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addressed on the attached list this 26th day of August, 2013.
Dated the 26th day of August, 2013
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2490 NORTH CR 3
CLYDE HEMBERGER
THORNTON CO
2465 E 101 CT
PATRICIA HOFFMAN
NEW RAYMER CO
63246 CR 78
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WELDONA CO
21460 CR 9
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CHEYENNE WY
6414 N COLLEGE DR
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addressed on the attached list this 22nd day of July, 2013.
Dated the 22nd day of July, 2013
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Date: 2013.07.22 09:13:22 -06'00'
Kristine Ranslem
Recording Secretary for Planning Commission
AFFIDAVIT OF INTEREST OWNERS
SURFACE ESTATE
i 80 acres parcel located in Township 8 North. Range 60 West, W/2 of Section 35
Property Legal Description
Weld County, Colorado
Parcel Number
0 5 4 1. 3 5_ j_ U 0_ J 3
(12 digit number - found on Tax I.D. information, obtainable at the Weld County Assessor's Office, or www.co.weld.co.us)
(Include all lots being included in the application area. If additional space is required, attach an additional sheet)
THE UNDERSIGNED, being first duly sworn, states that to the best of his or her knowledge the attached
list is a true and accurate list of the names, addresses, and the corresponding Parcel Identification Number
assigned by the Weld County Assessor of the owners' of property (the surface estate) within five hundred (500)
feet of the property being considered. This list was compiled from the records of the Weld County Assessor, or a
person qualified to do the task, and shall be current as of a date no more than thirty days prior to the date the
application is submitted to the Department of Planning Services.
Signatures of all fee owners of property must sign this application. If an Authorized Agent signs, a letter of
authorization from all fee owners must be included with the application. If a corporation is the fee owner, notarized
evidence must be included indicating the signatory has the legal authority to sign for the corporation.
I (We) hereby depose and state under the penalties of perjury that all statements, proposals and/or plans
submitted with or contained within the application are true and correct to the best of my (our) knowledge.
Signature D:te Signature Date Signature Date
-5-
WELD COUNTY COLORADO LAND RECORDS
AFFIDAVIT OF INTERESTED LAND OWNERS
SURFACE ESTATE
THE UNDERSIGNED, States that to the best of his or her knowledge the attached list is a true and accurate list of
the names, addresses, and the corresponding Parcel Identification Number assigned by the Weld County Assessor
of the owners of the property (the surface estate) within 500 feet of the property being considered. This list was
compiled utilizing the records of the Weld County Assessor available on the Weld County Internet Mapping site,
http://www.co.weld.co.us, and has not been modified from the original. The list compiled for the records of the Weld
County Assessor was assembled within thirty days of the applications submission date.
Signature
Date
Property Owners Within 500 ft. of Parcel # 054135000003
Account , .,
Parcel
Owner
Mailing Address A
R0550086
054126000002
BAILEY R V LIVING TRUST
PO BOX 1420
CASTLE ROCK CO 80104
R0552786
054135000003
BARRACUDA
INVESTMENTS LLC (1% INT)
R1036286
071903000005
BARRACUDA
INVESTMENTS LLC (1% INT)
R1036186
071902000001
EAVES REX & SHARON 1/2
INT
R6779838
054126400004
HEMBERGER CLYDE
2490 NORTH COUNTY ROAD 3
LOVELAND CO 80538
R6779838
054126400004
HEMBERGER JANICE E
_
R0552586
054134000004
HOFFMAN PATRICIA ANN
2465 E 101 CT
THORNTON CO 80229
R1036186
071902000001
KNOLL ELLIS L & PATRICIA
A 1/2 INT
63246 CR 78
NEW RAYMER CO 80742
R0552886
054135000004
KOBOBEL GLEN
R0552886
054135000004
KOBOBEL LARRY
21460 ROAD 9
WELDONA CO 80653
R0550186
054127000006
MILLER SUPATRAH
6414 N COLLEGE DR
CHEYENNE WY 82009
R0552886
054135000004
SCOTT T (1/3 INT)
R0552786
054135000003
UNITED SURFACE &
MINERALS LLC
C/O MERIT ADVISORS LP
P O BOX 330
GAINESVILLE TX 76241
R1036286
071903000005
UNITED SURFACE &
MINERALS LLC
C/O MERIT ADVISORS LP
P O BOX 330
GAINESVILLE TX 76241
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