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Home My WebLink About20112513.tiff MW 41/LIJ tI/I US L'b:lUI AM Weld County Water NAA f1i. J1U 35i 5Hbh F. UIU REeD r'" \C\171 • %/ATER TAP ASSIGNMENT Mark A FOR VALUE RECEIVED,VW1I erehy sell,transfer and axsign to A. bbser and Brenda J. bkues • - ,one l u u water tap in the CENTRAL WELD COUNTY WATER DISTRICT,on my/our • property described as follows situate in Weld County,Colorado,to wit: . See Attached chibit "A"r'7. IT IS UNDERSTOOD that these reps were purchased for the above described land and may not be transferred to other land,without express,written unseat,in addition to the below consent,of the CENTRAL WELD COUNTY WATER I DISTRICT. I/we further authorize the Secretary of said District to do any and all things necessary to ellirtuate this I transfer at the books and(wurds of said District. I/we hereby ante that all water rates and charges and other monies owed to the District have been paid and if not,shall be hold out at the closing of the sale of my/our premises. IN TESTIMONY WI IF.RF.OF,I/we have set myrnur signature this 5th day of Decanter ,20 05 . • ." ' LLtiA: TY ene L. $rhmidt, Trustee o£ the Tylene L. Schmidt Trust and the Clarence S. Schmidt Trust a a SELLER: I/WE FURTHER AGREE to pay any and all charges hereinafter leviedby said District for said taps and to abide by all • regulations adopted by said District. ACCRETED: ,,y,A • • C5D-{` DYER: B Seri CONSENT TO ASSIGNMENT I.lobo W.7adel.General Manager of the CUN'1'RAL WELD COUNTY WATER DISTRICT,frothy consent to the above assignment on hehaifnfsaid District. RY;,ke �,O W. Z GENERAL AGER ' DATE: i//O/ "TO PERSON EXECUTING Fills ASSIGNMENT-NAMES AS THEY APPEAR ON TITLE MIIS'I'lilt TYPI.D • AT THE APPROPRIA'T'E SPACES,FAII.IIRR TO DO SO WILL NWJA'TE'I'LIIS TEANSFPR. rw0 ORIGINAL TAP ASSIONMP.NTS MUS"t'BE COMPLETES)AND SENT TO CENTRAL WIAI.D COUNTY WATER DISTRICT" FOR DISTRICT CONSENT. • • • • • 2011-2513 5Ifl/L7/Lull/1JL F0:ul YN rela WunL% rlacer VAA H0. 777 iii 9bb7 r. UUi • • • EXHIBIT A • • • LOT A OW RECORDED EXEMPTION NO. 1055-18-1-RE1619 BEING A PART OF THE WEST HALF OF THE NORTHEAST QUARTER OF SECTION 18, TOWNSHIP 4 NORTH, RANGE 65 WEST OF THE SIXTH PRINCIPAL MERIDIAN, WELD COUNTY, COLORADO, AS PER MAP RECORDED AUGUST 16, 1994 UNDER RECEPTION NO. 2402425 IN BOOK 1455, COUNTY OF WELD, STATE OF COLORADO. • • • • • • • • • • • • • • • Form 6sXI IFA CT/Il/C3 FC250So253 Weld County Planning Application Checklist 1555 N. 17`h Avenue Greeley, CO 80631 970-353-6100 • Fax: 970-304-6498 Owner/Applicant: Ti n NI an lo1�c Case Type: -Nvw-va.I,1cy(/��e..c_ 7' ccoy-cuxlQ Mp oa The following items are still needed to process your land use permit: /� £o cr jo t A Should we not receive this information within 10 business days, your application will be returned to you. Date: Vi S I I I Planner �, SC• • CENTRAL WELD COUNTY WATER DISTRICT 2235 2nd Avenue,Greeley,CO 80631 PRESORTED 970.352-1284. FIRST CLASS MAIL Wat r :ill All ch r• s r •u •y the 1. h US POSTAGE PAID GREELEY,CO PREVIOUS' PRESEwr r PAEVIOUS`u` t'PRESEtf'?'. Poro•N No.74 DATE ..DATE " .READINGI. . READING - - 101990 11/01 12/01 77 7780 MOSER, MARK A. & BRENDA J. 18722 COUNTY ROAD 46 / 1LASALLE, CO 80645 1•\1..1115 j o\1r:Rt l.Uttlr:• u I'.\.ti11)1 I. . 49 7 10 • 0 R0 !� • Usage Shown in Thousand Gall ACCOUNT NUMBER THIS • -r s5 J 101990 /, rr 1; .1L••.I1,.rTf1. 1, 1 L••L••ILII•. ,I•h I L••Ill Weld County Environmental Health Services Department V Greeley,1555 17th Avenue rr V Greelele y, CO 80631 Phone: (970) 304-6415 JUDc• Fax: (970) 304-6411 LORADO Septic Perm it - Final Web: weldhealth.org Application Number: SP-1100069 Owner Name: MARK MOSER MAY 2 7 2011 Site Address: 18722 CR 46 LA SALLE, CO 80645 App Type: Health1Commercial\New\Septic Application Status: Applicant Name: TIM NAYLOR Ready to Final AGPROFESSIONALS LLC Applied Date: 4350 HWY 66 05!12/2011 LONGMONT, CO 80504 Issued Date: Parcel#: 105518000041-R0367394 05/16/2011 Legal Desc: PT W2NE4 18-4-65 LOT A REC EXEMPT RE-1619 (.44R) 18722 46 CR Finaled Date : 5/I7/I WELD App Specific Info: Location Description 18722 CR 46, LA SALLE CO Repair Reason Type Associated Building Permit Associated Building Permit Number Application Date 05/12/2011 Septic Permit Expiration Date 05/12/2012 Waive Fees No Waive Fees Comment umber of Persons 8 Number of Bedrooms 0 Basement Plumbing No Full Bathrooms 0 3/4 Bathrooms 0 1/2 Bathrooms 1 Public Water Supply Yes Public Water Supply Utility CWCWD Other Water Supply Utility Private Water Supply Private Water Supply Permit Reference Number Parcel Acres 2.56 Year Installed 2010 Actual Installation: Septic Tank: / 0 OO gallons Absorption Trench: sq ft Chambers Absorption Bed : / o cO sq ft Design Type: C f" Chamber Model NOTICE The issuance of this permit does not imply compliance with other state,county,or local regulatory or building requirements,nor shall it act to certify that the subject system will operate in compliance with applicable state,county and local regulations adopted persuant to Article 10,Title 25,CRS as amended,except for the purpose of establishing final approval of installed system for issuance of a local occupancy permit persuant to CRS 1973 25-10-111 (2). This permit is non-transferable and non-refundable.The Weld County Department of Public Health and Environment reserves the right to impose additional terms and conditions required to meet our regulations on a continuing basis.Final permit approval was contingent upon the final inspection of the completed sy to by the Weld County Department of Public Health and Environment. • /Mr tiA4O ( h 71 Environmental Health Spec li ate C _ Gtza n Report ID: EHS00033v004 LA-V c a` c._5./1///• Page 1 of 2 Print Date Time: 5/17/20112:12:19PM Weld County Environmental Health Services Department a 1555 N. 17th Avenue YPPP Greeley, CO 80631 Phone: (970) 304-6415 I�DC Web:(97 ) 304-6 111 COLORADO CO Septic Permit - Final Application Number: SP-1100069 Owner Name: MARK MOSER Site Address: 18722 CR 46 LA SALLE, CO 80645 • • Report ID: EHS00033v004 Page 2 of 2 Print Date Time: 5/17/20112:12:19PM Weld County Environmental Health Services Department • *it << 1555 N. 17th Avenue Greeley, CO 60631 Phone: (970)304-6415 Fax: (970)304-6411 Web:weldhealth.org VC Septic Permit Repair COLORADO Application Number: SP-1100068 Owner Name: MOSER MARK A Site Address: 18722 CR 46 LASALLE, CO 80645 App Type: HealthlCommercial\Repair\Septic Application Status: Applicant Name: TIM NAYLOR In Review AGPROFESSIONALS LLC Applied Date: 4350 HWY 66 05/12/2011 LONGMONT, CO 80504 Intake Person: Parcel Number: 105518000041-R0367394 MSWAIN Legal Desc: PT W2NE4 18-4-65 LOT A REC EXEMPT RE-1619 (.44R) 18722 46Itti4nit Expiration Date: WELD 05/11/2012 EHS Septic General: Location Description 18722 CR 46, LASALLE Repair Reason Type Repair for Failure Associated Building Permit • Associated Building Permit Number Application Date 05/11/2011 Septic Permit Expiration Date 05/11/2012 Waive Fees No Waive Fees Comment Number of Persons 8 Number of Bedrooms 0 Basement Plumbing No Full Bathrooms 0 3/4 Bathrooms 0 1/2 Bathrooms 1 Public Water Supply Yes Public Water Supply Utility CWCWD Other Water Supply Utility Private Water Supply Private Water Supply Permit Reference Number Parcel Acres 2.56 Year Installed UNKN • Report ID: EHS00028v006 Page 1 of 2 Print Date-Time: 5/12/2011 1:03:03PM • Weld County Environmental Health Services Department tom' 1555 N. 17th Avenue • Greeley, CO 80631 Phone: (970)304-6415 Wits Fax: (970) 304-6411 Web: weldhealth.org C°.. Septic Permit Repair COLORADO Application Number: SP-1100068 Owner Name: MOSER MARK A Site Address: 18722 CR 46 LASALLE, CO 80645 g Percolation Rate�3arisrv+ " � Limiting Zone ft in Description %Ground Slope Pa Direction — Soil Suitabl9/N) LC Engineering Design Required 9/N) In 100 Year Flood Plain(Y/tV / From the appletionr So rte^supplied and the site soil percolation da a the f Ilowing minimum installation specifications are required: is Septic Tank IOD° gallons Absorption Trench J I sq ft or Absorption Bed 5LJ._ sq ft Chambers: Standard BioDiffuser Trench Bed Infiltrator Quick4 Standard or Hi Capacity Trench �� Bed Biodiffuser Arc 36 Standard or Hi Capacity Trench Bed Infiltrator Quick4 EQ36 Trench Bed Infiltrator Quick4 Plus Standard Low Profile Trench Bed • All Weld County ISDS regulations apply. In addition, this permit is subjechto the following additional terms and conditions: . 1-Qe-e r' 7I ✓ € NOS_ This permit is granted temporarily to allow construction to commence.This permit may be revoked or suspended by the Weld County Department of Pubfic Health and Environment for reasons set forth in the Weld County Individual Sewage Disposal System Regulations Including failure to meet any term or condition imposed theron during temporary or final approval.The Issuance of this permit does not constitute assumption by the department or Its employees of liability for the failure or inadequacy of the sewage disposal system.This permit is nontransferable and non-refundable.Before issuing final approval of this permit the Weld County Department of Public Health and Environment reserves the right to impose additional terms and conditions required to meet our regulations on a continuing basis.Final permit approval Is contingent upon the final inspection of the completed system by the Weld County Department of Public Health and Environment This permit expires one year from the li • Envi n tal alth peci list Date tltltlttt ��y )��"�IP�'� " _ `1?—�.r.Q_ 07" t'.G4P� W • Report ID: EHS00028v006 Page 2 of 2 Print Date-Time: 5/12/2011 1:03:03PM I inn co cull 1u1: UJ.41 111 M V LlYY 11WP1ll1.IY IfL ncnL I❑ min IYU. 01U JU4 0411 r. UI • WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 1555 NORTH 17TH AVENUE • GREELEY, CO 80631 • PHONE (970) 304-6415 FAX (970) 304-6411 Finaled Permit#: SP-0500387 Sec/Twn/Rng: 18-04-65 Status: ISSUED Owner: SCHMIDT TYLENE L Applied: 10/26/2005 Applicant: SCHMIDT TYLENE L Issued: 11/03/2005 Permit Type: RREP c-Commercial,R=Residential+NEW,REPair,VauLT Pinged: II•2.3.05 Parcel#: 1055-18-0-00.041 Location: 18722 CR 46 LASALLE Legal Description: ' c_ ^ '� Installer: MIN Sdia P-FPr DI s5;n9 � V c Description: HOUSE Acres: 3 Commercial: N Residential:Y #of Persons: 4 Basement Plumbing: Y #of Bedrooms: 3 Bathrooms-Pull: 1 3/4: 1 1/2: 0 Water Public: Y Water Source: CWCWI) Water Private: N Cistern: N Well: N Well PeSt#: Percolation Rate: 33.3 Limiting Zone: 8 ft 0 in Description: Ground Slope: 0 Dir: Soil Suitable: ms ) Y Flood Plain: (Y/N) N lle:Year • Engineer Design Required: (Y/N) N 100 Chambers* Minimum Installation Septic Tank: 1000 gallons Absorption Trench: 1140 square feet or Absorption Bed: 1482 square feet Actual Installation Septic Tank: 1p gallons Absorption Trench: square feet Absorption Bed: I S D9_, square feet 4/9 Design Type: E7. A , Chamber Model ' --r i.-- NOTICE The issuance of this permit does not imply compliance with other state,county or local regulatory or building requirements,nor shall it act to certify that the subject system will operate in compliance with applicable state,coount valof insd talled local regulations egstem for adopted of a local etulant to Article 10,Title 25,CRS as amended,except for the purpose of establishing final app occupancy permit persuant to CRS 1973 25-10-111 (2). This permit is non transferable and non refundable. The Weld County Department of Public Health and Environment reserves the right to impose additional terms and conditions required to meet our regulations on a continuing basis. Final permit approval was contingent upon the final inspection of the completed system by the Weld County Department of Public Health and Environment. ' Post-IY Fax Note 7671 on 3 zct111 IPa°os1 4- - En • o tat Health Specialist Date ° Glary Pirket'm'r From �(Ytl•ttel0.— i! °.ASP- C°. W cQ P ag 7l r'"2r•ok, 4,, Phone# ,m-f 1.1, 1 ax# c 't.� �t Fax# grit; ��PP�'f_o 4 I I _ "Ha CO Cull IUL 1.),J 'II III VI V LIYV 1IUAYI ILIYI CIL IILf1LI II rMI IYV, oil -3424 11 I . UC 41111\ se_csposert It1P _...,.�..^ n 3O1 • L1 F„<prs • oF `Uettv'vPbe la"'azz 5 Ip‘a i oeip as Arm y � **- co-0 :inn-co-cull !LIE uO,41 III W iU CINV 11\VIYIILIY 1 tIL ncrIL1n Inn IYU. 7N 31.14 0411 I. UJ illnal count HEALTH DEPARTMENT 'iIc� FEE 00.00: 012 R SOH *:t: fi / q� ' INVIBONMSNTAL PROTECTION SERVICES LOAN t: 1517 16th Avenue Court p 4' l7t�lr� • Greeley. Colorado 80631 �P1dCA:intyHBd�ifiD2{Jgr�7EY1t UPS t: 65,$ `7& (303)353-0635 REPAIR *: STATEMENT OF EXISTING FOR SEPTIC SYSTEM (PLEASE FILL OUT IN BLACK INK ONLY) OWNER of RECORD: S 7(, e4 , JJ'L/l r e.Ji/6L PHONE:/30 )SY 79i)9 NAILING ADDRESS: 5 a W0 2JC..e c 9 ,L a-1 i--�1 Le CO L/ 41-5-- City State Zip SITE ADDRESS: fUp�i 4�� Y'4 2,ria9 i y state i (o z6 r LEGAL DESCRIPTION: PT: PT: IL 1JE/4 SECTION: 1 3 . TOWNSHIP: 4 N RANGE: IO5W SUBDIVISION: / LOT: _ BLOCK: FILING: NUMBER of PEOPLE: t9-- BEDROOMS: 3 BATHROOMS: I J/i WATER SUPPLY:C tL[CLLI T ENTZ/ COMMERCIAL BASEMENT PLUMBING: fic N LOT SIZE: S i D acres SYSTEM SIZE: Tank is constructed of C (material) FIELD: and has 1)(100 .of7 gallons capacity mLi— Bed o Tres 4 X le?0 square feet. DATE SYSTEM INSTALLED: • (49,07e.6 2,F_De,4i0) Yon are required to draw a diagram of the system on the reverse side of this fora in black ink only and indicate location, length, width, and distance from the dwelling. The undersigned property owner hereby certifies that the above described septic system is in fact installed, as described, and exists at this time on the parcel of ground identif er workingied by the above order and to thelbest ofal scription and his/her knowledge isnottes failing tot e system function prope in rly I further understand that any falsification or misrepresentation may result in revocation of any permit granted based upon this ration hereby submitted an��gal action for perjury as providad by lw• /h ,'j.(Z LGc `'( fi / Date own '/ // , 19 Subs,' ed and warn to befor��yyy'''''��""��this (n �Y by S/ U 't s-e. lwm-!A 1 f ht 0 -y Witness my hand and official seal. remisWpires. d III Date Qtil Ael Notary Public STATE:ENT OF EXISTING REVIEWED BY: Environmental Protection Specialist 'o ' N ..._±.______________>. aY• 44 ^1 I _ n a c o 4 • a -- Ho IX Q- Q • • J — IIJ G7 to • W "`� l�1 'L�l N • Q +� [y X' Q 0 tc • 0 �' I O W • ;p .W U C.775 CJI cr. . 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