TOWN OF PARACHUTE

WATERSHED PERMIT APPLICATION

THIS PAGE LEFT BLANK FOR TWO-SIDED DUPLICATION.

TOWN OF PARACHUTE PO BOX 100 222 GRAND VALLEY WAY PARACHUTE, CO 81635

LAND USE APPLICATIONName of Applicant: _________________________________________________________________

(IN CLUDE ADDRESS AND TELEPH O NE NO .)

Project Name: _________________________________________________________________________

Project Location: ______________________________________________________________________

LEGAL DESCRIPTION: _______________________________________________________________

Existing Zoning: _________________________ Proposed Zoning: ________________________

Type of Application (check all that apply):SUBDIVISION:

[ ] M INOR SUBDIVISION

[ ] M AJOR SUBDIVISION [ ] PRELIM INARY [ ] FINAL

[ ] RE-SUBDIVISION [ ] PRELIM INARY [ ] FINAL

[ ] P. U. D. [ ] PRELIM INARY [ ] FINAL

[ ] BUILDING DIVISIONS [ ] PRELIM INARY [ ] FINAL

[ ] AM ENDED PLAT [ ] PRELIM INARY [ ] FINAL

[ ] REZONING [ ] SIGN VARIANCE

[ ] ZONING VARIANCES [ ] FLOOD PLAIN DEVELOPM ENT

[ ] SPECIAL REVIEW USE [ ] VACATION OF STREET, ALLEY, R.O.W.

[ ] GEOLOGIC DEVELOPM ENT [ ] ANNEXATIONS

[ ] LOT CONSOLIDATION [ ] WATERSHED PERM IT

PROPERTY OWNER: ______________________________________________________________________________________________________________________________________________(INCLUDE NAM E, ADDRESS, AND TELEPH O NE NO .)

PROJECT ENGINEER/SURVEYOR:____________________________________________________________________________________(INCLUDE NAM E, ADDRESS, AND TELEPH O NE NO .)

____________________________________________________________________________________(INCLUDE NAM E, ADDRESS, AND TELEPH O NE NO .)

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Ursa Operating Company LLC/792 Buckhorn Dr. Rifle CO. 81650- Ph. # 970-625-9922

BMC L Pad

Battlement Mesa, CO.

Township 7 South, Range 95 West, Garfield County. CO.

X

Scott Abiner, River Valley Survey Inc. 110 East 3rd Street Suite 213, Rifle,CO. 81650-Ph # 970-379-7846

ADJACENT PROPERTY OWNERS: (attach separate sheet if needed)

Name Address________________________________________________________________________________________________________________________________________

___________ _______________________________ _______________________________ _______________________________ _______________________________ __________________________________

MINERAL RIGHTS OWNERS & LESSEES OF SUBJECT PROPERTY (attach separate sheetif needed) *PLEASE NOTE ALL MINERAL RIGHTS OWNERS AND LESSEES MUST BE NOTIFIED 30

DAYS IN ADVANCE TO APPLICATION REVIEW. PLEASE INDICATE ALL MINERAL RIGHTS OWNERS, &LESSEES AS (MR), OR (L)

Address_________________________________________________________________________________________________________

Name _______________________________ _______________________________ _______________________________

___________________________________

DESCRIPTION OF PROPOSAL: (INCLUDE PROPOSED USE, ACREAGE, ETC.)_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Describe how this Proposed Land Use Application Complies with the Town of Parachute LandUse Regulations and the Town of Parachute Master Plan 2002.____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Describe any possible Flood Plain issues:_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Describe Traffic Impact Fees Proposal: (Standard Calculation or Individual Traffic Study)__________________________________________________________________________________________________________________________________________________________

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Municiple development code: Development within the town of Parachute watershed districtis governed by Title 9 Chapter 9.15 of the Parachute municiple code. Ursa is submitting this permit application in accordance with the requirments of section 9.15.050 master development plan. The project is located outside the incorporated town of Parachute and would not effect the master plan.

Project is located outside the 100 yr. floodplain zone

N/A

See attached pad layout drawings

Battlement Mesa Energy Partners,LLCExxon Mobile Corporation

Paradise Valley Minerals

Battlement Mesa Land InvestmentsBattlement Mesa Partners LLCBattlement Mesa Inc.

Describe Land Dedication Proposal:__________________________________________________________________________________________________________________________________________________________

Describe Water Rights Dedication Proposal:_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________

I Certify that the information and exhibits herewith are true and correct to the best of myknowledge, and that in filing this application, I am acting with knowledge and consent of thosepersons listed above without whose consent the requested action cannot lawfully beaccomplished.

Name:(print)____________________________________________________________Address: _______________________________________________________________Signature: _________________________________Date: ________________________

INSTRUCTIONS:1. Read both sides of application thoroughly.2. Complete all of the requested information.3. Descriptions of property and dedication proposals on this form should be general and brief.4. All applications must include a CURRENT TITLE POLICY, indicating ownership and

encumbrances.5. All applications must include PROOF OF TAXES PAID.6. Applicants should review the Town of Parachute Land Use Regulations 15.01, 15.03, 15.04,

15.05, 15.06, and any other sections specified for the proposed request.7. All applicants who are not property owners must present a Letter of Representation,

signed and notarized by the property owners.8. Applications not signed and lacking any of the requested information will be deemed

incomplete and will not be scheduled for a Planning and Zoning Commission review.

ADMINISTRATIVE PERSONNEL:

APPLICATION FEE: ____________________________

APPLICATION RECEIVED DATE:________________ COMPLETE DATE: __________________

PLANNING & ZONING HEARING:________________ BOT HEARING: __________________________

MAILINGS DATE: __________________ PUBLICATION DATE:_____________________________

P&Z APPROVAL DATE: _____________ BOT APPROVAL DATE:___________________________

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N/A

N/A

792 Buckhorn Dr. Rifle, CO. 81650Dwayne Knudson