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Home My WebLink About790425.tiff • RESOLUTION RE: DENIAL OF LOT SIZE VARIANCE NO. 77 - GLENN AND JANIS SCHULTZ WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board of County Commissioners has determined at a public hearing held on the 29th day of January, 1979 , in the Chambers of the Board of County Commissioners of Weld County, Colorado that a certain parcel of land is owned by Glenn and Janis Schultz, which land is more particularly described as follows, to-wit: A tract of land located in Northwest Quarter of Section 9, Township 1 North, Range 68 West of the Sixth Princi- pal Meridian, Weld County, Colorado, and being more particularly described as follows: Commencing at the Northwest Corner of the Northwest Quarter of said Section 9, and considering the West line of said Northwest Quarter to bear South 00°00'00" West and with all other bearings contained herein rela- tive thereto: Thence South 00°00'00" West, along the West line of the Northwest Quarter of said Section 9, 1338.09 feet to the Northwest Corner of the South Half of the Northwest Quar- ter of said Section 9, said point also being the True Point of Beginning. Thence North 88°46'33" East, along the North line of the South Half of the Northwest Quarter of said Section 9, 2641.82 fact to the Northeast Corner of the South Half of the Northwest Quarter of said Section 9; Thence South 00°12'15" East, along the East line of the Northwest Quarter of said Section 9, 659.33 feet; Thence South 88°46'33" West, 2644.17 feet to a point on the West line of the Northwest Quarter of said Section 9; Thence North 00°00'00" East, along the West line of the Northwest Quarter of said Section 9, 659.38 feat to the True Point of Beginning. Said tract of land contains 40.00 acres and is subject to any and all existing easements and rights-of-way of record. WHEREAS, the owners of said tract of land desire to obtain a variance from the minimum lot size requirement so that they may make application to the Board of County Commissioners for a recorded exemption, as set forth in Section 9-4.A. (6) of the Subdivision Regulations, and 79042 5 WHEREAS, the Board of County Commissioners of Weld County, Colorado, based upon the recommendations of the Department of Planning Services, feels that the applicants has not show good cause for granting a lot size variance under Section 9-4.A. (6) of the Weld County Subdivision Regulations. NOW, THEREFORE, BE IT RESOLVED by the Board of County Com- missioners of Weld County, Colorado that a variance from lot size requirements be, and hereby is, denied to Glenn and Janis Schultz for the abovedescribed parcel of land. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 29th day of January, A.D. , 1979. BOARD OF COUNTY COMMISSIONERS W LD COUNTY, COLORADO `f J /r)tr.t'y ATTEST: m �'�,�! L v- V Weld County Clerk and Recorder and Clerk to the Boar76—` eputy County erk P` RO D AS TO FORM: !.I C2 County Attorney DATE PRESENTED: JANUARY 31, 1979 4J ?Y L DEPARTMENT OF PLANNING SERVICES PHONE (303)356-4000 EXT.404 915 10TH STREET GREELEY,COLORADO 80631 Wilk COLORADO January 22, 1979 Board of County Commissioners Weld County, Colorado 915 10th Street Greeley, CO 80631 RE : Lot Size Variance #77 Dear Commissioners: The attached letters and related materials are in reference to a re- quest for a lot size variance from Glenn and Janis Schultz. The parcel of land is described as Pt . NW* Section 9, T1N, R68W of the 6th P. M. , Weld County, Colorado. This property is located 2 miles northeast of Erie. The property contains approximately 40 acres of Class III and IV non-irrigated soils. The request is to obtain a variance from the mini- mum lot size requirement , Section 9-4 A. (6) so that they may make ap- plication to apply for a recorded exemption. If this lot size variance is granted, the Schultzs will proceed with their application for a recorded exemption to divide the property into two parcels of similar size. The property currently has no improvements. Mr. and Mrs. Schultz wish to divide the property to enable the easier sale of the parcel. Mr. and Mrs. Schultz have been unable to sell the. property as a 40 acre parcel for the last 3 years. Based upon the information submitted and the adopted policies in the County, the Department of Planning Services Staff recommends this re- quest be approved for the following reasons: 1. The request is in compliance with the policies of the Weld County Comprehensive Plan in that to minimize conflicting land uses, resi- dential development will be encouraged to locate adjacent to the existing towns and in accordance with the comprehensive plans and stated wishes of each community. The parcel of land is located just outside the Comprehensive Plan of the Town of Erie. The Erie Town Board has no objections to this request . Board of County Commissioners Page 2 January 22, 1979 2. The request is in compliance with the intent clause of the recorded exemption procedure (Section 9-2 of the Weld County Subdivision Regulations) , because said parcel does not contain prime agricultural lands. The 40 acre parcel in question has low utility for agri- cultural use due to the small acreage involved and lack of irriga- tion water. The parcel is located in an area of existing ten acre tracts of residential uses. There are rural residential subdivi- sions to the north, east and west of the parcel. The proposed use will be compatible with surrounding residential land uses. 3. The request complies with Section 9-4 A. (6) of the Weld County Sub- division Regulations because in the opinion of the Department of Planning Services Staff, the applicant has shown good cause for the variance. The Department of Planning Services Staff ' s recommendation for approval is conditional upon the applicant presenting evidence that an adequate supply of domestic water exists that can serve both parcels.,when ap- plication for recorded exemption is made (i. e. , an approved well permit from the Colorado Division of Water Resources) . Respectfully Th-1.-korka, UT for Thomas E. Bonn VT/csd . I ,�L • o A/0//00`gyp //7 % /t/o/' `i //i7e 47 71e A/. 64;117 /Vi'f/Cow �� 9, Via/¢, rev.g-/-6, 0-6°G-. 9, J'"/�. T/.v, �B�! •4. .e • • ?.1.-iv Pith ` Zlv37O7' f-ir� 49'‘.4•/ �o�rA' �u�arA.v o Goi7Ai B7,: recS Gb,,a .rf7A��/77 e/774 49/755 Can NA A 'A . . . .tj 0 % . 4" , . N D , -- Imo- rt 4 4 e i4,'/)771,,,/ ,� 0,,i/u- 4/6'.-. ."/".,,. ..J ,ge-9, -7,7,;7, A/6'.1° ".9. -67,33 4 I_. . SP` ' �' V•o//�ih /ou//�� "o� h1 ,, V ° . O®0 rgcAP A \`` ee ../7" ., 6�-a4.,fie, AI S,,o¢� ',O'-.lit tV ‘ A .9: -."6.. ...,giegffe-.? k , \k . . , „ _ • . • 7:-/At, /.?. .1,r/ \A \ s - R.' ,,Iii! S�1 47 -IC il/ AvW/7d/fay 1 W - . se -----. 7,&' .• -5 ,r5 ,. ' - ' )C1‘' Poi ._5..„ - L', s',..) ®--- //7,d/G4,/e'5' �//7✓' ,s•'vd,/i c� ,1/,,,71Lsi • , '�° �,�I O -/r7AiC �: • •''' rii_. .. 1 - LEGAL DESCRIPTION A tract of land located in Northwest Quarter (NW1/4) of Section 9, Township 1 North, Range 68 West of the Sixth Principal Meridian, Weld County, Colorado, and being more particularly described as follows: } Commencing at the Northwest Corner (NWCor) of the Northwest Quarter (NW1/4) of said Section 9, and considering the West line of said Northwest Quarter (NWl/4) to bear South 00° 00' 00" West and with all other bearing contained herein relative thereto: Thence South 00° 00' 00" West, along the West line of the Northwest Quarter (NW1/4) of said -Section 9, 1,338.09 feet to the Northwest Corner (NWCor) of the South Half (Sl/2)\ of the Northwest Quarter (NW1/4) of said Section 9, said point also being the True Point of Beginning: - Thence North 88° 46' 33" East, along the North line of the South Half (Sl/2) of the Northwest Quarter (NWl/4) of said Section 9, 2,641.82 feet to the Northeast Corner (NECor) of the South Half (S1/2) of the Northwest Quarter (NWl/4) of said Section 9; Thence South 00° 12' 15" East, along the East line of the Northwest Quarter (NW1/4) of said Section 9, 659.33 feet; Thence South 88° 46' .33" West, 2,644..17 feet to a point on the West line of the Northwest Quarter (NWl/4) of said Section 9; Thence North 000 00' 00" East, along the West line of the Northwest,Quarter (Nbtl/4) of said Section 9, 659.38 feet to the True Point of Beginning. Said tract of land contains 40.00 Acres and is subiect to any and all existing easements and rights-of-way of record. SURVEYOR'S CERTIFICATE I do hereby certify that, under my personal supervision, this plat and legal description were prepared and that. the corner monuments indicated hereon were properly placed during an actual and accurate survey of the land cozy-- plated on July 18, 1968. acs/ Paul E. Radasch, Registered .and Surveyor and lorrerg* e. R40,0 Professional Engineer, Colorado Reg. No. 5080 • `%ft.� �C3ISTE�F� �.a - ' -estY \\ 1ELSON, HALEY, PATTERSON, and QUIRK, INC. k 5080 Engineering Consultants IdA Greeley, Colorado g41),. .3. fry ..t4,1, aF :OC a` r I 441nA J A' { f. it October 21, 197P) County Commissioner Weld County Greeley, Colorado 30631 Dear Sir, This letter is to apply for recorded exemption on property located in Weld County. A nclosed is map, survey, and copy of deed. Reasons for requesting lot size variance are: i... East half of the Iroperty cannot be irrigated 2. 40 acres is too small of a parcel to farm for a living 3. Sharecropper has retired and Mr. Schultz has changed jobs in the company that demands longer orking hours 4. Make property more mar:metable as two 20 acre parcels (approximately) as acreage has been up for sale for over 3 y ars This is not a fins nc i a i. hardship as prop rty is free and clear. 3' �_ "� > s"] e e See �ncl o��:d r�.l�•a�� of deed of trust. ater is to be sup pied by two separate do1A stic wells-p rmits to be app.,Li d for as soon as e pUion is approved. Yours truly, 7 Glenn and Janis Schultz 4469 Tennyson Denver, Colorado 30212 4 2- 4 . pcT 191B ED �. ',?..9 f-SIV c.,-2, Weld MO -,,es punning togsissiot .4viln 1 S ON VNi'2 67G 9 - ► - 6$ 'tIM6 V S V - "77 b1" -CD '"---- 6613 56 A8 0 X406 41B R R.16►,q'ri3 i� NON.�,RR��,�TG D OLD NO . 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C!' 1 ';. 1 J,'.° 1/ � / .r {7; r F �'. • y. t.tali { , d w + .:. sf i ' , y, •' y r .r. d i r d ': j fit, ✓», � ''•r yt,-,,.it, •' 7 , a,, _ rr , .. : (—it.'141,-. ,,,-1, - • ', 4 ,,i,,,. i .i.,,,kr, ; :,, „ , F , 1 iY e - .i,1 , ''.' :'-iikr:::.?;;'4'i.i.:1;••:.-','I'-n:_ F +; _ ,AifF . E• ..... -, ^` { �" �x►ti '+4 r o,�'• • , i #t«�'wda ..'l:a "' L r 'tJ,''T. r YSr= x� s ,,,,,,4,: ,.. .., ,.r ..., � .. " • 4,,,,,,,...,....„..,.:,,,_,..,.,,.....,..,„, � . .,:,,,„•1: r ., a E,'' -�R� ,7r y , ., a W BOARD OF HEALTH e/ / ounty Health Department DAVID WERKING, DDS, Greeley FRANKLIN D. YODER, MD, MPH WILLIAM BLICK, Roggen Director 1516 HOSPITAL ROAD DORIS DEFFKE, Greeley GREELEY, COLORADO 80631 A. M. DOMINGUEZ, JR., J.D., Greeley ANNETTE M. LOPEZ, Greeley (303)353-0540 FRANK MYERS, M.P.H., Windsor HERSCHEL PHELPS, JR., M.D., Greeley KATHLEEN SHAUGHNESSY, PHN, Ault ARTHUR G. WATSON, Platteville November 6, 1978 Gary Fortner, Director Planning & Zoning 915-10th Street Greeley, CO 80631 TO WHOM IT MAY CONCERN: The Lot Size Variance as requested by Glenn and Janis Schultz has been reviewed by Environmental Health staff and no apparent conflict with health regulations is indicated. Sincerely, %pa vizzAirsei hn G. Hall, M.P.H. , Director nvironmental Health Services JGH:dr �, 4 -e,,,; `� NOV 197 RECEi vE - N a Weld County a Planning Commission `'>> C ��I UG✓' if • MEMORAnDUM lung O To Planning Commission Date November 6, 1978 (WM)COLORADO From Gilman E. Olson, Utility/Subdivision Administrator Subject: Glenn Schultz, (L.S.V.) There are no engineering problems anticipated by this request. There is an existing access. Gilman E. Olson Utility/Subdivision Administrator GEO:sar ft ( NOV 19 {sue RE Weld CoURFy `� !laming connnissioA TOWN OF ERIE POLICE DEPARTMENT 645 HOLBROOK FIRE DEPARTMENT 828-3200 BOX 98 828-3232 ERIE, COLORADO 80516 828-3843 449-3085 November 3, 1978 Yield County Department of Planning Services 915 Tenth Street Greeley, CO 80631 Dear Commissioners ; At the regular meeting of the Planning Commission for the To of Erie held on November 2, 1978, we discussed an application for a Lot Size Variance requested by Glenn Schultz. The Planning Commission of the Town of Erie has no objections to per- mitting Mr. Schultz to divide his 40 acres lot into two ( 2) twenty ( 20) acre lots. Sincerely; • C-\ _ Carolyn Dav-i Secretary, Planning Commission (j0-11,49. 10 ,77 V /.).) , N0V'O1$ '5?'` Welfi County :`f ct.en`� inC Colmissio0 Iii) Lpc) 1�8A8 r • FIELD CHECK FILING NUMBER: UST-77 DATE OF INSPECTION: 11/8/78 NAME : Glenn Schultz REQUEST: Lot Size Variance LEGAL DESCRIPTION: Pt. NW4 Section 9, T1N, R68W LAND USE : N Agricultural E Agricultural S Agricultural jq Agricultural ZONING: N Agricultural LOCATION: 2 miles northeast of Erie E Agricultural S Agricultural W Estate COMMENTS : The property presently has no improvements located on it . It appears the property was in wheat at one time. There does not appear to be an access off of County Road 5 to the property. Natural drainage to the property appears to be to the west and north. The property immediately adjacent to the north has one residence located on it . There are no improvements located to the south of the property under consideration. Parkland Estates is located across the road to the west . • BY: (LVIS)"4.# • C.J. KUIPER RICHARD D. LAMM \'0 State Engineer Governor • 18'16 DIVISION OF WATER RESOURCES Department of Natural Resources 1313 Sherman Street-Room 818 Denver,Colorado 80203 Administration(303)839-3581 Ground Water(303)839-3587 November 2, 1978 Mr. Chuck Cunliffe Weld County Department of Planning Services 915 10th Street Greeley, CO 80631 Re: Schultz Lot Size Variance Dear Mr. Cunliffe: We have reviewed the information submitted concerning the above referenced variance . The applicant proposes that individual domestic wells will be used to supply the two proposed lots which would probably be drilled into the Laramie-Fox Hills Aquifer. Our Ground Water Section has indicated that this aquifer may be considered tributary in this area and permits for wells may not be issued. It may be possible to obtain one well as the only well on 35 acres or more, CRS 1973 , 37-92-602(3) (b) (II) , and serve both homes. Due to this uncertainty, we cannot recommend approval of the Schultz variance. We suggest that the applicant contact our Ground Water Section concerning the issuance of well permits in this area. We would be most happy to reconsider this proposal when additional information is submitted. Very truly your , 0\ . Jeris A. Danielson JAD/GDV:mvf D:•putt' State Engineer cc: Jim Clark, Div. Eng. . Reiner Haubold X23 6 ',,. moo' 4 , 4/0k N � {Za O 44 44 etiZ 6104 .c• O RICHARD D. LAMMd C.J. KUIPER Governor O State Engineer 1878 DIVISION OF WATER RESOURCES Department of Natural Resources 1313 Sherman Street-Room 818 Denver,Colorado 80203 Administration(303)839-3581 Ground Water(303)839-3587 December 18, 1978 Mr. Thomas E. Honn Weld County Department of Planning Services 915 10th Street Greeley, CO 80631 Re: Schultz Lot Size Variance Dear Mr. Honn: In your letter of December 6 you asked that we answer two questions concerning the Schultz Lot Size Variance. First, could two household use wells be issued for the property? Second, could a single well serving both lots be permitted? In answer to your first question, this area is geologically complex with numerous faults cutting the aquifers and putting them in contact with streams at various places . Since the Laramie-Fox Hills Aquifer is exposed very near the Schultz property, wells on the property would invariably inter- cept tributary water from an over-appropriated stream system. Therefore, permits for two household use wells could not be issued by our office. Since the Schultz property is larger than 35 acres , a permit for one exempt domestic well could be issued in accordance with 37-92-602(3)(b)(II), CRS 1973, as amended. This type of well may be used to serve up to three single family dwellings and to irrigate up to one acre of lawn or garden. We would have no objection to a well being utilized to serve two separate lots; however, the owner must obtain the permit prior to dividing the property. If the single well is accepted as the water supply, we suggest that an agreement be prepared which specifies responsibility for operation and maintenance of the well. This agreement should also be noted in the deed or covenants so that both purchasers are aware of the details of the water supply. Mr. Thomas E . Honn -2- December 18, 1978 We hope that this adequately answers your questions . Should you desire any further information, please feel free to contact our office. Very truly yours, Dr lens A. Danielson De •uty State Engineer JAD/GDV:mvf cc: Reiner Haubold ,�G,•\6 17 18 9-43 � *c;ec ® 9a4 �� 8 cy)r- c.,,to ��'�' � o' sViz I, 06'C' DEPARTMENT OF PLANNING SERVICES PHONE (303)3564000 EXT.404 915 10TH STREET GREELEY,COLORADO 80631 O • COLORADO December 6 , 1978 Dr. Jeris A. Danielson Deputy State Engineer Division of Water Resources Department of Natural Resources 1313 Shermann Street Room 818 Denver, Colorado 80203 RE : Schultz Lot Size Variance Dear Dr. Danielson : This office received your letter of November 2 , 1978, regarding the above subject . Because your letter indicated you could not recommend approval, we advised the Schultz' s to contact your office. The purpose of this letter is to receive clarity of your position . This office needs to be aware that a single well could be authorized on the property with a dependable water supply to serve two residences . Our regulations do not require separate wells for each parcel . We do require evidence of availability of domestic water, however . I did note that on November 16 , 1978 , you indicated that a dependable water supply will be available from proposed household only use wells on the Ammon exemption . Ammon Exemption #RE-351 is located approximately 1 mile west from the Schultz property. Is it possible to have two household only use wells for the Schultz property? Thank you for your assistance and cooperation in this matter. If you have •u-stions, please feel free to call . Ve• y my o rs homas E. Honn Zoning Administrator TEH:sap January 2, 1979 Thomas r . Ilona Zoning Administrator Department of P'lanninp: Dery ..ces Greeley, Colorado :0631 Dear ;'1r. donn, s per my conversation with Chuck Cunliffe this morning about the delay i._n the hearin.g for the variance change on the 4 acr s in z i , I now understand the problem may be solved by my takinm out tq ye :r ;m a )l c. -__on and strt .n. t!i o c L . _ file . Ilease let me know of any further delays. I,A.... anika has told me this permit will rrobably not be o.k. ed for several months but hope- fully will not d lay much loner these h arings or what must be one at my end after the h :arin sincerely, nn�� A 6 \ f�, Janis Schultz cSr w D c mask, 026LC4 . . . . 7 COLORADO DIVISION OF WATER RESOURCES WRJ 5-Rev. 6 • 818 Centennial Bldg., 1313 Sherman St., Denver,Colorado 8020 PERMIT APPLICATION FORM Application must be complete where ( 1 A PERMIT TO USE GROUND WATER applicable. Type or ( .) A PERMIT TO CONSTRUCT A WELL print in BLACK FOR: ( 11 A PERMIT TO INSTALL A PUMP INK,No overstrikes or erasures unless ( ) REPLACEMENT FOR NO. initialed. ( 1 OTHER WATER COURT CASE NO. (1) APPLICANT - mailing address FOR OFFICE USt ONLY: DO NOT WRITE IN THIS COLUMN 1 -r /I( '/ -TZ Receipt No. • / STREET is , < 7I_ t, 'I\ ' t/ �L,i. 'I Basin Dist. i I. 1- ' 1-( k i\ I� ( V /2__ CONDITIONS OF APPROVAL CITY (State) (Zip) ,/1 ) -4 ,_`-) This well shall be used in such a way as to cause TELEPHONE NO. no material injury to existing water rights. The issuance of the permit does not assure the applicant (2) LOCATION OF PROPOSED WELL• that no injury will occur to another vested water right or preclude another owner,of a vested water �, L L i_, right from seeking relief in a civil court action. County ,,1 '/. of the K) 1A) '/.,Section 6 ' N ) L�, Rng. L �j U I, P.M. Twp. W) tN,SI (E, ' • (3) WATER USE AND WELL DATA . Proposed maximum pumping rate (gpm) / �A t_cZ MS Average annual amount of ground water — F��j . to be appropriated (acre-feet): C . Number of acres to be irrigated: i Proposed total depth (feet): Aquifer ground water is to be obtained from: Owner's well designation GROUND WATER TO BE USED FOR: 1 HOUSEHOLD USE ONLY - no irrigation; (0) NDUSTRIAL (5) ( ,) DOMESTIC (1) ( ) IRRIGATION (6) I LIVESTOCK (2) ( ) MUNICIPAL (8) 1 COMMERCIAL (4) ( OTHER (91 APPLICATION APPROVED DETAIL THE USE ON RACK IN (1 1) PERMIT NUMBER (4) DRILLER DATE ISSUED Name ''' : \.\, ', N , r t'` EXPIRATION DATE Street -- , - / ' '' / 1 City ) I > S� (STATE ENGINEER) { t\ it f, j l (State) k�� N_, (Zip) BY C- (c` "� ('-`- Lic. No. - Telephone No. ID. COUNTY (5) THE LOCATION OF THE PROPOSED WELL and the area on (6) THE WELL MUST BE LOCATED BELOW ' which the water will be used_must be indicated on the diagram below. • by distances from section lines. Use the CENTER SECTION (1 section, 640 acres) for the well location; _ II— _. _ _ /2 A n ft.from 1l sec. line + — —t- — ± —I— —4- — 4_ -I- -'1- ...4_ (north or south) .4 1 MILE,5280 FEET----)- I Z3 U ft.from (east or est)W sec. line I + -4- ± -1-- + ± LOT BLOCK FILING NORTH SECTION LINE SUBDIVISION (7) TRACT ON WHICH WELL WILL BE II LOCATED NORTH Alwner: -. l 1(- _z T y T —_rn y + •+ No.of acres q C . Will this be J -c I p m ' the only well on this tract? 't..._`. . t w� } I 5 (8) PROPOSED CASING PROGRAM v, I I z I- r Plain Casing cn + - -{- - -t - - -t- -m fin.from LI - ft.to -C' ft. I 4 in.from ---D'0 ft.to -:',O t 1 ft. _ I — 4_ _ i. Perforated casing SOUTH SECTION LINE . 4 in. from 3(1' �l ft.to -65- (( ft. 1 --- + 44- -I- in. from ft. to `t. (9) FOR REPLACEMENT WELLS givedistance and direction from old well and plans for plugging + -i , -4-- --- -I-- -L- — --1- i t: The scale of the diagram is 2 inches= 1 mile Each small square represents 40 acres. WATER EQUIVALENTS TABLE (Rounded Figures) An acre-foot covers 1 acre of land 1 foot deep - 1 cubic foot per second (cfs) 449 gallons per minute (gpm) A family of 5 will require approximately 1 acre-foot of water per year. • 1 acre-foot 43,560 cubic feet . 325,900 gallons. 1,000 gpm pumped continuously for one day.produces 4.42 acre-feet. (10) LAND ON WHICH GROUND WATER WILL BE USED: Owner(s): SA I/E• No. of acres: `-hi 7L Legal description: (11) I ETAILED DESCRIPTION of the use of ground water: Household use and domestic wells must indicate type of disposal system to be used. , kit'c ,fr:/-k)L n U ,E- --- _s PTT? c. 7 1�k K LEA c FI F/ELI) . • (12) OTHER WATER RIGHTS used on this land, including wells. Give Registration and Water Court Case Numbers. Type or right Used for(purpose) Description of land on which used q C/ l/\C[ .w IRLn /4AL .._ 1 e )e -7-1- N • • \ktlTEt;' , , (13) THE APPLICANT(S) STATE ) T AT THE INFORMATION SET FORTH HEREON IS TRU O THE B OF S WLEDGE. 1 ...- Sl A TURF OF APPLICANT(S) Use additional sheets of paper if more space is required. 1' Hello