HomeMy WebLinkAboutApproachPermit_8566 (2) (1)Montana Department of Transportation
Approach Permit
Printed Date: 07/09/2024
2701 Prospect Ave
PO Box 201001
Helena, MT 59620-1001
(406) 444-6200
www.mdt.mt.gov
8566Permit Number:
CRAIG RICKERTName:
C. A. RICKERT AND ASSOCIATES INC.Company Name:
34 OUTLIER WAYAddress:
BOZEMAN, MT 59718
(406) 624-3630Phone Number:
Nature of Permit:
AN APPROACH PERMIT FOR THE USE OF THE ENTIRE BOZEMAN REST AREA DEEDED AREA UNDER THE CONDITION
THAT THE PROPERTY IS USED FOR A FAST-FOOD RESTAURANT AND HOTEL. THIS APPROACH IS LOCATED AT THE
EXISTING APPROACH TO THE BOZEMAN REST AREA.
1) All other necessary permits for this project must be obtained by and are the responsibility of the applicant/permitee.
2) Permittee shall repair any damage done to MDT right of way as soon as possible
3) Permittee shall be responsible for all utility locates
4) If any deviation from the approved plans is determined necessary at the time of construction, the deviation must be approved
by MDT.
5) Applicant/Permitee Shall Not Store or Park Equipment or Materials in Right-A-Way After Hours of Project.
6) Any affected ground on MDT right of way must be returned to its original condition and reseeded with certified weed free seed.
7) Approval is contingent upon the applicant complying with all applicable environmental laws. The applicant is solely responsible
for any environmental impacts as a result of this project and is solely responsible for obtaining any necessary environmental
permits, notifications, and/or any other necessary environmental clearances.
8) Applicant/Permittee Shall Only Work in MDT Right-Of-Way Monday Through Friday, No Holidays.
9) Applicant/Permitee is responsible for any rocks, gravel or debris that is carried onto the roadway by this activity. Sweeping
and cleaning the highway surface will be done daily at the permitee's expense as required.
10) The applicant/permittee will submit a traffic control plan to the Division Office for approval before entering MDT right of way
for construction.
11) Permittee shall keep area clean of garbage and debris.
12) Permittee or their contractors are required to meet all signing and traffic control requirements while working on MDT right of
way in accordance with MUTCD specifications. A traffic control plan must be submitted and approved prior to any work
beginning. Provisions may or may not be necessary for pedestrians and bicyclists (site specific). Contractor is responsible for
Traffic Control and work schedule coordination with other projects in the vicinity to ensure public safety, adequate traffic flow and
appropriate signage is met at all times.
13) If any aquatic resources, such as streams, canals, wetlands, irrigation ditches, springs, etc. will be impacted as a result of
this project, the appropriate water quality permits should be obtained from state, federal, tribal, and/or local agencies.
14) Final Issuance of Approach Permit is conditional upon a passing inspection by MDT.
15) If permittee does not clean up and remove debris from MDT site within a reasonable timeframe, the permittee will be invoiced
for MDT personnel, materials, & equipment required to clean up site.
16) Applicant/Permittee shall have permit on hand and able to display to MDT personnel on site upon request.
Conditions of Permit:
0.800.70C001201
Sign Route Corridor Mile Post Start Mile Post End
N-412
County
Gallatin
Page 1 of 5
Montana Department of Transportation
Approach Permit
Printed Date: 07/09/2024
2701 Prospect Ave
PO Box 201001
Helena, MT 59620-1001
(406) 444-6200
www.mdt.mt.gov
17) Applicant/Permittee or their contractors are required to meet all signing and traffic control requirements while working on
MDT right of way in accordance with MUTCD specifications.
18) Applicant/Permitee Is Responsible of Putting Slopes and Borrow Ditch to Match Existing Area.
19) All disturbed area must be returned to original compacted condition with topsoil and certified weed free seed or comparable
grass seeded. Initial full growth is the responsibility of the permittee.
20) Permittee shall not disturb any Right of Way Markers
21) Permittee or their contractors are required to locate and move or protect all utilities currently in MDT right of way. Repair of
any damage caused by construction will be the responsibility of the permittee.
22) The portion of the approach on the Montana Department of Transportation right of way must be paved.
23) If any deviation(s) from the MDT-approved plans is determined necessary at the time of construction due to unforeseen
obstacles, the deviation(s) must be approved by MDT in writing before installation begins.
24) Applicant/Permittee or their affiliates are required to meet all signing and traffic control requirements while occupying MDT
right of way in accordance with MUTCD specifications and standards.
25) The applicant/permitee must coordinate their project with any MDT projects in the area.
26) Any work performed before MDT review and approval that requires permitting is subject to removal by the applicant/permitee
at their sole expense if MDT design standards and/or guidelines are not met.
27) Applicant/Permitee Shall Provide MDT A 24 Hour Emergency Call List to The Division Office.
28) Permittee shall not effect the flow of water or block any drainage structures
29) No open trenches are allowed overnight or unattended.
30) Any work performed prior to MDT review and approval is subject to removal if MDT design standards and/or guidelines are
not met.
31) Additional Conditions
• If any aquatic resources such as streams, wetlands, canals, irrigation ditches, springs, etc. will be impacted as a result of this
project, the appropriate water quality permits will need to be obtained from state, federal and/or local agencies.
• The applicant must obtain approvals from downstream landowners if their proposed actions impact downstream properties
(easements, etc.) and provide documentation of appropriate coordination with affected landowners.
• Any damage done to MDT facilities or adjacent landowners as a result of the applicant’s design or construction is the sole
responsibility of the applicant and MDT will not be liable for damages.
• The permit, along with all conditions and restrictions, will be transferred to any subsequent parties. It is the responsibility of the
applicant or their successor to notify MDT of any ownership changes within two weeks of the change.
• If any deviation(s) from the MDT-approved plans is determined necessary at the time of construction due to unforeseen
obstacles, the deviation(s) must be approved by MDT in writing before installation begins.
• Any work performed before MDT review and approval that requires permitting is subject to removal by the applicant at their
sole expense if MDT design standards and/or guidelines are not met.
• The applicant will submit a traffic control plan to the District office for approval before entering MDT right of way for
construction.
• The applicant must coordinate their project with any MDT projects in the area.
• MDT design reviews are meant to ensure compatibility with existing facilities and design standards and guidelines. The
applicant is responsible for all survey and plan errors and/or omissions that impact the constructability or intended design
function of the project.
• The applicant must provide full time construction inspection and certification for any work done within MDT right-of-way. Upon
completion of the project, or at any time upon request from MDT, the applicant must provide all construction inspection reports.
The MDT District Office may assign staff to provide construction inspection oversight at their discretion.
• The applicant will provide “as-builts” to MDT Planning within 30 days after construction company, contractor, or work crew
have demobilized from the work zone
32) All Flaggers used on project shall be Montana certified.
Page 2 of 5
Montana Department of Transportation
Approach Permit
Printed Date: 07/09/2024
2701 Prospect Ave
PO Box 201001
Helena, MT 59620-1001
(406) 444-6200
www.mdt.mt.gov
33) LIABILITY CLAUSE - That the approach owners shall protect the state and save it harmless from all claims, actions, or
damages of every kind which may accrue to, or be suffered by persons, or persons by reason of performance of the work, or by
the improper occupancy of the highway right of way. In the event any legal suit or action is brought against the state arising out
of any of the above causes, the approach owners shall defend the suit or claim.
34) MDT design reviews are meant to insure compatibility with existing facilities and design standards and guidelines. The
applicant is responsible for all survey and plan errors and/or omissions that impact the constructability or intended design
function of the project.
35) Environmental Services has the following condition:
Approval is contingent upon the applicant complying with all applicable environmental
laws. The applicant is solely responsible for any environmental impacts incurred as a result of
this project and is solely responsible for obtaining any necessary environmental permits,
notifications, and/or any other necessary environmental clearances
36) Applicant/Permitee shall cease all operations when inclement weather creates a hazard to the roadway conditions for the
traveling public. MDT maintenance division reserves the right to make this determination.
37) Provide full time construction inspection and certification for any work the applicant/permitee does in MDT right of way. The
applicant/permitee will provide construction inspection reports upon MDT request during construction and will provide all
construction inspection reports upon completion of the project.
38) MDT design reviews are made to insure compatibility with existing facilities and design standards and guidelines. The
permittee is responsible for all survey and plan errors and/or omissions that impact the constructability or intended design
function of the project.
39) If in the future MDT needs more right of way for road expansion or any other use it will be up to the permittee at their
expense to remove or relinquish at no charge the improvements to MDT.
40) Permittee shall notify the City of Bozeman of work being done and for how long.
41) All memorandum of understanding and maintenance agreements are applicable to this permit
42) All improvements must follow any City requirements for installations or repair to current landscape improvements now being
maintained by the City. All maintenance of the sidewalk will be the responsibility of the permittee.
Feb 28, 2024
Applicant Date Issue Date End Date
Feb 28, 2024
Permit Type
Bozeman
Maintenance Division
Hydraulic impacts of redevelopment to be evaluated and mitigated with future encroachment permit, no additional flow to
interstate R/W without MDT approval. Any use of the subject property other than listed in the Scope of Work above will constitute
a change in use and will require a new approach permit application. Daily trips from attached TIS. When executed the document
"Bozeman Rest Area Conveyance Statement of Understanding" will be considered part of this permit and are to be attached. Any
future agreements for improvements related to this development will be considered part of this permit and are to be attached. By
signing these and all future agreements the listed applicant/landowner tacitly signs and approves this application.
Other Remarks and/or Conditions:
Drainage Information:
Type Size Length Drain Site Distance Right Drain Site Distance Left
Existing N/A N/A N/AN/AN/A
Type Signature Title
MDT District Rep on Behalf Of Applicant LeRoy Wosoba SIAP Section Supervisor
MDT District Rep Ted Jones Bozeman Field Maintenance Chief
Signatures
Page 3 of 5
Montana Department of Transportation
Approach Permit
Printed Date: 07/09/2024
2701 Prospect Ave
PO Box 201001
Helena, MT 59620-1001
(406) 444-6200
www.mdt.mt.gov
SIGNATORIES TITLE: Bozeman Field Maintenance Chief
DATE:SIGNATORIES NAME: Ted Jones 02/28/2024
Applicant will review the terms and conditions of this permit. In signing and submitting this permit, the applicant has agreed to
accept and abide by those terms and conditions in their entirety. This permit has been officially approved by the Montana
Department of Transportation by:
Page 4 of 5
Approach Permits are subject to the following terms and conditions:
TERM - This permit shall be in full force and effect from the date hereof until revoked as herein provided.
REVOCATION - This permit may be revoked by State upon giving thirty (30) days notice to Permittee by ordinary mail, directed
to the address shown in the application hereto attached, but the State reserves the right to revoke this permit without giving said
notice in the event Permittee breaks any of the conditions or terms set forth herein.
COMMENCEMENT OF WORK - No work shall be commenced until Permittee notifies the Maintenance Chief shown in
application the date the Permittee proposes to commence work.
CHANGES IN HIGHWAY - If the State changes the highway, or there are other changes to adjoining streets, alleys, etc., which
necessitate alterations in structures or installations installed under this permit, Permittee shall make the necessary alterations at
Permittee's sole expense or in accordance with a separate agreement.
STATE SAVED HARMLESS FROM CLAIMS - In accepting this permit the Permittee, its/his successors or assigns, agree to
protect the State and save it harmless from all claims, actions or damage of every kind and description which may accrue to, or
be suffered by, any person or persons, corporations or property by reason of the performance of any such work, character of
materials used, or manner of installations, maintenance and operation, or by the improper occupancy of said highway right of
way, and in case any suit or action is brought against the State and arising out of, or by reason of, any of the above causes, the
Permittee, its/his successors or assigns, will upon notice to it/him of the commencement of such action, defend the same at
its/his sole cost and expense and satisfy any judgment which may be rendered against the State in any such suit or action.
PROTECTION OF TRAFFIC - Submit a traffic control plan for review and approval prior to any work being performed in MDT
Right-of-Way. Traffic control must meet current MUTCD and MDT standards and guidance. The approval shall in no way operate
to relieve or discharge the Permittee from any of the obligations assumed by acceptance of this permit, and especially those set
forth under Section 6 thereof.
HIGHWAY AND DRAINAGE - If the work done under this permit interferes in any way with the drainage of the State Highway
affected, Permittee shall, at its/his own expense, make such provisions as the State may direct to take care of said drainage.
RUBBISH AND DEBRIS - Permittee is responsible for debris that is carried onto the roadway by this construction with sweeping
and cleaning done daily at permittee's expense. Upon completion of work contemplated under this permit, all rubbish and debris
shall be immediately removed and the roadway and the roadside left in a neat and presentable condition satisfactory to the State.
WORK TO BE SUPERVISED BY STATE - All work contemplated under this permit shall be done under the supervision of and to
the satisfaction of the authorized representative of the State, and the State hereby reserves the right to order the change of
location or removal of any structure or installation authorized by this permit at any time, said changes or removal to be made at
the sole expense of the permittee.
STATES RIGHT NOT TO BE INTERFERED WITH - All such changes, reconstructing or relocation shall be done by Permittee, in
such a manner as will cause the least interference with any of the State's work, and the State shall in no way be liable for any
damage to the Permittee by reason of any such work by the State, its agents, contractors or representatives, or by the exercise
of any rights by the State upon the highways by the installations or structures placed under this permit.
REMOVAL OF INSTALLATIONS OR STRUCTURES - Unless waived by the State, upon termination of this permit, the Permittee
shall remove the installations or structures contemplated by this permit and restore the premises to the condition existing at the
time of entering upon the same under this permit, reasonable and ordinary wear and tear and damage by the elements, or by
circumstances over which the Permittee has no control, excepted.
MAINTENANCE AT EXPENSE OF PERMITTEE - Permittee shall maintain, at its/his sole expense the installations and
structures for which this permit is granted, in a condition satisfactory to the State.
STATE NOT LIABLE FOR DAMAGE TO INSTALLATIONS - In accepting this permit the Permittee agrees that any damage or
injury done to said installations or structures by a contractor working for the State, or by any State employee engaged in
construction, alteration, repair, maintenance or improvement of the State Highway, shall be at the sole expense of the Permittee.
STATE TO BE REIMBURSED FOR REPAIRING ROADWAY - Upon being billed therefor Permittee agrees to promptly
reimburse State for any expense incurred in repairing surface or roadway due to settlement at installation, or for any other
damage to roadway as a result of the work performed under this permit.
OTHER CONDITIONS:
All approach side slopes will preferably be constructed on 10 to 1 slope but not less than 6 to 1 slope, unless otherwise
approved.
No private signs or devices etc., will be constructed or installed within the highway right-of-way limits.
This permit is valid only if approach construction is completed within specified months from date of issue as described in Other
Remarks and/or Conditions.
Montana Department of Transportation
Printed Date: 07/09/2024
2701 Prospect Ave
PO Box 201001
Helena, MT 59620-1001
(406) 444-6200
www.mdt.mt.gov
Approach Application
The Montana Approach Manual can be found on the web at
https://www.mdt.mt.gov/publications/docs/manuals/approach_manual.pdf
First Name *
CRAIG
Last Name *
RICKERT craig@rickertdevelopment.com
Email *
Applicant Information
Company
C. A. RICKERT AND ASSOCIATES INC.
Mailing Address *
34 OUTLIER WAY
Contact Phone *
(406) 624-3630
City *
BOZEMAN
State *
MT
Zip *
59718
Alternate Contact/Co-Applicant Information (Optional)
First Name Last Name Email Phone Contact Type
STEVE WILSON swilson@sm-wilson.
com (303) 802-9001 Co-Applicant Alternate Contact
Location Information
Mile Post Start *
N 19TH AVE
Route Name
0.7
Sign Route *
N-412
Mile Post End
0.8
NORTH 19TH AVENUE
Physical Address *
City *
BOZEMAN
County *
GALLATIN
Legal Description
RangeTownship Section
Page 1 of 8
Montana Department of Transportation
Printed Date: 07/09/2024
2701 Prospect Ave
PO Box 201001
Helena, MT 59620-1001
(406) 444-6200
www.mdt.mt.gov
Approach Application
Permit Information
Nature of Permit (Give sufficient detail of anticipated build/structure/activities that the applicant is requesting to occur
in MDT's right-of-way.) *
AN APPROACH PERMIT FOR THE USE OF THE ENTIRE BOZEMAN REST AREA DEEDED AREA UNDER THE
CONDITION THAT THE PROPERTY IS USED FOR A FAST-FOOD RESTAURANT AND HOTEL. THIS APPROACH IS
LOCATED AT THE EXISTING APPROACH TO THE BOZEMAN REST AREA.
Apply Date *
2/28/24
For how long a period is the permit desired? (e.g. Permanent, 30 days, May 1-June 30, 202x)?
Project Scope (Please describe location of work and entire project scope. Include distance from existing highway
survey station (if applicable), milepost, centerline, or right-of-way line near which installations of structures will be
installed. Please attach a map depicting location.)
AN APPROACH PERMIT IN ORDER TO USE THE ENTIRE BOZEMAN REST AREA DEEDED AREA UNDER THE
CONDITION THAT THE PROPERTY IS USED FOR A FAST-FOOD RESTAURANT AND HOTEL. THE DEVELOPER WILL
ENTER INTO AN AGREEMENT FOR FUTURE IMPROVEMENTS TO THE ADJACENT INTERSECTION OF N19TH AND E
VALLEY CENTER RD THAT WILL BE COVERED BY A SEPARATE ENCROACHMENT PERMIT TO BE COMPLETED AT A
LATER DATE.
If a Corporation, give State of Incorporation and names of President and Secretary
Commercial
Side of Roadway *
North
Single Family Residence
West
Estimated Trips/Day *
Mutli Family Residence
South
East
Use of Property *
Field Access
3280
Other. If 'Other' please enter Use of Property
Joint Use
No
Are there environmental actions involving hazardous waste sites? (Superfund, Spills, Underground Storage Tanks, Old
Mines, etc.) If Yes you will need to fill out additional environment questions.
Yes
Page 2 of 8
Montana Department of Transportation
Printed Date: 07/09/2024
2701 Prospect Ave
PO Box 201001
Helena, MT 59620-1001
(406) 444-6200
www.mdt.mt.gov
Approach Application
Environmental Checklist
Checklist Conditions and Required Approvals
A. The applicant is not authorized to proceed with the proposed work until the checklist has been reviewed and approved, as necessary, and
any requested conditions of approval have been incorporated.
B. Complete the checklist items 1 through 16, indicating "Yes" or "No" for each item. Include comments, explanations, information sources,
and a description of the magnitude/importance of potential impacts in the right hand column. Attach additional and supporting information as
needed. The checklist preparer, by signing, certifies the accuracy of the information provided.
C. If "Yes" is indicated on any of the items, the Applicant must explain the impacts as applicable. Appropriate mitigation measures that will be
taken to avoid, minimize, and/or mitigate adverse impacts must also be described. Any proposed mitigation measures will become a condition
of approval. Use attachments if necessary. If the applicant checks “No” and the District concludes there may in fact be potential impacts, the
Environmental Checklist must be forwarded to Transportation Planning for review and approval.
D. If “Yes” is indicated in item 11 a. (threatened or endangered species), the Applicant should provide information naming the particular
species and the expected location, distribution and habitat use in the proposed action area, i.e. within the immediate area of the proposed
action; or, in the general area on occasion (seasonally passes through) but does not nest, den or occupy the area for more than a few days.
E. If the applicant checks "Yes" for any item, the approach permit, occupancy agreement or permit, along with the checklist and supporting
information, including the Applicant's mitigation proposal, documentation, evaluation and/or permits must be submitted to Transportation
Planning. Electronic format is preferred.
F. When the applicant checks “Yes” to any item, the Applicant cannot be authorized to proceed with the proposed work until the MDT
Environmental Services Bureau and/or Transportation Planning, as appropriate, reviews the information and signs the checklist.
G. Applicant must obtain all necessary permits or authorizations from other entities with jurisdiction prior to beginning the proposed action or
activity. The Applicant is solely responsible for any environmental impacts incurred as a result of the project; obtaining any necessary
environmental permits, notifications, and/or clearances; and ensuring compliance with environmental laws and regulations.
The Montana Environmental Checklist Help Guide can be found on the web at
https://www.mdt.mt.gov/other/webdata/external/planning/forms/environmental-checklist-helpsheet.pdf
Impact Questions *
Actions that qualify for Categorical Exclusion under MEPA and/or NEPA (See ARM
18.2.261 and 23 CFR 771.117)
Comment, Explanation, and/or
Information Source (Attach supporting
information, as necessary.)
1 Will the proposed action impact any known historical or
archaeological site(s)?
NO
2 Will the proposed action impact any publicly owned parkland(s),
recreation area(s), wildlife or waterfowl refuge(s)?
NO
3 Will the proposed action impact prime farmlands? (If "YES", attach a
completed Farmland Conversion Impact Rating Ad-1006.)
NO
4a Will the proposed action have an impact on the human environment
that may result from relocations of persons or businesses, changes
in traffic patterns, changes in grade, or other types of changes?
YES See attached TIS for changes.
4b Has the proposed action received any preliminary or final approval
from the local land use authority?
NO Permitting/approvals from City of
Bozeman.
5 For the proposed action, is there documented controversy on
environmental grounds? (For example, has the applicant received a
letter of petition from an environmental organization?)
NO
6 Will the proposed action require work in, across or adjacent to a
listed or proposed Wild or Scenic River?
NO
7 Will the proposed action require work in a Class I Air Shed or
nonattainment area?
NO
Page 3 of 8
Montana Department of Transportation
Printed Date: 07/09/2024
2701 Prospect Ave
PO Box 201001
Helena, MT 59620-1001
(406) 444-6200
www.mdt.mt.gov
Approach Application
8 Will the proposed action impact air quality or increase noise, even
temporarily?
YES Noise during construction, temporary.
Within existing developed area, between
Interstate and N 19th Ave. Not likely to
increase noise permanently above
existing.
9a Is the proposed action located within an MS4 Area?
(HTTPS://TINYURL.COM/3H54CNMD)
YES within Bozeman MS4 area. will need to
contact local MS4 coordinator.
9b Will the proposed action have potential to affect water quality,
wetlands, streams or other water bodies? If "YES", an environment-
related permit or authorization may be required.
NO NWI shows no wetlands present.
10 Are solid or hazardous wastes or petroleum products likely to be
encountered? (For example, project occurs in or adjacent to
Superfund sites, known spill areas, understorage tanks, or
abandoned mines.)
NO
11a Are there any listed or candidate threatened or endangered species,
or critical habitat in the vicinity of the proposed action?
YES Canada Lynx, Grizzly Bear, North
American Wolverine, and Candidate
Monarch Butterfly. There are no critical
habitats at this location. None impacted
by redevelopment of existing developed
area.
11b Will the proposed action adversely affect listed or candidate
threatened or endangered species, or adversely modify critical
habitat?
NO None impacted by redevelopment of
existing developed area. There are no
critical habitats at this location.
12 Will the proposed action require an environmental-related permit or
authorization? If the answer is "YES", please list the specific permits
or authorizations.
YES SWPPP
13 Is the proposed action within designated sage grouse habitat (
https://sagegrouse.mt.gov/ProgramMap ). (If "YES", a consultation
letter issued from the Montana Sage Grouse Habitat Conservation
Program is required.)
NO
14a Is the proposed action on or within approximately 1 mile of an Indian
Reservation?
NO
14b If "YES", will a Tribal Water Permit be required?N/A
15 Will the proposed action result in increased traffic volumes, increased
wait or delays on state highways, or have adverse impacts on other
forms of transportation (rail, transit or air movements)?
YES Impacts of redevelopment will be
mitigated by separate agreement.
16 Is the proposed action part of a project that may require other
governmental permits, licenses or easements? If “Yes”, describe the
full extent of the project and any other permits, licenses or
easements that may be necessary for the applicant to acquire in the
project scope box above.
YES SWPPP
17 Attach a brief description of the work to be performed, including any
subsurface work.
YES
18 Attach representative photos of the site(s) where the proposed action
would be implemented. Photos are to include any structures,
streams, irrigation canals, and/or potential wetlands in the project
area.
NO
19 Attach map(s) showing the location(s) of the proposed action(s);
Section, Township, Range; highway or route number and
approximate route post(s).
NO
Page 4 of 8
Montana Department of Transportation
Printed Date: 07/09/2024
2701 Prospect Ave
PO Box 201001
Helena, MT 59620-1001
(406) 444-6200
www.mdt.mt.gov
Approach Application
Checklist preparer:LEROY WOSOBA
(Signature)
Page 5 of 8
Montana Department of Transportation
Printed Date: 07/09/2024
2701 Prospect Ave
PO Box 201001
Helena, MT 59620-1001
(406) 444-6200
www.mdt.mt.gov
Approach Application
Applicant Signature Date
Page 6 of 8
Montana Department of Transportation
Printed Date: 07/09/2024
2701 Prospect Ave
PO Box 201001
Helena, MT 59620-1001
(406) 444-6200
www.mdt.mt.gov
Approach Application
Review Signatures
Project Name
Review for completeness by:
MDT Representative DateTitle
Checklist approved by:
TitleEnvironmental Services Bureau Date
Title DateTransportation Planning
Access Control Title Date
FHWA Approval Title Date
(Anytime a TCP is submitted on an interstate)
(Anytime a project is proposed in an access control area)
(When any of the items 15 or 16 are checked 'Yes')
(When any of the items 1 through 16 are checked 'Yes')
Page 7 of 8
Approach Permits are subject to the following terms and conditions:
TERM - This permit shall be in full force and effect from the date hereof until revoked as herein provided.
REVOCATION - This permit may be revoked by State upon giving thirty (30) days notice to Permittee by ordinary mail, directed
to the address shown in the application hereto attached, but the State reserves the right to revoke this permit without giving said
notice in the event Permittee breaks any of the conditions or terms set forth herein.
COMMENCEMENT OF WORK - No work shall be commenced until Permittee notifies the Maintenance Chief shown in
application the date the Permittee proposes to commence work.
CHANGES IN HIGHWAY - If the State changes the highway, or there are other changes to adjoining streets, alleys, etc., which
necessitate alterations in structures or installations installed under this permit, Permittee shall make the necessary alterations at
Permittee's sole expense or in accordance with a separate agreement.
STATE SAVED HARMLESS FROM CLAIMS - In accepting this permit the Permittee, its/his successors or assigns, agree to
protect the State and save it harmless from all claims, actions or damage of every kind and description which may accrue to, or
be suffered by, any person or persons, corporations or property by reason of the performance of any such work, character of
materials used, or manner of installations, maintenance and operation, or by the improper occupancy of said highway right of
way, and in case any suit or action is brought against the State and arising out of, or by reason of, any of the above causes, the
Permittee, its/his successors or assigns, will upon notice to it/him of the commencement of such action, defend the same at
its/his sole cost and expense and satisfy any judgment which may be rendered against the State in any such suit or action.
PROTECTION OF TRAFFIC - Submit a traffic control plan for review and approval prior to any work being performed in MDT
Right-of-Way. Traffic control must meet current MUTCD and MDT standards and guidance. The approval shall in no way operate
to relieve or discharge the Permittee from any of the obligations assumed by acceptance of this permit, and especially those set
forth under Section 6 thereof.
HIGHWAY AND DRAINAGE - If the work done under this permit interferes in any way with the drainage of the State Highway
affected, Permittee shall, at its/his own expense, make such provisions as the State may direct to take care of said drainage.
RUBBISH AND DEBRIS - Permittee is responsible for debris that is carried onto the roadway by this construction with sweeping
and cleaning done daily at permittee's expense. Upon completion of work contemplated under this permit, all rubbish and debris
shall be immediately removed and the roadway and the roadside left in a neat and presentable condition satisfactory to the State.
WORK TO BE SUPERVISED BY STATE - All work contemplated under this permit shall be done under the supervision of and to
the satisfaction of the authorized representative of the State, and the State hereby reserves the right to order the change of
location or removal of any structure or installation authorized by this permit at any time, said changes or removal to be made at
the sole expense of the permittee.
STATES RIGHT NOT TO BE INTERFERED WITH - All such changes, reconstructing or relocation shall be done by Permittee, in
such a manner as will cause the least interference with any of the State's work, and the State shall in no way be liable for any
damage to the Permittee by reason of any such work by the State, its agents, contractors or representatives, or by the exercise
of any rights by the State upon the highways by the installations or structures placed under this permit.
REMOVAL OF INSTALLATIONS OR STRUCTURES - Unless waived by the State, upon termination of this permit, the Permittee
shall remove the installations or structures contemplated by this permit and restore the premises to the condition existing at the
time of entering upon the same under this permit, reasonable and ordinary wear and tear and damage by the elements, or by
circumstances over which the Permittee has no control, excepted.
MAINTENANCE AT EXPENSE OF PERMITTEE - Permittee shall maintain, at its/his sole expense the installations and
structures for which this permit is granted, in a condition satisfactory to the State.
STATE NOT LIABLE FOR DAMAGE TO INSTALLATIONS - In accepting this permit the Permittee agrees that any damage or
injury done to said installations or structures by a contractor working for the State, or by any State employee engaged in
construction, alteration, repair, maintenance or improvement of the State Highway, shall be at the sole expense of the Permittee.
STATE TO BE REIMBURSED FOR REPAIRING ROADWAY - Upon being billed therefor Permittee agrees to promptly
reimburse State for any expense incurred in repairing surface or roadway due to settlement at installation, or for any other
damage to roadway as a result of the work performed under this permit.
OTHER CONDITIONS:
All approach side slopes will preferably be constructed on 10 to 1 slope but not less than 6 to 1 slope, unless otherwise
approved.
No private signs or devices etc., will be constructed or installed within the highway right-of-way limits.
This permit is valid only if approach construction is completed within specified months from date of issue as described in Other
Remarks and/or Conditions.