 MILES TO THE INTERSECTION WITH GARDEN GULCH ROAD,
PROCEED LEFT IN A WESTERLY DIRECTION ALONG GARDEN GULCH ROAD ±19.6 MILES TO AN INTERSECTION WITH A
DIRT/GRAVEL ROAD, PROCEED LEFT IN A SOUTHERLY DIRECTION ±0.8 MILES TO THE EXISTING TR 44-27-597 DRILL PAD
LOCATION, AS SHOWN HEREON.
REWSED: 8/9/16 Construction Plan Prepared for:
136 East Third Street SCALE: I" = 2000' TERW TEP Rocky Mountain LLC
Rifle, Colorado 81650 DATE: 9/19/14
Ph. (970) 625-2720 PLAT. 5 of 10
Fax (9 70) 625-277`+Il�l`t� ■ f PROJECT: Trail Ridge TR 44-27-597Drill Pad - Plat 5
DFT: CS ACCESS ROAD & TOPO MAP