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Home My WebLink About20103095.tiff H i Fy o E ;dig k '1$'; tap a � i piais An 9 _ lit t t.gM i i Jg� IIIIIi pi pi c Y 6g@a4w N- <IIHk P rt g RI ig ! ; l'I §1 a fle ) b . 0 ts!:, !& $ ril u!! it gs ct "§ i € E E f 4 ; ; Iii $i k II: . . . E ggm sap₹a sysE4�3 � 6E6 H fan@ $ 3E 1 Pi 75O X t i i Jia ;iiz Lgm ion i y �8 i i yy ; uE lb i }R " t ggggY Fy y II ive lei �� Wx�F � a tl y g 11 i Ey � � .; � � i.� a�� L !iIIIR TS qigM N W E"I 2 tl 8 i- o Mika w h W y _ gm v i8v g � = o a i `INgq : € t€6 ii m g v i x t hg i %# � : lig p;0 4at Nb W z a q i I y 5 el; , !iI $ ',2.' !;I I *g9 ` @� lIr I . l44 ga 9€i5 ilqi Ct Y 4 35 €" 8 W r Q W tr 3 a ! i; wi 01 1 4 dog li mi ` s `� y e :4�Ia 4 �� ® ti mil Py 5, lE !iti 8s E ! am y r y 0 E 4z ! VI' 'N '@ a s ff 6 Yc yya$ M 0li � Q �� g 5 ! �/n/g D�y I�� ia � W€dy�� 2qqi 3l �lw �•i�� l yC� �`y� IS� NIP �$4 a istialkw ��o ;8�E5iW� ‘1° a' W a• as i. ' s a 9 a s 3 48 t o y � Y 9 r� a Whig vxfa et @ ogni !� W "E c 2 s' as d 2_ „ LL i s �° asa" s n_ 5S'_o" 3 gn a MLY r Ill- f i vp J ZQ O V Ag 22 i g ag a s a@ X2 3ge € 5@ -gig e�3 i %L i$ K real W:ra q eg', 06;0 �. $v # �Jy 63 a Z O F• ° ~Q �y�111 � z s9 aWinO I MF- WC) I 41 Et D LLIWQ3 0 tXO u. % y;, 'te e ✓2da O O O Z y =159 ((13�bJJ3tl i&YU) A'u4L MAOi'OJOS W cow z w y g .roe cim 3.w.ro.Lax Q< k a a r �gpp3 ��5 S �� i O a �Eg 1p8 U Lem x�14�N��i ag W y 3 rliw at ' V MJM Vr . gis n __.. ._...— - m i p3 9 I ~�Y�-a E —=s L mu I mg- -___ = e lya - i le .. ..i: aLA s aEl s z ' ra ovahm a pa • • '6r DEPARTMENT OF PLANNING SERVICES V iiRECORDED EXEMPTION C ADMINISTTRATIVE REVIEW COLORADO Applicant: Sandra Wollert RE-5027 Planner: C. Gathman Legal Description: Section 18, Ti N, R65W of the 6`" P.M., Weld County, CO. Parcel ID#: 1473 32 0000017 Lot A Size: +/-2.5 acres Lot B Size: +/- 7.4 acres Water Source: Lot A: Existing Shared Well Sewer System: Lot A: Septic Permit# 44494 SP-9600382 Lot B: Existing Shared Well Lot B: Septic Permit# 44494 SP-9600382 Criteria Checklist Yes No X 1. Conforms with Chapter 22 of the Weld County Code and any adopted municipal plan. X 2. Compatible with the existing surrounding land uses. X 3. Consistent with the intent of the zone district. X 4. Consistent with efficient and orderly development. X 5. Complies with Recorded Exemption standards in Section 24-8-40 of the Weld County Code. X 6. Provides for adequate protection of the health, safety, and welfare of the inhabitants of the neighborhood and the County. Approved with Conditions The Weld County Department of Planning Services has determined through an administrative review that the standards of Section 24-8-40 of the Weld County Code have been met. This Recorded Exemption is approved with the following conditions in accordance with information submitted in the application and the policies of Weld County. 1. A Weld County septic permit is required for any proposed home. The septic system shall be installed according to the Weld County Individual Sewage Disposal System (I.S.D.S.) regulations. 2010-3095 2. The applicant has proposed a well as the source of adequate water for Lots A and B. Property owners are advised that the quantity of water available for usage may be limited to specific uses, i.e., "Domestic Use Only," etc. Because each situation is unique, the Department of Planning Services encourages property owners to contact the Office of the State Engineer, Division of Water Resources (1313 Sherman Street, Room 818, Denver, Colorado 80203. Phone 303-866-3581), to discuss each individual situation. 3. Topographic or physical features of the proposed Lot A, such as ravines, ditches, streams etc. may limit the area available for a new or replacement septic system. Prior to recording the plat the Weld County Department of Public Health and Environment recommends that the applicant review the Weld County Code pertaining to septic systems to assure that any installed septic system will comply with all setback requirements found in the Code. In the event the proposed lot is not of sufficient size to allow the installation of a septic system the lot may need to be enlarged. 4. Prior to recording the plat: A. The plat shall be titled: Recorded Exemption No. 1473-20-1 RE-5027 B. The applicant shall submit a joint ownership, access and/or operation maintenance agreement for the shared well. This agreement shall be recorded and delineated on the plat and an appropriate certificate using the language set forth in the Weld County Code, Appendix 24-F.2 shall be included. C. Lot A shall use the existing residential access point as no additional accesses shall be granted. D. Lot B shall use the existing residential access point as no additional accesses shall be granted. E. All approved accesses shall be clearly shown on the plat. F. County Road 8 is designated on the Weld County Road Classification Plan as a collector status road, which requires 80 feet of right-of-way at full build out. The applicant shall verify the existing right-of-way and the documents creating the right-of-way. The edge of future right-of-way for County Road 8 shall be designated on the plat. All setbacks shall be measured from the edge of future right-of-way. If the right-of-way cannot be verified, it shall be dedicated. This road is maintained by Weld County. All septic systems must be located on their respective lots and meet all lot line set back requirements. Provide a drawing of the septic system, with dimension and distances from or) lot lines, to W.C. Department of Public Health and environment for verification of setbacks. H. All septic systems located on the property shall have appropriate permits from the Weld County Department of Public Health & Environment. Any existing septic system which is not currently permitted through the Weld County Department of Public Health & Environment will require an I.S.D.S. Evaluation prior to the issuance of the required septic permit. In the event the system is found to be inadequate, the system must be brought into compliance with current I.S.D.S. regulations. The applicant shall complete and submit the appropriate zoning permit application and pay the appropriate fees to the Weld County Department of Planning Services for the mobile home located on Lot A. The applicant shall submit a mobile home zoning permit and 75$ application fee to change the use of the existing mobile home from a medical hardship to a principle residence. J. Lot A shall comply with the two and one-half (2 1/2) acre net minimum lot size required by Section 24-8-40.L of the Weld County Code. Net acreage calculations should not include reserved road right-of-way. K. The applicant shall provide the Weld County Department of Planning Services with a Statement of Taxes from the Weld County Treasurer showing no delinquent taxes exist for the original parcel. L. The following notes shall be placed on the plat: 1) All proposed or existing structures will or do meet the minimum setback and offset requirements for the zone district in which the property is located. Pursuant to the definition of setback in the Weld County Code, the required setback is measured from the future right-of-way line. * No building or structure as defined and limited to those occupancies listed as Groups A, B, E, F,H, I, M and R in Section 302.1 of the 2003 International Building Code, shall be constructed within a 200-foot radius of any tank battery or within a 150-foot radius of any wellhead. Any construction within a 200-foot radius of any tank battery or 150-foot radius of any wellhead shall require a variance from the terms of the Section 23-3-10 of the Weld County Code. 2) Any future structures or uses on site must obtain the appropriate zoning and building permits. 3) Lot A is not eligible for a future land exemption in accordance with Section 24-8- 20.C.1 of the Weld County Code. 4) Prior to the release of building permits, the applicant shall submit a recorded deed describing the Lot upon which the building permit is requested with the building permit applications. The legal description on such deed shall include the Lot designation and Recorded Exemption number. 5) Prior to the release of building permit, the applicant shall submit evidence of approval from the Hudson Fire Protection District to the Weld County Building Department. 6) Potential purchasers should be aware that Lots A and B may not be eligible for a domestic well permit which allows for outside irrigation and/or the watering of stock animals. The State Division of Water Resources issues all well permits. 7) Potential purchasers should be aware that groundwater may not meet all drinking water standards as defined by the Colorado Department of Public Health and Environment. The Weld County Department of Public Health and Environment strongly encourages well users to test their drinking water prior to consumption and periodically there after. • • 8) Should noxious weeds exist on the property or become established as a result of the proposed development the applicant/landowner shall be responsible for controlling the noxious weeds, pursuant to Chapter 15, Articles I and II of the Weld County Code. 9) Building permits shall be obtained prior to the construction of any building. Buildings that meet the definition of an Ag Exempt Building per the requirements of Section 29- 1-20 and Section 29-3-20.6.13 of the Weld County Code do not need building permits, however, a Certificate of Compliance must be filed with the Planning Department and an electrical and/or plumbing permit is required for any electrical service to the building or water for watering or washing of livestock or poultry. 10) Effective January 1, 2003, Building Permits issued on the proposed lots will be required to adhere to the fee structure of the County Road Impact Program. (Ordinance 2002-11) 11) Effective August 1, 2005, Building permits issued on the subject site will be required to adhere to the fee structure of the Capital Expansion Impact Fee and the Stormwater/Drainage Impact Fee. (Ordinance 2005-8 Section 5-8-40) 12) Potential Purchasers are hereby notified that a confined animal feeding operation (SUP-352 — Dairy for 200 cows) is located directly west of County Road 39 and 1/2 mile north of County Road 8. Off-site impacts that may be encountered include noise from trucks, tractors and equipment; dust from animal pens and odors from animal confinement, silage, and manure. 13) WELD COUNTY'S RIGHT TO FARM: Weld County is one of the most productive agricultural counties in the United States, ranking fifth in total market value of agricultural products sold. The rural areas of Weld County may be open and spacious, but they are intensively used for agriculture. Persons moving into a rural area must recognize and accept there are drawbacks, including conflicts with longstanding agricultural practices and a lower level of services than in town. Along with the drawbacks come the incentives which attract urban dwellers to relocate to rural area: open views, spaciousness, wildlife, lack of city noise and congestion, and the rural atmosphere and way of life. Without neighboring farms, those features which attract urban dwellers to rural Weld County would quickly be gone forever. Agricultural users of the land should not be expected to change their long-established agricultural practices to accommodate the intrusions of urban users into a rural area. Well run agricultural activities will generate off-site impacts, including noise from tractors and equipment; slow-moving farm vehicles on rural roads; dust from animal pens, field work, harvest, and gravel roads; odor from animal confinement, silage, and manure; smoke from ditch burning; flies and mosquitoes; and the use of pesticides and fertilizers in the fields, including the use of aerial spraying. Ditches and reservoirs cannot simply be moved out of the way of residential development without threatening the efficient delivery of irrigation to fields which is essential to farm production. Section 35-3.5-102, C. R. S., provides that an agricultural operation shall not be found to be a public or private nuisance if the agricultural operation alleged to be a nuisance employs methods or practices that are commonly or reasonably associated with agricultural production. • • Weld County covers a land area of over 4,000 square miles in size (twice the State of Delaware) with more than 3,700 miles of state and County roads outside of municipalities. The sheer magnitude of the area to be served stretches available resources. Law enforcement is based on responses to complaints more than on patrols of the county and the distances which must be traveled may delay all emergency responses, including law enforcement, ambulance, and fire. Fire protection is usually provided by volunteers who must leave their jobs and families to respond to emergencies. County gravel roads, no matter how often they are bladed, will not provide the same kind of surface expected from a paved road. Snow removal priorities mean that roads from subdivisions to arterials may not be cleared for several days after a major snowstorm. Snow removal for roads within subdivisions are of the lowest priority for public works or may be the private responsibility of the homeowners. Services in rural areas, in many cases, will not be equivalent to municipal services. Rural dwellers must, by necessity, be more self-sufficient than urban dwellers. Children are exposed to different hazards in the county than in an urban or suburban setting. Farm equipment and oil field equipment, ponds and irrigation ditches, electrical power for pumps and center pivot operations, high speed traffic, sand burs, puncture vines, territorial farm dogs, and livestock present real threats to children. Controlling children's activities is important, not only for their safety, but also for the protection of the farmer's livelihood. Parents are responsible for their children. 5. The applicant shall submit three (3) paper copies of the plat for preliminary approval to the Weld County Department of Planning Services. Upon approval of the paper copies the applicant shall submit a Mylar plat along with all other documentation required as conditions of approval. The Mylar plat shall be recorded in the office of the Weld County Clerk and Recorder by Department of Planning Services. Staff. The plat shall be prepared in accordance with the requirements of Section 24-8-60 of the Weld County Code. The Mylar plat and additional requirements shall be submitted within sixty (60) days from the date the Administrative Review was signed. The applicant shall be responsible for paying the recording fee. 6. In accordance with Weld County Code Ordinance 2005-7 approved June 1, 2005, should the plat not be recorded within the required sixty (60) days from the date the Administrative Review was signed a $50.00 recording continuance charge may be added for each additional 3 month period. 7. The Department of Planning Services respectfully requests the surveyor provide a digital copy of this Recorded Exemption. Acceptable CAD formats are .dwg, .dxf, and .dgn (Microstation); acceptable GIS formats are ArcView shapefiles, Arclnfo Coverages and Arclnfo Export files format type is .e00. The preferred format for Images is .tif (Group 4). (Group 6 is not acceptable). This digital file may be sent to dhuerterco.weld.co.us co.weld.co.us 8. The Weld County Department of Planning Staffs approval of this Recorded Exemption Application is based on satisfying the Conditions of Approval. Should an applicant be unwilling or unable to meet any one of these conditions within 60 days of approval, then this case will be forwarded to the Weld County Board of County Commissioners with a staff recommendation for denial. By Date June 22, 2010 Chris Gathman 0 Planner Ill ) WELD COUNTY,COLORADO ? ) -- DEPARTMENT OF PLANNING SERVICES' 918 10TH STREET GREELEY,CO 80631 PHONE: 970-353-6100,EXT.3540/FAX:970-304-6498 Date: 20_1_ Receipt No. Received From: j Permit Type No. Description Fee 4221-RE/SE 4221-ZPMH 4221-USR 4221-SITE PLAN REVIEW 4221-CHANGE OF ZONE 4221-PU D 4221-MINOR/MAJOR SUB #OF BUILDABLE LOTS 4221-ADDITIONAL 30% FEE FOR SUB's 4221-RE-SUBDIVISIONS 4221-BOA 4221-FHDP/GHDP 4430-MAPS/POSTAGE 4430-COPIES 4730-INVESTIGATION FEE 6560-RECORDING FEE ( r' MISC. ❑ CASH ❑JCHECK NO. ' j , TOTAL FEE • Receipted By: i DL# Exp. Chris Gathman From: Chris Gathman Sent: Tuesday, July 13, 2010 9:05 AM To: 'sandhf@aol.com' Subject: RE: Recorded Exemption Staff comments: RE-5027 (Wollert) Sandra, Sorry for the delay in getting back to you. Depending on when the septic was put in (if it was on older system) there may not be a permit on file for the home on Lot B. It is my understanding that an evidence of an existing septic system form is typically required to be submitted to allow the Health Department to verify that the septic system is still functioning properly. Here is a link to the form: http://www.co.weld.co.us/assets/90B95Ca8a838D1Da99bc.pdf. If you have any questions in regards to this, you can contact Laurie Exby with Environmental Health - (970)304-6415 ext. 2223. In regards to Section 18. You are correct - it is Section 20. That is an error on my part. Thanks for catching it. Thank you for the well permit #. Let me know if you have any additional questions. Sincerely, Chris Gathman Planner III Weld County Department of Planning Services 1555 N. 17th Avenue, Greeley CO. 80631 Ph: (970)353-6100 ext. 3537 Fax: (970)304-6498 Original Message From: sandhf@aol.com [mailto:sandhf@aol.com] Sent: Monday, June 28, 2010 1:59 PM To: Chris Gathman Subject: Re: Recorded Exemption Staff comments Chris, I am working on getting the survey. But in the letter from the health department it says the have the septic permit for the modular home, which is on proposed lot A, and then says they don't have a septic permit for 19692 CR 8 which is the address for the modular home on lot A. The wood home on lot B would have had the septic put in when the home was built. Lot A (19692 CR 8) has Septic pemit # SP-9600382 - I do not know the number for 19676 CR 8 which is the wood frame house. Also on the Administrative Review form under legal desctiption it says Section 18 on everything I have it says Section 20. 1 The well permit number was changd when I got the well registerelltnto my name the well permit number is 283002. ( I received the permit back after sending in my application, when I told you this you said it wasn't a problem, just wanted you to have the correct number. ) Sandra Wollert 303-947-6692 Original Message From: Chris Gathman <cgathman@co.weld.co.us> To: sandhf@aol.com <sandhf@aol.com> Sent: Tue, Jun 22, 2010 11:13 am Subject: Recorded Exemption Staff comments Sandra, Here is the staff recommendation along with referral responses for your recorded exemption. Please provide a copy of these staff comments to your surveyor. Let me know if you have any questions. Sincerely, Chris Gathman Planner III Weld County Department of Planning Services 1555 N. 17th Avenue, Greeley CO. 80631 Ph: (970)353-6100 ext. 3537 Fax: (970)304-6498 2 • Chris Gathman From: Sandhf@aol.com Sent: Thursday, May 13, 2010 8:59 AM To: Chris Gathman Subject: Re: Case RE-5027 Chris, I will go with the 2.5 acres, I had never been told what the requirement was so I had just used 2 acres, I wanted to go with the smallest amount I had to use. I have talked to a surveyor, but hadn't had the survey done yet. I was under the impression that the survey was the last thing I should do to make sure that everything was going to be approved, so as not to incur the expense if it wasn't going to be approved. If I need to go ahead and do it I will get it started. Thank you, Sandra Wollert In a message dated 5/13/2010 8:50:55 A.M. Mountain Daylight Time, cgathman(dco.weld.co.us writes: Sandra, Referral agencies (towns within 3 miles, local fire district, school district, Health Department, Public Works Department. . . ) are in the process of reviewing and commenting on the case. Referral agencies have until June 4th to provide comment on this case. Upon receipt of referral comments - planning staff will finalize our review and prepare staff comments. These comments will be forwarded to you along with whatever referral responses we have received. The application processing time is 60 days from the date the application was submitted. In the meantime you could (if you haven't already) look into contacting a surveyor re: doing the survey work. One item of note: your application proposes Lot A to be 2 acres in size. The Weld County Code requires a minimum lot size of 2.5 acres for lots with a well and a septic system. Lots smaller than 2.5 acres will require approval by the Board of County Commissioners at a hearing. Your options are to either make the smaller lot at least 2.5 acres or proceed as is and we will schedule a hearing before the Board of County Commissioners once the staff review has been completed and comments have been prepared. Let me know if you have any questions and what you wish to do re: the size of the smaller parcel. Sincerely, Chris Gathman Planner III Weld County Department of Planning Services 1555 N. 17th Avenue, Greeley CO. 80631 Ph: (970)353-6100 ext. 3537 Fax: (970)304-6498 1 Original Message • • From: Sandhf@aol.com [mailto:Sandhf@aol.com] Sent: Thursday, May 13, 2010 7:50 AM To: Chris Gathman Subject: Re: Case RE-5027 Chris, I went to Hudson's planning commission meeting last night and they will be sending a letter stating that they have no objections to my recorded exemption. What is the next step I need to do to get this finalized? Thank you, Sandra Wollert 19676 CR 8 Hudson, CO 80642 303-947-6692 In a message dated 5/5/2010 4:35:40 P.M. Mountain Daylight Time, cgathman(co.weld.co.us writes: Don't worry about coming up here tomorrow. You are not required to come up for a meeting since we have set the case up and it has been sent out for referrals. I can contact via phone/e-mail if I have any questions. Sincerely, Chris Gathman Planner III Weld County Department of Planning Services 1555 N. 17th Avenue, Greeley CO. 80631 Ph: (970)353-6100 ext. 3537 Fax: (970)304-6498 From: sandhf@aol.com [mailto:sandhf@aol.com] Sent: Wednesday, May 05, 2010 9:41 AM To: Kristine Ranslem Subject: Re: Case RE-5027 Chris, I have called Hudson and their meeting is the 12th of May, Lochbuie says I don't need to come that it dosen't effect them. I have a meeting set up with you for tomorrow May 6th @ 3;30 do I still come to this meeting? Sandra Wollert 303-947-6692 2 • • Original Message From: Kristine Ranslem <kranslem@co.weld.co.us> To: sandhf@aol.com <sandhf@aol.com> Sent: Wed, May 5, 2010 8:47 am Subject: Case RE-5027 Please see the attached letter Kristine Ranslem Planning Technician Weld County Planning Services 1555 N 17th Ave, Greeley CO 80631 970-353-6100 ext. 3519 3 ) WELD COUNTY,COLORADO APARTMENT OF PLANNING SERVICES 918 10Th STREET GREELEY,CO 80631 PHONE: 970.353.6100,EXT.3540/FAX: 970-304-6498 Date: i � 2011 Receipt No. Received From: Permit Type No. Description Fee 4221-RE/SE 4221-ZPMH 4221-USR 4221-SITE PLAN REVIEW 4221-CHANGE OF ZONE 4221-PU D 4221-MINOR/MAJOR SUB #OF BUILDABLE LOTS 4221-ADDITIONAL 30% FEE FOR SUB's 4221-RE-SUBDIVISIONS 4221-BOA 4221-FHDP/GHDP 4430-MAPS/POSTAGE 4430-COPIES 4730-INVESTIGATION FEE ' 6560-RECORDING FEE MISC. ❑CASH 4 CHECK NO. r TOTAL FEE , Receipted By: DL# Exp. WO`Pc APPLICATION FLOW SHEET COLORADO APPLICANT: Sandra Wollert CASE#: RE-5027 REQUEST: Two-Lot Recorded Exemption LEGAL: Part NE4 20-1-65 1 LOCATION: South of and adjacent to CR 8 and 40f rfof and adjacent to CR jliC PARCEL ID #: 147320000017 ACRES: +/- 10 acres Date By Application Received 4/21/10 Application Completed 5/3/10 Referrals listed 5/4/10 CG Vicinity map prepared File assembled tV51/D Case logged in computer Letter to applicant mailed Referrals mailed Field check by DPS staff 1 M WWWWII° cat Administrative Review decision: Co rzZl N • Nab 44 Board of County Commissioners hearing (if applicable) Date By County Commissioners Hearing Date Surrounding property owners notified Presentation prepared CC action: CC resolution received �/� Date a BV Plat recorded and filed OS /6 . 6 'J fJ„ Overlay Districts r-� Zoning Agricultural _ . ��' MUD Yes No_X_ c �� i < < 1� ✓ IGA Yes No_X_ 1L1 4\` "`s Airport Yes No_X_ F Geologic Yes No_X Flood Hazard Yes No_X Panel#080266 • • DEPARTMENT OF PLANNING SERVICES 1555 1VE rec:.%%%*H( � COth8 540 GREELEY, O 80631 PHONE: (970) 353-6100, Ext. 3540 FAX: (970) 304-6498 COLORADO May 5, 2010 Sandra Wollert 19676CR8 Hudson CO 80642-9033 Subject: RE-5027-A Recorded Exemption located on a parcel of land described as Part NE4 of Section 20, Ti N, R65W of the 6th P.M., Weld County, Colorado. Dear Applicant: Your recorded exemption application is being processed. If it is determined that the application meets the approval criteria of Chapter 24 of the Weld County Code, you will be notified that the recorded exemption is approved. If staff determines that the application does not meet the approval criteria or if staff has concerns with the application, staff may elect to forward the application for review to the Board of County Commissioners. You will be notified and asked to appear before the Board of County Commissioners at a public hearing. You will be informed of the hearing date prior to the hearing. The Board of County Commissioners will then consider your application and make a final decision on the recorded exemption. It is the policy of Weld County to refer an application of this nature to any town or municipality lying within three miles of the property in question or if the property under consideration is located within the comprehensive planning area of a town or municipality. Therefore, our office has forwarded a copy of the submitted materials to the Hudson and Lochbuie Planning Commission for their review and comments. It is recommended that you and/or a representative be in attendance at the Hudson and Lochbuie Planning Commission meeting to answer any questions the Commission members may have with respect to your application. Please call Hudson at 303-536-9311 and Lochbuie at 303-655-9308, for further details regarding the date, time, and place of this meeting. If you have any questions concerning this matter, please call me. Sincerely, Digitally signed by Kristine Ranslem JAA4 ZY]C(1 N` Reason:lam the author of l 1115 document l�lLU' Location:1555 N 17th Are Date;Date:2010 05.05 08:29:37 46'00' Chris Gathman Planner • • RECORDED EXEMPTION (RE) APPLICATION FOR PLANNING DEPARTMENT USE DATE RECEIVED: RECEIPT/AMOUNT# 1$ CASE#ASSIGNED: APPLICATION RECEIVED BY PLANNER ASSIGNED: Parcel Number / '/ 7 3 - a 0 - O - 0 O - G / (12 digit number-found on Tax I.D. information, obtainable at the Weld County Assessor's Office,or www.co.weld.co.us) Legal Description /0 cni c rt Ale Y Io i0Ec- 51 'ov'& Jel , Section 7O, Township 0/ North, RangeC45 West a cbae,o;i Has the property been divided from or had divided from it any other property since August 30, 1972? Yes No)( Is this parcel of land, under consideration, the total contiguous land owned by the applicant? YesX No FEE OWNER(S) OF THE PROPERTY: Name: odr)de,a S 6='0/Ayti?c Work Phone# 3vy-65`i-23s-3 Home Phone#fu3 536- 5Y4,09 Email Address Sn ,-)r/h, &vc% rein Address: /96 )ri C , > City/State/Zip Code #a/ft'n, 0 3=0 di 4d•10.71 APPLICANT OR AUTHORIZED AGENT (See Below:Authorization must accompany all applications signed by Authorized Agent) Name: 3« rid/a .c /Jo��is-/- Work Phone# 706-&Pi-2313 Home Phone# 36.7 5;'Z-'/ 6V Email Address J'u'nc//l p Q C-/en, Address: /9(, 7G C 2 ,S- City/State/Zip Code //z,4/(',-,n CC Sod r/d-5GT3 Lot A Lot B Lot C Lot D Smaller Parcel Water Source 45/20A,,1 /-,.., P/ / > e// Type of Sewer C e y$;r 3 Q p7/1ic Proposed Use Seconrl he m t horn cc. Acreage Z,S 9 Existing Dwellings? If Yes, list address If Yes, list address If Yes, list address If Yes, list address below: below: below: below: / ro9a size /'i67o c28' If the property is vacant or unimproved write proposed water source and proposed sewer system for each parcel in the blanks above. For example, if a well and septic is proposed state:proposed well, proposed septic. I (We) request that the following described property be designated a Recorded Exemption by the Weld County Board of County Commissioners. I (We) hereby depose and state under 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. 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 showing the signatory has the legal authority to sign for the corporation. �� Geex,S§ alure: wl er/ 4&/ Jc orized Agent bate Signature: Owner or Authorized Agent Date -4- RECORDED EXEMPTION (RE) QUESTIONNAIRE Please type or print your responses to the following questions on a separate sheet of paper. 1. Water supply statements addressing the following: a. Domestic use. The statement will include evidence that a water supply of sufficient quality, quantity and dependability will be available to serve all proposed lots. A letter from a water district, municipality, or a well permit are examples of evidence for domestic use.- (Example - "Water will be provided by the 123 Water Company, a tap agreement has been purchased and a copy of the receipt is attached," or "Water will be provide by a well (Well Permit # 12345 is attached.") b. Irrigation water. The statement will include the type and quantity of irrigation water to the site, whether irrigation water has been removed from the site and, if so, when. (Example - "Four (4) shares of ABC Ditch Company Water will remain with the site, a copy of the purchase agreement addressing this item is attached," or"The parcel was purchased with no water rights.") 2. A statement explaining that the proposed lots will have an adequate means for the disposal of sewage in compliance with the requirements of the underlying zone district and the Weld County Department of Public Health and Environment. A copy of the septic permit or a letter from the sewage disposal facility must accompany the application. (Example - "Sewer service will be provided by Anytown Sewer and a "Commitment to serve" letter from Anytown is attached." or "An engineered Septic system will be designed, constructed and permitted according to Weld County ISDS requirements." or "A copy of the existing Septic Permit and appropriate copies (#123456789) are included with the application.") 3. A description of how the property is being used. When the parcel(s) is located in the agricultural zone district, the number and types of livestock and any existing improvements such as the principal residence, labor home, mobile home, manufactured home, barn, outbuildings, and oil/gas well production facilities on the property. If the property is being farmed the location of any pivot sprinklers and irrigation ditches as well as types of crops being produced. (Example - 'The parcel has one farmhouse, one mobile home for the hired hand (permitted under Mobile Home Permit# ZPMH-123), two barns, a one loafing shed. The north half is currently used for pasture for approx. One hundred head of cattle and six to ten horses. There is an oil and gas well head and tank battery in the northeastern corner. The south half of the property is flood irrigated and currently planted in alfalfa.") 4. A description of the location, size, present and future use of the area where the proposed new lot(s)will be created. (Example-"The new lot will be approx five acres in size and located west of and adjacent to CR. _and the north boundary of the property. It is being created to be sold for a single family dwelling site.") 5. A statement describing any unique physical characteristics on the site, if applicable such as rock outcroppings, hills, ditches. (Example-'The ABC ditch runs diagonally across the southeastern quarter of the property.") 6. A statement indicating where a primary building envelope and/or alternative building envelope will be designated on any of the lots. Building envelopes may not be necessary on lots that are smaller than thirty-five acres. The Department of Planning Services reserves the right to recommend building envelopes on smaller acreage. (Example-"No building envelopes are requested") Is there a Business or Use by Special Review permit on the property? If so, will it be vacated or remain on the Recorded Exemption lot(s)? (Example -"USR 1234 for my concrete business will be vacated as I am retiring. My son is moving the business and equipment to his property outside of Weld County.") -6- Recorded Exemption Questionnaire 1. a. Domestic use—Water will be provided by a well (well permit#44494 is attached). b. Irrigation water—N/A 2. A copy of the existing septic permit(SP-960038) is included with application. 3.The property is being used for personal use with a couple head of livestock for personal pleasure. There Is one main home and one modular home permitted as medical hardship wanting it to become permanent.One home will be located on each lot.There is one garage,tool shed,five loafing sheds, a lean to and a pole barn.At present there are 2 horses on the property and I plan on getting a steer to raise to butcher.The south%of the property is dryland pasture. 4.The new lot will be approximately 2 acres and is located on the east side of the property—east of the main house and south or CR 8 (north boundary of property). It is being created as a single family home to eventually house me when my son and his family moves into the main house. 5.There are no unique physical characteristics. 6. I have not been requested to do a building envelope. Weld County Treasurer Account Parcel Number Receipt Date Receipt Number R6399186 147320000017 Apr 30, 2010 WEB-2010-04-30-4159 WOLLERT SANDRA S 19676 CR 8 HUDSON,CO 80642 Situs Address Payor 19676 8 CR WELD 00000 Legal Description 10804C PT NE4 20 1 65 BEG S1D04'W 30'& E822.65' FROM NW COR S1D04'W 1532.94'N44D22'E 188.15' N41D45'E 292.86'N1D04'E 1179.89'W320'TO BEG (1/8R) Property Code Actual Assessed Year Area Mill Levy SINGLE FAM.RES.-LAND- 1112 118,560 9,440 2009 2497 53.376 SINGLE FAM.RES-IMPROVEMTS- 1212 185,991 14,800 2009 2497 53.376 Payments Received Credit Card Multi-Account Payment Payments Applied Year Charges Billed Prior Payments New Payments Balance 2009 Tax $1,293.83 $0.00 $1,293.83 $0.00 $1,293.83 $0.00 Thank you for your payment all payments subject to final bank clearance Tax Account Page 1 of 1 Tax Account Summary Account Id R6399186 Parcel Number 147320000017 Owners WOLLERT SANDRA S Address 19676 CR 8 HUDSON,CO 80642 Situs Address 19676 8 CR WELD 00000 Legal 10804C PT NE4 20 1 65 BEG S I D04'W 30'&E822.65'FROM NW COR S I D04'W 1532.94'N44D22'E 188.15' N4ID45'E 292.86'NID04'E 1179.89'W320'TO BEG(1/8R) Inquiry As Of 108/04/2010 J Payment Type C First Full Total Due $0.00 Update Value Area Id Mill Levy Tax Area 2497-2497 53.3760000 Actual Assessed SINGLE FAM.RES.-LAND- 1112 118,560 9,440 SINGLE FAM.RES-IMPROVEMTS- 1212 185,991 14,800 Total Value 304,551 24,240 Taxes $1,293.83 The amounts of taxes due on this page are based on last year's property value assesments. https://www.weldtax.com/treasurer/treasurerweb/account.jsp?account=R6399186 8/4/2010 • • Weld County Treasurer Statement of Taxes Due Account Number R6399186 Parcel 147320000017 Assessed To WOLLERT SANDRA S 19676 CR 8 HUDSON,CO 80642 Legal Description Situs Address 10804C PT NE4 20 1 65 BEG S1004'W 30'&E822.65'FROM NW COR 51004W 1532.94' 19676 8 CR WELD 00000 N44D22'E 188.15'N41045'E 292.86'Ni 0041E 1179.89'W320'TO BEG(1/8R) Year Charges Billed Payments Balance 2009 Tax $1,293.83 $0.00 $1,293.83 Grand Total Due as of 04/06/2010 $1,293.83 Tax Billed at 2009 Rates for Tax Area 2497-2497 Authority Mill Levy Amount Values Actual Assessed WELD COUNTY 16.8040000* $407.32 SINGLE FAM.RES.- $118,560 $9,440 SCHOOL DIST RE3J 21.7050000 $526.13 LAND CENTRAL COLORADO WATER 0.4250000 $10.30 SINGLE FAM.RES- $185,991 $14,800 IMPROVEMTS (CCW CENTRAL COLORADO WATER 1.3380000 $32.43 Total $304,551 $24,240 SUBD HUDSON FIRE 3.5370000 $85.73 AIMS JUNIOR COLLEGE 6.3120000 $153.01 HIGH PLAINS LIBRARY 3.2550000 $78.91 Taxes Billed 2009 53.3760000 $1,293.83 'Credit Levy ALL TAX LIEN SALE AMOUNTS ARE SUBJECT TO CHANGE DUE TO ENDORSEMENT OF CURRENT TAXES BY THE LIENHOLDER OR TO ADVERTISING AND DISTRAINT WARRANT FEES. CHANGES MAY OCCUR AND THE TREASURER'S OFFICE WILL NEED TO BE CONTACTED PRIOR TO REMITTANCE AFTER THE FOLLOWING DATES: PERSONAL PROPERTY AND MOBILE HOMES-AUGUST 1,REAL PROPERTY-AUGUST 1. Weld County Treasurer P.O.Box 458,Greeley CO 80632 1400 N 17th Ave,Greeley CO 80631 (970)353-3845 ext.3290 • • Weld County Treasurer Statement of Taxes Due Account Number M 1032096 Parcel 147320000017 Assessed To WOLLERT SANDRA S 19676 CR 8 HUDSON,CO 80642 Legal Description Situs Address 10804-C IMPS ONLY MH PT NE4 20 1 65 MOBILE/MODULAR 19692 8 CR HUDSON 80642 Year Charges Billed Payments Balance 2009 Tax $198.02 $0.00 $198.02 Grand Total Due as of 04/06/2010 $198.02 Tax Billed at 2009 Rates for Tax Area 2497-2497 Authority Mill Levy Amount Values Actual Assessed WELD COUNTY 16.8040000' $62.36 MANUFCTRD.HOUSI $46,636 $3,710 SCHOOL DIST RE3J 21.7050000 $80.52 NG-IMPRVMT CENTRAL COLORADO WATER 0.4250000 $1.57 Total $46,636 $3,710 (CCW CENTRAL COLORADO WATER 1.3380000 $4.96 SUBD HUDSON FIRE 3.5370000 $13.12 AIMS JUNIOR COLLEGE 6.3120000 $23.42 HIGH PLAINS LIBRARY 3.2550000 $12.07 Taxes Billed 2009 53.3760000 $198.02 Credit Levy ALL TAX LIEN SALE AMOUNTS ARE SUBJECT TO CHANGE DUE TO ENDORSEMENT OF CURRENT TAXES BY THE LIENHOLDER OR TO ADVERTISING AND DISTRAINT WARRANT FEES. CHANGES MAY OCCUR AND THE TREASURER'S OFFICE WILL NEED TO BE CONTACTED PRIOR TO REMITTANCE AFTER THE FOLLOWING DATES: PERSONAL PROPERTY AND MOBILE HOMES-AUGUST 1,REAL PROPERTY-AUGUST 1. Weld County Treasurer P.O.Box 458,Greeley CO 80632 1400 N 17th Ave,Greeley CO 80631 (970)353-3845 ext.3290 Kristine Ranslem From: Kristine Ranslem Sent: Wednesday, May 05, 2010 8:47 AM To: Bethany Salzman; 'joanna.williams@state.co.us'; 'jeff.deatherage@state.co.us'; 'ron.schierer@co.usda.gov'; 'Mari Sanchez'; 'clerk@hudsoncolorado.org'; 'Hudson Fire Dept'; 'manuel@farmersres.com'; 'mlockhart@farmersres.com' Subject: RE-5027 Referral Attachments: Referral Sheet.pdf; Application.pdf We have just received a case (RE-5027) in which we ask that you review the attached material and send a referral to us by June 4, 2010. Attached is the application and referral sheet. You may send your comments to the Planner assigned to this case, which is Chris Gathman (cgathman@co.weld.co.us) If you have any problems or have any questions, please don't hesitate to contact me at the number below. Thank you! K rktLLin.C Ro insLevv. Planning Technician Weld County Planning Services 1555 N 17th Ave, Greeley CO 80631 970-353-6100 ext. 3519 1 • • Kristine Ranslem From: Kristine Ranslem Sent: Wednesday, May 05, 2010 8:47 AM To: 'sandhf@aol.com' Subject: Case RE-5027 Attachments: Applicant letter.pdf Please see the attached letter KvbstLve RgwsLevu. Planning Technician Weld County Planning Services 1555 N 17th Ave, Greeley CO 80631 970-353-6100 ext. 3519 REFERRAL LIST Name: Sandra Wollert Case#: RE-5027 Co Towns & Cities Fire Districts Attorney _Ault _Ault F-1 x Health Department _Berthoud _Berthoud F-2 _Extension Office _Brighton Briggsdale F-24 _Emergency Mgt Office- Ed Herring _Dacono _Brighton F-3 _Sheriffs Office _Eaton _Eaton F-4 x Public Works _Erie _Fort Lupton F-5 _Housing Authority _Evans _Frederick _Airport Authority _Firestone _Galeton F-6 _Building Inspection _Fort Lupton x Hudson F-7 x Code Compliance Beth _Frederick _Johnstown F-8 Kim Ogle (Landscape Plans) _Garden City _LaSalle F-9 _Lin (Addressing Change of Zone) _Gilcrest _Mountain View F-10 _Ambulance Services Milliken F-11 _Greeley _ _Grover _Nunn F-12 State x Hudson _Pawnee F-22 x Div. of Water Resources _Johnstown _Platteville F-13 _Geological Survey _Keenesburg _Platte Valley F-14 _Department of Health _Kersey _Poudre Valley F-15 _Department of Transportation _LaSalle _Raymer F-2 _Historical Society x Lochbuie _Southeast Weld F-16 _Water Conservation Board _Longmont _Union Colony F-20 _Oil & Gas Conservation Commission _Mead _Wiggins F-18 _Milliken _Windsor/Severance F-17 Division of Wildlife _New Raymer _South Hwy 66 (Loveland) _Northglenn Commissioner _North Hwy 66 (Greeley) _Nunn _Division of Minerals/Geology _Pierce _Platteville Soil Conservation Districts _Severance _Big Thompson/ FTC _Thornton _Boulder Valley/Longmont _Windsor _Brighton/SE Weld _Centennial Counties _Greeley/West Greeley _Adams _Platte Valley _Boulder _x_West Adams _Broomfield _Little Thompson _Larimer Federal Government Agencies Other _US Army Corps of Engrs _School District RE- _USDA-APHIS Vet Service _Central Cola Water Cons Federal Aviation Admin (Structures _RR over 200 ft or w/in 20000 ft of Pub x Beebe Seep Canal Ditch Airport Company _Federal Communications Comm _Art Elmquist (MUD Area) --� r \� � Referral List • case# 4' — ±`t 2_7 Name: - "^c�+z.- c 1l County Towns&Cities Fire Districts Attorney Ault Ault F-1 J< Health Department Berthoud Berthoud F-2(Will charaeS) Extension Office Brighton Briaasdale F-24 Fmeraencv Management Office-Fd Herrina Dacono Briahton F-3 Sheriffs Office Faton Faton F-4(Will charge SI X Public Works Erie Fort I uoton F-5 Housina Authority Fvans Galeton F-6 Airoort Authority Firestone X Hudson F-7 Buildina Inspection Fort Lupton Johnstown F-8 X Code Compliance-Beth Ann Frederick I aSalle F-9 Garden City Mountain View F-10 Kim Dale(I andscaoe Plans) Gilcrest Milliken F-11 Lin or Peaav(Addressina Chanae of 7onel Greeley Nunn F-12 Ambulance Services Grover Pawnee F-22 State ,X Hudson Platteville F-13 X Div of Water Resources Johnstown Platte Valley F-14 Geological Survey Keenesbura Poudre Valley F-15 Department of Health Kersey Ravmer F-2 Department of Transportation I aSalle Southeast Weld F-16 Historical SocietyX I ochbuie Union Colony F-26 Water Conservation Board I onamont Western Hills F-20 Oil&Gas Conservation Commission Mead Wiaains F-18 Division of Wildlife Milliken Windsor/Severance F-17 South Hwy 66(I oveland) New Ravmer North Hwy 66(Greeley) Northalenn Legal Division of Minerals/Geoloav Nunn Parcel ID# Soil Conservation Districts Pierce Zone Acres? Bia Thompson Platteville USDA Boulder Valley Severance , Airoort Briahton Thornton Geo Haz Centennial Windsor FP? Panel# , Fort Collins Counties Road Impact Fee Area? Greeley Adams (SW#1 #2 #3 Windsor 1 Lonamont Boulder IGA? ORD# Moraan Broomfield MUD? Platte Valley Southeast Weld Other ,X West Adams Central Cob.Water Conservancy Dist Federal Government Agencies _Left Hand Water _US Army Corps of Friars _School District RE- USDA-APHIS Vet Service _Art Elmquist(MUD Area)Federal Aviation Admin(Structures over X Ditch Company, 5 5' (/ora.ic--1 over 200 ft or wan 20000 ft of Pub Airport Commissioner _Federal Communications Comm • • Print Form Weld County Referral C. COLORADO May 5, 2010 The Weld County Department of Planning Services has received the following item for review: Applicant Sandra Wollert I Case Number RE-5027 Please Reply By I June 4, 2010 Planner Chris Gathman Project I Two Lot Recorded Exemption Legal Part NE4 of Section 20, Ti N, R65W of the 6th P.M., Weld County, Colorado. Location South of and adjacent to CR 8 and North of and adjacent to CR 104. For a more precise location, see legal. Parcel Number 1473 20 000017 The application is submitted to you for review and recommendation. Any comments or recommendation you consider relevant to this request would be appreciated. Please reply by the above listed date so that we may give full consideration to your recommendation. Any response not received before or on this date may be deemed to be a positive response to the Department of Planning Services. If you have any further questions regarding the application, please call the Planner associated with the request. Please note that new information may be added to applications under review during the review process. If you desire to examine or obtain this additional information, please call the Department of Planning Services. ❑ We have reviewed the request and find that it does/does not comply with our Comprehensive Plan ID We have reviewed the request and find no conflicts with our interests. ❑ See attached letter. ❑ Please notify me of any public hearings regarding this request. Comments: Upon review of my case files and computer,no ACTIVE violations were noted. Signature *a 1 't. �� Date 05/05/2010 Agency Zoning Com. ce Officer II +Weld County Planning Dept. 4'1555 N 17'"Ave, Greeley,CO.80631 4'(970)353-6100 ext.3540 +(970)304-6498 fax Fax sent by : 13835364753 TOWN OF HUDSON 05-10-10 13:23 Pg: 1/1 • • .. .%. 6 �� • Weld County Referral 1111 k May 5, 2010 COLORADO • The Weld County Department of Planning Services has received the following item for review: Applicant Sandra Wollert Case Number RE-5027 Please Reply By June 4,2010 Planner i Chris Gathman Project Two Lot Recorded Exemption Legal Part NE4 of Section 20,T1 N, R65W of the 6th P.M.,Weld County, Colorado. • Location South of and adjacent to CR 8 and North of and adjacent to CR 104. For a more precise location,see legal. Parcel Number 1473 20 000017 The application is submitted to you for review and recommendation. Any comments or recommendation you consider relevant to this request would be appreciated. Please reply by the above listed date so that we may give full consideration to your recommendation. Any response not received before or on this date may be deemed to be a positive response to the Department of Planning Services. If you have any further questions regarding the application,please call the Planner associated with the request. Please note that new information may be added to applications under review during the review process. If you desire to examine or obtain this additional information,please call the Department of Planning Services. ., . a We have reviewed the request and find that it does/does not comply with our Comprehensive Plan 2,have reviewed the request and find no conflicts with our interests. © See attached letter. Please notify me of any public hearings regarding this request. Comments: Signature r j�,�^�cn1/ Date 51/P-j1 Agency ic15o7\- Ca Iytna.i. (r Asi • +Weld County Planning Dept +1555 N 17"Ave, Greeley,CO.80631 +(970)353-6100 ext.35.10 +(070)30441498 tax • • 4iECEIVEL ii clit: 6 MAY 0 6 2010 iiiiiWeld County Referral C. May 5, 2010 COLORADO The Weld County Department of Planning Services has received the following item for review: Applicant Sandra Wollert Case Number RE-5027 Please Reply By !I June 4, 2010 Planner Chris Gathman Project Two Lot Recorded Exemption Legal Part NE4 of Section 20, Ti N, R65W of the 6th P.M., Weld County, Colorado. Location South of and adjacent to CR 8 and North of and adjacent to CR O7 For a more precise location, see legal. 3q_ y ( Parcel Number ! 1473 20 000017 The application is submitted to you for review and recommendation. Any comments or recommendation you consider relevant to this request would be appreciated. Please reply by the above listed date so that we may give full consideration to your recommendation. Any response not received before or on this date may be deemed to be a positive response to the Department of Planning Services. If you have any further questions regarding the application, please call the Planner associated with the request. Please note that new information may be added to applications under review during the review process. If you desire to examine or obtain this additional information, please call the Department of Planning Services. ❑ We have reviewed the request and find that it does/does not comply with our Comprehensive Plan ❑ We have reviewed the request and find no conflicts with our interests. / . See attached letter. Please notify me of any public hearings regarding this request. Comments: Signature Wt/ Date 5 - .2 -10 Agency •?W +•Weld County Planning Dept. +1555 N 17th Ave, Greeley, CO. 80631 V(970)353-6100 ext.3540 V(970)304-6498 fax ..cm uuuury nammmg uepanmen[ • GREELEY OFFICE MAY 2 H ?nln (itkMEMORANDUM RECEIVE® WI C TO: Chris Gathman, Planning Services DATE: May 25, 2010 FROM: Donald Carroll, Engineering Administrator ti COLORADO SUBJECT: RE-5027, Sandra Wollert The Weld County Public Works Department has reviewed this proposal. Staff comments made during this phase of the process may not be all-inclusive, as other concerns or issues may arise during the remaining application process. Issues of concern must be resolved with the Public Works Department. Our comments and requirements are as follows: COMMENTS: Weld County Road Classification Plan (FHU): (June 2002) WCR 8 is a collector road and requires an 80- foot right-of-way at full build out. There is presently a 60-foot right-of-way. This road is maintained by Weld County. Pursuant to the definition of SETBACK in the Weld County Zoning (23-1-90), the required setback is measured from the future right-of-way line. The applicant shall delineate or dedicate an additional 10-foot of right-of-way parallel to the WCR 8 right-of-way for future build-out. WCR 41 is a collector road and requires an 80-foot right-of-way at full build out. There is presently a 60-foot right-of-way. This road is maintained by Weld County. Pursuant to the definition of SETBACK in the Weld County Zoning (23-1-90), the required setback is measured from the future right-of-way line. The applicant shall delineate or dedicate an additional 10-foot of right-of-way parallel to the WCR 41 right-of-way for future build-out. REQUIREMENTS: Utilize the existing access to this parcel (Lots A & B) Utilize the existing agricultural, oil and gas, and ditch roads that are necessary for your agricultural operation. Pursuant to Chapter 15, Articles I and II of the Weld County Code, if noxious weeds exist on the property or become established as a result of the proposed development, the applicant/landowner shall be responsible for controlling the noxious weeds. All vegetation, other than grasses, needs to be maintained at a maximum height of 12 inches until the area is completely developed. Flood Hazard Development Standards: This area IS NOT in a Special Flood Hazard Area (SFHA) as determined by the Federal Emergency Management Agency (FEMA).Please add the following notes to the plat: • pc: RE-5027 Page 1 of 1 M:\PLANNING-DEVELOPMENT REVIEW\RE-Recorded Exemption\RE-5027.docx . • • • WELD COUNTY ROAD ACCESS INFORMATION SHEET Weld County Department of Public Works 111 H St PO Box 758 Greeley CO 80632 Phone: (970) 356-4000 x3750 Fax: (970) 304-6497 Road File#: ' Date: -1'-/-/o RE# : 5a 21n I/ // Other Case#: 1. Applicant Name Ora nrj c2 S__ o //4' f- /, Phone.303-`�y9-&ry 92 (r.e /)/ Address )9& 9A .C R k City h'i c/4o.: State Cb Zip SS? e 2. Address or Location of Access /9 02/a C/Z &' CY /9/,9'2 CA'8-- Section ,2C, Township E% Range /GS i/L./ Subdivision Block Lot Weld County Road#: $7 Side of Road Distance from nearest intersection */ 3. Is there an existing access to the property? Yes X No #of Accesses 4. Proposed Use: Nt Permanent ❑ Residential/Agricultural U Industrial ❑ Temporary ❑ Subdivision ❑ Commercial ❑ Other 4*********************************************************************************************************************** 5. Site Sketch Legend for Access Description: J i CA AG = Agricultural RES = Residential O&G = Oil &Gas A DR = Ditch Road I n25 !? �L O = House to c u O = Shed (_ ! O ` t d �G A = Existing Access �yV LI = Proposed Access h V I u I G 4t �✓ V NI -I 7-- OFFICE USE ONLY: Road ADT Date Accidents Date Road ADT Date Accidents Date Drainage Requirement Culvert Size Length Special Conditions U Installation Authorized ❑ Information Insufficient Reviewed By: Title: -7- Kip ct, Memorandum TO: Chris Gathman, W.C. Planning DATE: May 27, 2010 • FROM: Laurie Exby, W.C. Department of Public COLORADO Health and Environment CASE NO.: RE-5027 NAME: Wollert Environmental Health Services has reviewed this proposal to exempt 2.5 acres from a 9.88 acre site. Proposed lot A will consist of 2.5 acres and proposed lot B will consist of 7.88 acres. Domestic water will be provided to both lot A and lot B from a shared domestic well (well permit#444994). There is an existing modular home on proposed lot A. Lot A has individual sewage disposal system (permit number SP-9600382). Proposed lot B has a wood frame home located on the property. It appears the residence located at 19692 CR 8, does not have a septic permit on file. The following conditions are recommended to be part of any approval: 1. All septic systems must be located on their respective lots and meet all lot line set back requirements. Provide a drawing of the septic system, with dimension and distances from lot lines, to W.C. Department of Public Health and environment for verification of setbacks. 2. All septic systems located on the property shall have appropriate permits from the Weld County Department of Public Health & Environment. Any existing septic system which is not currently permitted through the Weld County Department of Public Health & Environment will require an I.S.D.S. Evaluation prior to the issuance of the required septic permit. In the event the system is found to be inadequate, the system must be brought into compliance with current I.S.D.S. regulations. 3. Since the two houses are proposed to share a common well, the applicant shall submit a document providing for shared well operation and maintenance by both parcels of land. The declaration shall be recorded and the recordation number indicated on the plat. A joint easement agreement shall be indicated on the plat. Additionally, please note the following: 1. Topographic or physical features of the proposed lot, such as ravines, ditches, streams, etc. may limit the area available for a new or replacement septic system. Prior to recording the plat the Division recommends that the applicants review the County Code pertaining to Septic Systems to assure that any installed septic system will comply with Ili ill all setback requirements found in the Code. In the event the proposed lot is not of sufficient size to allow the installation of a septic system the lot may need to be enlarged. • • OF 'COO DEPARTMENT OF NATURAL RESOURCES 4Cet; Mr)Cn DIVISION OF WATER RESOURCES \# _ � Bill Ritter,Jr. X876 � Governor May 7, 2010 James B.Martin Executive Director Mr. Chris Gathman Dick Wolfe,P.E. Director/State Engineer Weld County Planning Department 1555 N 171h Ave. Weld County Planning Department Greeley, Co 80631 GREELEY OFFICE Re: Exemption from Platting-Sandra Wollert MAY 1 3 7(110 Case E1 ,o. R 20, T RECEIVED NE 114, Sec. 20, T1N, R65W, 6th P.M. Water Division 1, Water District 2 Dear Mr. Gathman: We have reviewed the above referenced proposal to create by exemption two lots of 2 acres (Lot A) and 7.88 acres (Lot B). The water supply for the two lots will be provided by an existing well permit no. 44494. Since the submitted material does not appear to qualify as a "subdivision" as defined in Section § 30- 28-101(10)(a), C.R.S., pursuant to the State Engineer's March 4, 2005 memorandum to county planning directors, this office will only perform a cursory review of the referral information and provide comments. The comments will not address the adequacy of the water supply plan for this development or the ability of the water supply plan to satisfy any County regulations or requirements. In addition, the comments provided herein cannot be used to guarantee a viable water supply plan or infrastructure, the issuance of a well permit, or the physical availability of water. According to our records, permit no. 44494 was canceled and permit no. 283002 was issued on April 14, 2010 pursuant to the State Engineer's Policy Memorandum 93-5 for the expansion of use of an existing well constructed under permit no 44494. The original well permit no. 44494 was issued on February 18, 1971 for domestic purposes. Pursuant to the State Engineer's Policy Memorandum 93-5 the use of a pre-May 8, 1972 well may be expanded by one single family-dwelling if the lot and well will meet certain criteria. Permit no. 44494 was expanded by one single-family dwelling, therefore. the use of ground water from well permit no. 283002 is limited to ordinary household purposes inside two (2) single family dwellings, the watering of poultry and domestic animals, and the irrigation of not more than 1,000 square feet of home gardens and lawns. Well permit no. 283002 can be used to serve proposed Lots A and B as long as the well is operated in accordance with the terms and conditions of the well permit. Should you have any questions in this matter, please contact loana Comaniciu of this office. Sinc-rely, l n� Joan a Williams, P.E Wate Resource Engineer Cc: Jim Hall, Division Engineer Scott Edgar, Water Commissioner, District 1 JMW/IDC Office of the State Engineer 1313 Sherman Street, Suite 818 •Denver,CO 80203• Phone: 303-866-3581 •Fax:303-866-3589 www.water.state.co.us a _x M tia ^it �� rya ��' , _.. �„ t��„,i z . W ry T .. >5'` 9fyP, 4 -- —"`:''')/ ' 4•4- " �` by rill ��l .,1/ -7 �/ /� �� 1.—/ _ -_--'II 1 — ( - n f''' , h r 9; � I� ►-ous4, i 24 Fp- " _ nr� c G 1 � - I '4-1<c i ,s A i.� et( 9 " r' cc t ,-, f 3oro ' L , 2,,,,/,,F l�' itusk sn rt/ _ jy ,-,a I G,,, (Cr..2 '.I 31,e- -in I /57 Pd � r It � � LI ' IJiII 1 eAc p, ,-,___\ /` 7 .:.. • • WELD COUNTY ROAD ACCESS INFORMATION SHEET Weld County Department of Public Works 111 H St PO Box 758 Greeley CO 80632 Phone: (970) 356-4000 x3750 Fax: (970) 304-6497 Road File#: Date: RE# : I/ L Other Case#: 1. Applicant Name On ncl h et S �(/o ��.v / Phone 30.?-u74,7-14L 92 ( Address I9/& 9/n C R , ' City kun/so., State (b Zip .$64467 2. Address or Location of Access /9 (0_24, C4 CY /5G7S2 C/i dr Section ,j2(i) Township (3/ Range lE5' tU Subdivision Block Lot Weld County Road#: 1 Side of Road Distance from nearest intersection yam' 3. Is there an existing access to the property? Yes X No #of Accesses 4. Proposed Use: Permanent ❑ Residential/Agricultural ❑ Industrial ❑ Temporary ❑ Subdivision ❑ Commercial ❑ Other ******************************************************************************************************************************* 5. Site Sketch Legend for Access Description: AG = Agricultural CR RES = Residential O&G = Oil& Gas 0 DR = Ditch Road ( u5 = House 7 = Shed I. c C • = Existing Access A = Proposed Access N n G 1 NI OFFICE USE ONLY: Road ADT Date Accidents Date Road ADT Date Accidents Date Drainage Requirement Culvert Size Length Special Conditions ❑ Installation Authorized ❑ Information Insufficient Reviewed By: Title: -7- CERTIFICATE OF CONVEYANCES WELD COUNTY STATE OF COLORADO DEPARTMENT OF PLANNING SERVICES COUNTY OF WELD Land Title Order No.: Wollert The Land Title Guarantee Company TITLE INSURANCE or ABSTRACT COMPANY hereby certifies that it has made a careful search of its records, and finds the following conveyances affecting the real estate described herein since August 30, 1972, and the most recent deed recorded prior to August 30, 1972. Legal Description: See Attached Exhibit"A" CONVEYANCES (if none appear, so state): Reception No. 1555382 , Book 683 Reception No. 1647204 , Book 725 Reception No. 1696543 , Book 775 Reception No. 1877122 , Book 955 Reception No. 1877123 , Book 955 Reception No. 2817929 Reception No. 3282124 This Certificate is made for the use and benefit of the Department of Planning Services of Weld County, Colorado. This Certificate is not to be construed as an Abstract of Title, nor an opinion of Title, nor a guarantee Title, and the liability of Land Title Guarantee COMPANY, is hereby limited to the fee paid for this Certificate. It Witness Whereof, Land Title Guarantee COMPANY, has caused this certificate to be signed by its proper officer this 2"d day of April, 2010 at 5:00 o'clock P.M. LAND TITLE GUARANTEE COMPANY B9: iVfl / J Title Examiner EXHIBIT "A" THAT PART OF SECTION 20, TOWNSIP 1 NORTH, RANGE 65 WEST OF THE 6TH P.M., COUNTY OF WELD, STATE OF COLORADO, DESCRIBED AS FOLLOWS: BEGINNING AT THE NORTHWEST CORNER OF THE NORTHEAST QUARTER OF SECTION 20, THENCE SOUTH 1 DEGREE 04' WEST, ALONG THE WEST LINE OF THE NORTHEAST QUARTER OF SECTION 20, 30.00 FEET; THENCE EAST PARALLEL TO THE NORTH LINE OF SECTION 20, 822.65 FEET TO THE TRUE POINT OF BEGINNING; THENCE SOUTH 1 DEGREE 04' WEST, PARALLEL TO THE WEST LINE OF THE NORTHEAST QUARTER OF SECTION 20, 1532.94 FEET; THENCE NORTH 44 DEGREES 22' EAST, 188.15 FEET; THENCE NORTH 41 DEGREES 45' EAST, 292.86 FEET; THENCE NORTH 1 DEGREE 04' EAST, PARALLEL TO THE WEST LINE OF THE NORTHEAST QUARTER OF SECTION 20, 1179.89 FEET TO A POINT 30.00 FEET SOUTH OF THE NORTH LINE OF SECTION 20; THENCE WEST PARALLEL TO THE NORTH LINE OF SECTION 20, 320.0 FEET TO THE TRUE POINT OF BEGINNING, COUNTY OF WELD, STATE OF COLORADO. r tea, .,t oy qq no 393 arar S..._JL./b.r.J..._M.— SE3$9-FC---,-_ O et ,step.rue te •,Tali lJ u. r•w XIII rate s.eteaber ,o ) , I Mateo Yarn 1. man r Nora J. roam a I .� yr.payrrowory Fr • I • p .r� rs" tea al rata e;i . ..'.Z../�... ... ' N 11i O runt J. Due a. Masa O. peon .. wY rawly Alapaha era Mar e W :y..r,r atoms err M . w IIIIII/Pit1.Oa Ow W tots of a na art a w b m.ldwea ea ma Of Y Y o Ya-Ssrrr rinr*Yane as m,lw O r raw poi mart trldmila •a um pia rt4.n.•-- .na a as.Y"wawa. al a ▪ Fa OP Mm..r.r 4rw.r teal arse ecr.re.r:art tea r..rat r a.wr , r'lu era..+a Ira PP*tuM a••.•ad arra at a•.Y'sea*R roar Yea IIe- ISM roardao.lilt b user.mamar loam soap.r dm semi dare or a israte rbLL agar lest owl Sala a Jay or arrr a jjt j pg sharp Ift18iaiNT}��jfrl�ry311r1Y Il ate elttMb��lirr]]�?yy8}6�{t • r r a. rik r.i5 fwi ti.e t e• L. .K.w`. ' prise I it r pre tea elrlld a the sal lira of a,ire e(Jt aortae of Barr Se Ian 11 bet in m point ire tat rata or W North Ito et JrYa of uw p UM Antra a IS lYU ltr a moat or t 20, n).41 root a lr ten peat of '4' ytteen& niWlj 1p.0 arts moat et blur �No lung W M (pr.wrb YweW wool for eptwl— slut) Oar tf -g l lI OM Ira IS r rime r aearta r eam.eaa llamalam rag pall I r r- aarbheM W r!WSW r errwl.A rater r eraer a�.r palls r.rl r el reia Jimaa bluerilu r meal rap r Si sr w l MrIMYrr St,tea. .w.*Sae*ate ter se piaYa ate ram rrd•r.eo r Ygaeaaa r WO aO A Ma Oa ell err teems broad ad Sena toa••team•••as r W guar et r•petaled per Y bolos r else.law r/r ell parr rat lb*pa r tat it Ha�s Samba tea rrnrw.Yam arb sa w n.bra i soil pailloa r la ter On Mr bar at ate Mr Mae Nat as marpr tarp el lamps*r e as rote te r pals+aw raterm r wr a.eta aaar r route alma r*Masan Si Y•a raread raPal raw MI am r War tale t•eta S ter sot isle r per SS r tea 1r.a.re am r ate am al lute r air roam agra air Mr lea•sasod a.reew of riser W.urn era Yaps No age dgaila a a, I. 1911. r W atr YiYlY pair la at lrel r orals palm a rs r ran a b std pa,rat soma.rtea.S 5 rat tat•ad aye te lab molt..taV di r IPSteea erg ' reel aarp.le air a.aa nog as weer M.W on at tam or ram r rJ wawa an Yon DEMO Its Mbar mete Mr Seib rat lira,W Owl la S.is Y an clap lab rte Y Sable Os r or.. to.mom.mr,P a rte per Of a re aro a Irma al K bra g.. as slam stela der Bar al IJnrte a a Para te lI y� fL-aJ170 1�iwrY.af/as0ars1 nana O. Ia. b It a r+_4.iu` • 1r IaaaYs.w r- '-&/mawriI o�B.Iimp a allig,. ,rlO. WI in.neet J. W.Is.d an //ra-w 3. Aram IS;,•... e N.Gerlaa err .M . ,r� wOSA.nyeMILimb 7 - • Ns Mat Aswan er..w Ira masa—warm s ea as tea . v.i7et AGi:'e 0iriihy ti.•iittti',:12is L' 'C....... .':.3i.'' . . . ... . '''1740`31 1.4 •r!�4n�i� •.Y+v may., 1 soot ,V. 'il:.i ` 5 e•nNtl.t......3.dr.'......__.'ebet-..�....M, (JUT n,, J �i Recr'rue.me_.SLUA7ZQ9.._.. a La:MWile, ik aserOr. _ i.. --_—" _r_ _f u` Dos DUD, Marks 15th nod October ,1374 , WILING STAMP Sts..... HERBERT J. DORN and MARION G. DORN, husband end 5 wire - 1 :Atli.LL.L-nailia•, ,q c, .rW Cmard Weld sad Slate or Oiler 01000 e.rtW ROBERT L. BROWN and NORMA R. Dale On 221714 i Tr BROWN e o B S C)0 w tier cramped World cod Bred , .-I Celende,d the lased pert, e▪, WITHEBBRTII,Wt Me mil purr of Me first art for end la eesNetlm of lb.Ara of • ti FIFTY NINE THOUSAND AND NO/l ODthe e0ULtAiJ n end slier pad and Nadle,wldonUon le W Nd party et Os Dr*pen la bird pW es Me sell poles el W 0 .. sewed sea ill mesh*slaw(le Mnbda,e. eel ellWwe ebded Impend.end.kn. sell wad seemsR iv , Wei Wm moane dose not.bepeln,M,nemt We sra all ill nM d mea l ad part Mete n Min d assigns formic m Ia inn la m en est S plat lean,ell W following dawndawnedst w 1 s 11001 of Sna,sled.,lying pad balm In W Crab d Weld W eats it Caanda,N.MG That pert of Section 20. Township I North, Rings 65 West Of the 6th r0 P. M., WELD COUNTY, COLORADO, desert bed as follows: ware at the North+ep .T corner or the 1134 of sold Section 70, Thence South I ON West along the West line ', 3 of the NO of Sectlon20 B distance of )0.0 feet( Thence Eat Vets 1.1 to the Morin ,p line of SKtioo 21 0, a t peril's? erk O to f 822.69 fe►t to the TTRReUE EPtOOINf OF Section 2IMGs ra df.tennc°ofh155�322..94Wfeeet, ThThence NortM4482211 line of feet, Thence North 41° 450 Ent 292.86 feet, Thence North I°del Ent parallel to the Mast line of the feet South of the Northflinetof Secction 20;ence of Theence Wait lelt�tGoo�the North line of Section 20, a toloredo, along with l of Rill l pooh.T OF BEGINNING, other ;snow as Stn Route, TOOTIMEN MIX.D W stpSr the baadieaab sad asseria ease Musts trdeeslar,re la envier spp..eslel,t ad W n.edei she nrerele°e,rsaeleder W.aa.Maae ea chum W sane tla.eff W ae the adds.Mat,till.Wenn,Mina W dais vision d the mill party et tee NS pet Item Ia be.s : whatnot.S W to Me Mee Mesapad pea.with W bamMuaag W gpertasea TO MATT AND TO NOLO Me all per bee Sear berRdW sal dried.Mil IS appoleamem rag the Iall perdu el tee wad sari.este son and mine fan.Aid IS ad parts d Me ant pert.far W sag.W emend necksM W SNOW,'W era,Met et h to d neat, eared*awl d eons tri ail pane,es l tea End a w9 ediYM d tee Men aeg TIMM n ed.ss ee peed.at,palest Online ea WdwWMe eNda el IASXmN le lave be I Lw.Mpl,sad Mi 00 Mot feD pane W Sail esl0r0/Spat hasten,IO PM cat,Me am Fs=ma 1 Whys des.seld.W Wt the mow an In.W Oar Ira.n harm W Misr Rat%banNse,a ea IS.. lwa,swrnds sal ennntsera et whets.WS c•satin sawn.. except the 1974 General Tests payable in 1975, all texas for subsequent years and subject to easements, restrl i dons and protective covenants of record, further subject First Deed of Trust let ad February 14, 1972, recorded in Book 662 as Reception No. 1583762. further Bub- Ifact to Secant Deed of Trust dated April 23, 1977, recorded in Book 690 es Recap- '. tier' No. 1617058, ddch pestles of the second port agree tossup.* and nay. W the also ha.pgaf snake a W wid rod pmalg mimesis.us efOnalt puts etdearmed we,W I' mew or des.deb weirs w WWnW weeps el.a annex egad an rod orrery psoaw rem I, Maley dabs w to ado'mm,W lads w, an IoW allpw.1,ode tem pet Ad W WISATTANT I' AND TORT=OTFL10.Isotader maw Sc Inge Me*.at W*nlMe be.ler,W ems Mean maw Sae.spewMe le pit swam 53 wITNR°°erlNFVDAF Me ma poly of W nrd ant Mr boned.vat We bard Siva,Me day el se 1 ,. ithew abets Wehees �/,./ , MamA:0 0WIei.smd an Ms New.al I i !%.yrr',• yf .•G.•... ,fARslt I r rt J:'l'^:n I <CI 0 ' 77)112'.1. f" 2,,-(. ti ..iota- r_ ITGLI k { sees. .. ... I Oag�n[• L,n,I r-..,.1`=.N .•ac ai4. ... irrATR QY COI.rAtl'O 1: is owed ewe : r spy y.amat is sdlewstalnd tar we o.. 15th dos d .r4 .October .! by.T 4 ''C.4. Si*W$*RICO C. 0050$ I cod.el n. ersoneNeespsye�..wnh 8,1978. .efaW.e,p4ieW I ... ......... :: sees ,-.937A. warn aailla.-a w mesa-040.1 Fir.a.a.a.Nan rem ant tae••arm. . wrr.a�+ ..sa,.. aY.YY area e.� v •Di°"7`75 R.eaed u./::�°._._..._.'.>�j�_....v._.JillCr.18]915'--._..__.._...._.._ 04 eweptlan No, 1.54€.543, ....•...••.........MMY..ANN.fWVJRICR1...SeeNo. `0 • RRCORDRRY RAN? THIN Dim, Kam 13th der of st • Augu le 76.between Robert L. Drown and NO R. Brown, as Hueiand and Wife. .p-, ^•pule Docum:nloty Fes ' o. DCie. QUG._L.8 1¢76 rn of IS. Cony erWeld end State ef B 4OO • IN Celeriac,of the tint portend Trunnion A. Brunger t and Jeanie e G. Ewngszdt as Nua:n¢d and Wife efAV 7/(d 'CJ • "I of the Camtbef Elbert W Elated Colonels's!the served poet: • WITNlLaETD,that Weer puttee of the fle pert,brand leens$$$$$n$ thermal$$$$of • Ten Dollars and other good and valuable coneideretiens S$$$$$$$$5$$$$$$$DOLIAEE. o, n n mf to the old part fee of.t fire pert in hand Mid by W see Mr end ce Vee wowed part,to inapt do 0 le es a n hereby barman, rfessed and a y*,lad roc haPave pests,berielwine of sold men pant atred,&l by in end seams do 05 a u In a nexy la comma,my*, n Mot tenlne ancy.ete the N the t llest. deleted lets Oa d r panels ef land,Mean,plea sad Rimer,set a ,O WertW Casty of Weld and Stale of Womb.to wit: ti . That part of Section 20, Township 1 North, Range 65 West of the 6th P.N., Weld ',-,.°, co County, Colorado, described a follow. Beginning at the Northwest corner of the NEk of aid Section 20, Thence South 1'04' West along the West line of the NEk of eo Section 20, a distance of 30.0 (eat; Thence East parallel to the North line of - Seccinn 20, a d(stance of 822.65 feet to the IRIlE POINT OF BEGINNING: Thence South VO4' Vest parallel to,the West line of the NEk of Section 20, a distance of 1532.94 feet; Thence North 44'22' Sint, 188.15 feet; Thence North 41'45' East 1292.86 feet, thence No—th 1'04' Seat parallel to the West line of the NEk of Sect'. n 20, I a distance of 1179.89 test to • point 30.0 feet South of the North line of Scotto 20; Thence West parallel to the North line of Section 20, a distance of 320.0 feet to the TRUE POINT O BEGINNING. County, Road 8 Star Route Box 23, Weld TOGETHER with ell end dards.the herdle note end apporteeaot thermele belaper.or In enpwbe n t ayperialalaa.W merlin end wanton.remainder lad remalnden.rata Kann and prelim there;and all the I 1 S' J ,.tats,right,VW,Interest.aim end demand easterner of the Wd part Lee of duffed put,either In law or ' I( .Dent.er,W and to t e shore bartalnd OrrmtsW with W beditamans eadanporlenanea I(5(g/ .. TO NAVE AND TO BOLO the add preeir ehon be,5abel aid drnibad,with the EpppNaanor,ante the sold l-Y petheew the sewedpart,WNhelm and salons former.And the lathtart tea of the tint pert,for them agree t}'1[heirs salon.and.dminhtrabn does revenant Franc Pamela end scree to and with the ad Pardee of the rend part their kin and saitne,that at the was of the ensue{and delivery of then pram rots they are well melted of the premien above honeyed,as of egad,an,perfect.aleelon and Indefeasible estate of montane.to law,in fee simple.end he ve geed right fall power and lewfal uthedly to trunk ban rain,all and convey the sews In manner end form eforweld,and that the now on free sad eke hen eh former end other grants,barman.oaks,Ilem tun,anemone and nambnnme of whaWru kind or oaten ewer. except easements, restrictions, and covenants of record, except general taxes for 1976 and subeeq,mnt years. e nd the stove bargained premien in the safe and ramble poewlen of the meld parties of the woad put,their helm and anigna,against all wed every peneen or priory lawfully claiming orb clew Nnwhale or any pert thereof. the wild part Lett of the lint put'lull and will WARRAN.^AND FOREVER DEPEND. IN WITNESS WHEREOF andw the easel vpertw icerat of the first Ian hetLande and net e the day and tar the oboe ican. Signed.Steed and Delivered In the Preenceof , e,... ._. -e•"_ (SEAL) bert L. Brown, Husband •/Xla•'la.i ✓l-t...... 't'L'l`-) f9EAL1 ..... ... .........._... . (SEAL1 STATE OP COLORADO,//.�///fI Norse R. Brown, Wife [bone of Ida. 4 The toreIng Inetremnl wee erknnwlegd Wen ere thin 13th dyer August 19 76.bpe Robert L. 1/411•-tee and Worms R. brown. as Husband and Wife. •Ef,S megWfde,iWrs l ..tam'i'C.Ill'4(.W lmae my bud and effkhal eat. JV_a n..t— 9 ,4_,,..,„._,.,..,..Lnl M1u,e r 1:'•,py j\.\^''G i Keg, dOitw;4 odes—I.Mel newm—Bore male 0a.MOS spa ap..t ,po.,ocw.w—Pre pjr.a..,'Newer.m.,Lema' annt mantis;m 't,in r w'iuie nren e,"...0 lea Y qp 4 r T▪M,-4 hr.ww+.aM nn,a4e,sr,rafilemvefhr•1.n nee"rt.' K-r�ti • WIWOW , Li 955 J I! s BEc 15 rlat 6�K Recorded• leer P M..e IN/Ile& reorder. .p O, Reception No__7.N o' THIS DEED. Madethie dry of November ,it 81, 1 between c' SEANNIE G. BRUNGARDT orthe County of - and state of o Colorado,of the first part,and TRUEMAN A. BRUNGARDT o whose I nsloddre.ia 19676 Weld County Rd., Hudson, C of the County of Weld and state of O t Colorado.of the second part. WITNESSETH.That the said party of the first',girt,for and in consideration of the sum of n f �LL r, O TEN DOLLARS AND OTHER GOOD AND VALUABLE CONSIDERATION / I(IG46, o to the said part y of the first pert In hand paid by the•aid part y of the second part.the receipt whereof to II is hereby ronfened and acknowledged.hit/eternised.released.sold.conveyed and QUIT CLAIMED.and by these t presents do remise.roles..,salt,coey and QUITCLAIM unto the said part y of the second part, his helm I convey I successors and assigns.forever.all the right,title,interest.ela lin and demand which the maid partY of the first part) ', ha s in and to the following described lot prparrei of land situate,lying and being in the County i. Il of Weld and State of Colorado.to wit: II C I; SEE ATTACHED 1 N I' ` y 1�I QI I NI p ii il, ii d II aloe known as street and number 19676 Weld County Rd. TO HAVE AND TO HOLD the same,together with all and singular the appurtenance.and privileges thereunto belonging or in anywise thereunto appertaining,and all the musts,right,title,Interest and claim whatsoever,of the acid part of the first part,either in law or equity,to the only proper use,benefit and behoof of the said part y of the second part,his heirs and assigns forever. i IN WITNESS WHEREOF,The said part y'of the first part ha s hereunto set hetland 1 and seal the day and year first above written, „ •• '% ' JEAITNI I Signed.Sealed and Delivered in the Presence of R G. BRUAliAlFrtFj __ ISEALI I; ___ ISEALI II I, _____ 'SEAL' STATE OF¢yivo y1)O,(KA a sty} p ns, Countyof fjtwnAA IThe foregoing Instrument woe acknowledged before me this 3j4' day of N M_t/...-Gtn_/ 39 flyby JFANNIE G. BRUNGARDT My commbsion empire. 3 -g `/ .ia22.Witness my hand and official seal. *..WE vi g ' "r 01Alir.. .q . __ c' k.%1.Dam N.,p.... y,• t ...• '• :r:Y Eta Au ; 5`s A; ..PU B V.••:`?i•,,. ,,// /// / 'ASH e '..0 fR-: t '. • 3H - ffi3o No.SU .(mecalaoeeD aaammruan.mna...:.xo.e..n.,s,.,.'o tvnm _, „ ns.n_an m,:II.I.18“.51 . • Boa955 RECEPTION 14'7'712".+. • 1 ,. nr, ry •;,11. 1tY�\ P KVS [ 1g'�� S } 1 +it . .x\iyv X2c s t't cr S�.. 4 F'+ I _ , Ic♦ i~j� reel�yy:!•r�>n\.w.�. . • yr2t t' \ 1::.'. Yom, '% S l y NN., 14 J`L v • t \ �.' 5 • W 'L . • } ' • 2,721..k. F�� 3� 4a K4Y vA '•,q t.1/4: ti st rr >[ { t j icy. 1 . 5• °`C 'Sy 1. 11sVJ fl sJA3Y�11�yx`t�F 1}L fv j Wl.�r Y plan. ••1?,•.t< FQc�i ir, � �[ fa .� M ••‘', i 1. 1 rNlvr�ty) . .I geY:,t'i' ffs 0 BOOK 955 Re.,rded at 3C''ryY 'elockf „ ote 15Y181 __ .- o v • RxMepninn\ 127 123- �'.{rte' •rder. �� R' IC r. C.e „• THIS DEED. Mao-:Ihl. 4th dal'.: December .1081 I FILING STA\II' between �' TRCEMAN A. BRUVGA.RDT • I ' 1 Stale Documentary Fee -•. oflhr en:nn,d Aadts :.:.r,,..,i rol,.aaa.rrnhe n..:.remand Day DE0 15 195' HAROLD 0. WOLLER'F, JR. AND SANDRA S. WOLLERT I y_[ OD Q_ _--.__ I--, c who laddre„r• 19676 Weld County Rd., Eudson, cc. o of c,. C„rr,.. .• `held ,,,.v.r+,.. C'aba a.b.af,he e,r, ,,. p. tdT\t YTi1.:4a1,I . . .•.. . mar.. w C- ONE HUNDRED THOUSAND AND NO/1Ci '- aobt,ARs '" .I .Ii, 1 r 1 I... f the See Attached °i` Weld Count: Rd. ' al...,,n.md e,aecr .ntm.n.oe. 19676 ' TO IIRE 1Cbin HDII 1 pp - m. . -nd m1 t h.n.ILh- leis. n d ad .,, l e. .re,' i v., and wi l..r rd parties r and part. the,'he s.irnet Dept an ! .li , .....,. l tb.:. pre:rnn.bel.' Il: - d:h,premises gorai ric. .v.11 J • end f..nu... ..., ar.1 con in',antler end Cmn:afn esaid. and thai thed deur Pidn ue rerme• snd et key di Ant:.bartone.sated ter ns.'wee-.asSyssments and ,.na.eeert ,1r, r . . except General Taxes for 1981 and sub- sequent years, easements, restrictions, reservations and covenants o'_ record, if any; Rights of way for County Roads recorded October 14, 1889 in Book 86 at Page 273, Condition contained in the united States Patent recorded June 12, 1906, in Book 131 at Page 163, an undivided 1/2 interest in all oil, gas and other minerals, as res- erved by John W. Maul & Lois T. Maul recorded Anvil 6, 1959 in Book*.[heaarmdn.a.tb ♦na the nbo. .,.r r,..rd n an.en.n are.a., ,.,.1:. ,.anal, .,.:....., r.r,.tr.r !p, .re. ,. aefuls I :ten ,,daim Ihe t . .. 1 ,i1 .Pall, a; wit WARRANT AND shall be apt!- bi t' lli . ah,.,.,,,.[en. *1528 at Page 432, Oil & gas lease r corneae d uuYy 11, Th 1n Book 802 under Reception n1724 2.66,0i1 Di1 and des lease recorded �Sept- S:gned Seale and Delivered, h h,. ember 2, 1980, in Book 913, under , TRLE41AV A. BRU:GAR � Recepp on. ;.1$31.667, and Deed o? Trust recorded August 13, 1976 in Book_.715_nntier_naceptlon '1696544 _.. ..ISEALI which parties of the second part agree to assume and pay, STATE OF COL,.,P..4Po . cucnt,of Adams j.,• Thefnregrd g tr mt `'n wal k: wlrr e,n,.c.rara. e:; 4th .1a:: . December .1981 by TeHLR, Nu A. BRUNGPRDT my ca,,, [ n r Februar, 24 ry 8 t . eee my 3r.0 And of rifle]seal. Sir e-n1-s1 TI EeCOMPAt.r.y �,Ic '.'. � , 'GEa`:cn. ..r.,fii,;uJ 80208 4.— , . j \u.'J"!\. ,Fri...rl rn.. .n.l.mn. X' a rrr r. ,.l s,.u.:J:Nu •d„r,,,ur am "YYYa eao SKLD LG SKL10422 WE 1877123-1981 . 001 3OOK.955 RECEPTION...1 77123 _ That part of Section Twenty (20) , Township One (1) North, Range • • Sixty-five (65) West of The Sixth (6th) P . . . County of Weld , • • • State of Colorado, described as follows : Re; ir.^.1no at the Northwest Corner (NW Cor of the Northeast Quarter (N `.1 4 of Suction theuc_ South l 04 ' West , aLoog the West line- of the Nor the-.at rter (NL) /4) of Sect-in 20, 3c . 0 feet; • thence East parallel to the North 17.r.£ of Section. 20 , !./ 2 . 65 fact to t0L True Point of Pa _ in . r. •_c South =o JC 4.cst, :a,. alle'_ to the West line of . ht, Northeast _.cearter (N71/4) car-L.cn _ _ , - fee-c.; .:t _.. _ _ North .C ` Ea=t Si? . i; feet -ec North r -14'-'45 ' fast2c;2 . 26 fnet7 .-'.Co North •1-} ' -as: . parallel to the :c= it,._ 2_ the Northeast _ (NLI •4' of .'.ec__c_. _ ., . 1179. 5 feet to a :Gent. 30 feet _ _,. of the North .. _..c of Section ;.._ the Tr2e Point of EE . .__ _nc SKLD LG SKL10422 WE 1877123-1981 . 002 \��, <IV' ( ', yYJ y..,..�� t 44 .+' Ii +,J5 m` /7 � / I... Vii~. ,.-=r /a ci --\ /F —"^.. \I'•�/`CERFIFICATION OF VITAL RECORD \-.01 - \: \ ` • r STATE OF COLORADO t , Y ,• :•1 -- .4„...., .��.. , ,� r_ ,./ STATE OF COLORADO \-•"- l• CERTIFICATE OF DEATH STATE FILE NUMBER (' 1.KCNCMfe NOM (Fr*MAY L/,0 1e@ ad1TE OFOAI.NJpWtyI.R/1MINIUM •\V Harold Dave WOLLERT,a�aAq[[ JR. Male October 25, 2000 €. ' 4.WWI erwTY S..U( ) 50.LAMER I YAM SC UNDER,DAV a lens �OF 9.tuft(W'MSAM weyn all 523-76-1770 49 Ia,. I Seat 15, 1951 Denver, CO c V eAa a ter a 0 CAS?IN \a , OF Anhwei 01.414 �—{ge Y❑8.. ma fAG-13 p�M o ERICAOsWP 0 00A U Nine,xw ei PNW,s. Deem lau,M/1 Ee.EMIulY.mum Or rat wbro. .fw~milwinter)eMwinter) a. m ) - C .TOSS, N O eR LOCATION OATH it CW a� WTYOF DEATH Y r A 19676 WCR $O Hudson. Weld F'"a .�\. IT..OECEURTS DUVAL OCCUPATION TA.IRU SF W[IMCIWDUSTM 11.INos NK.TATIJU Ir SPOUSE a s.,ea mW*,+n) �;0 1Cc eEN..Naaa..Nyn' u.N.N(3ANS.I Sandra Sue `N '-. k.i. Painter Auto Married Hoover �a��V \. IS..MWLNC!-!TATE{,s.cowry Ix.cry TONTlLItLOCATIOM - , 1x4 RPEITNID MOMER \ Colorado Weld I Budeon - " .. `I)676. WC". S at�Ia,a 1,' It coo¢ or NUC 10.weer AIATR.MNIn 1k Deceowra eDvuTWll4.w.+r xxn• � ax Ta.ore la v�L".,.e.,pli ". a1r,MNe..aati.Ns1 6".wy°'°Fln`° o"i`"+..wP,':.e1'iy i_eo'� �1S WITS, >" ew 00642 In.ti iPh1Le 12 �' c 11.ATMDSNWe (MN Mak TR.D II MOTa1LME1 Pelt saw Imane4(,. fa.P:EONadNU•NNE M ebbs.**iw..E ;,a / Se' Harold Dave Mollatt Betty Lou !opus Sandra S. Hoover - Wife ��$0 We IMMO OP DISPOSITION MN WORD/ I .ENMEIossweeps a ae LaW.MW-cM.t.e bee ,��vv \., 0D.W 0si.Ma ORa..IMRar , - �� g N� OD.ea„ 00.(4..Ya Boulder.Cremetory'.as1soe. ,Boulder, Colorado an I.- bt xL.aIbYTYIIaOi NMAPLdPICIDRg1 ApCnNOM WCx.' xlAce NOAOokl/y FAC reITY. `as _ RSON Rice Mo``teary &'Crematory N O �- 100 S. 3rd Ave., Brighton, CO. TIP 80601 ��p'� ,,- a. AS IdWOURE yN DATE RAJiMAw O.e'Fuel M'- a ,� QrY--n_ ;..DEPUTY l CCDOBSE 26, 2000 ppN -*al- .� 610,. ( U. 1..aa NW R NOTtEDr .�eEOF CAM ��aePRONouueeoDABry vw Na p. . / 9:30 PM M October 2C 2000 1:05,AM YGS `, TO SI COMPLarm ONLY CSIMIYWO MFaYH TO Se DRVLEIFd eY CORONER A. rz."-t.7'a"w.I"'...N. . ----- - a.viva nntixdtreva.Iat::-•- A ,•4 1- at Mrz&CNen bH a.,. a.okra mot math.DV..Neel e ID '24(0401 fi) -2T-De a.M S A144 TIRE AND MSALMO ADDAES4 OF CGOVE R n)NCORCNeWIW) ' Dw/-c R. ft-egIOL ' MD /23 5-/777# Me.,I�e/6rrtai ech- go o7 J/I ]I.NAME OFArnommi°Ewesea.W IF come TUN CIATIFeA (Nee** `• 1 > CA DEATH a.ATE OF POKY xa.mew TC INJURY AT 740 DEECAIe,MOW INJURY OCCURRED 4 Er 9.11NER Morey ody.Yee INJURY WOA4? %q. 0 a oil. Ox. '*. • S o.a1. ,.......n. M ❑ 74.y Me PIACEOFe.tiY.N hare lam NM Nem ciOn xa IOCATIW lee.n and Neese i MM 11v.1.Nwrb,CM Gee*SMNI - _. WIMFo.M leweYtl __.A NTtDlA l I _ Mt L" V Il ,. at IMAMATE CAUSE meta ONLY ONE CAUSE PIA tie FDRDO.e).WA a. 4HN.3e.^i.r P'q^4Y Ain., /. � COCOON! CAUI.JOMA or r,..)0s�FRct - �r d-b I, M AMY MACH Due'CO OR AZ ACOIIONAINCe Of U""."'Y'"" WE RUT) rJmuTE cwa VI Ft STATISM TIE _.N.NM- wyyYWOyyae DUE TO OR M A COIIECUENOE'oP �. • WTI. e , PANT OTHER eGMPIVNTDONCTOxl.Co4u Van n%n dNHit rtlnls.d least aAUTOPSY a b'Kw!eYlleregrieleC E PMT I V4,.LMJ abuse.`S..IM.eei.C. RN NN.. .N.. 1•. No ', MRS-%TJEIMW.1-O) .. THIS IS TO CERTIFY THAT THIS IS A TRUE AND CORRECT COPY OF THE �OFFICIAL RECORD WHICH IS IN MY CUSTODY. *. „� Trn DATE ISSUED � . ( STATEO.:L//J.GAnarrr,rtD. a. ..- / _Neejly, RRLV ,JrIISTATE AEOIBTMA r x'�' e ^i4*` ,`ay'< Do no t ass prepared on security paper with engraved border displaying the Colorado state s• ` 1,,,,,.„.J.‘,..„I n 7,tL seal and signature of the Rest PENALTY BY: W, Section 25-2.118, Colorado Revised J. gn Registrar uses, attempts f d .,A Wo �$ yrp!t Art...z. Statutes, 1982,if any person altos, hem is to use or furnishes to another or deceptive use &L, NN P any vital statistics record NOT VALID IF PHOTOCOPIED a` ' 4J / .R I` 1 4 , ^1v f .(_ --/' I YY ALTSRA NOfl ERASURE Vv 1: ' ,C ERTIFIC•j I�' . . .'V. . `J Pt 1 'Ce.tSKLD LG SKL10422 WE 2817929-2001 . 001 111111 11111 11111 11111 11 1111111111111111111111111111111 12a t4o` 3282124 05102/2005 11:08A Weld County, CO 1 of 2 R 11.00 0 0.00 Steve Moreno Clerk&Recorder SV lLRB4UPTE,L AinritoVIT STATE OF COLORADO )as. *County of In the matter of the title to real property in join tenancy. /J ��f r join �U being n / deposes and says, that Sex (4 of first duly sworn upon oath, P° .YX, Vt/1/ the undersigned affiant is of legal age and has APa personal knowledge of the fact that *MOLD 0. WaLLYlT, at `%4Uf is the sane person as HAROLD DAVE HOLLERS, JR. referred to in the attached copy of the Death Certificate, certified in accordance with the laws of the State of Colorado, on the date of January 0B, 2001 , end was at the time of death on the date of October 26, 2000 the owner in joint tenancy with SANDRA S. 110Li+ClT of the following described real property situate in the County of Weld and State of Colorado, to wit: TWAT PART OP sECTIal 30, TOWNSHIP 1 WORTH, RAE 66 TIBET or TES 6TH P.N., O00NTT OR WELD, STASH OF COLORADO DESQI® A3 FOLLOWS: 0 -0 ® E 0. 3acTiat CUNET D AT THE MORTEST COEER Or THE NOITREAST QUARTER 20; MOM SOOTS 1 PSIS 04 MIMRSS REST Mae SUREST WINS OW TIS NORTABAST QUARTER OF SHCTICM 20, 30.00 TUT; TIO242 EAST PAiALL.Et. TO TUE NAM LI)E de SECSI01 20, 822.66 PERT TO IS TIDE POINT oW psentn o; TEEN= BOOTH 1 OSERIES 04 NUWTSS REST, `A A ZSL TO TIE WEST LIIE OP MS And that the undersigned affiant has no record interest in said real property. gh, ,VrVwnun t' .SAT " i Affiant we \\31Ar?1• t. .G/ 9ubsc',� tl and sworn to before me in the county of 1 c/".os4\tiitttI 141/0 adO , nn Oed/ iq, ' es s f. �yg rnry hand and official aeal.W //Public r ,f ianiaaion expires: B7 n /�'yf, s9P ///'(v f/�` Notary PPuublii/c�/` •It L bent,NKt'al4 Pe an.ammo et term btrtlY Only Crated lot MutNS et (se-l-teS•s, C.A.s.) 7423033361 11505421 eon,7e4 02/19/03 a1PPM OPPIABID,I AtilawxT (In Joint Tmey u ) SKLD LG SKL10422 WE 3282124-2005. 001 t + ', sr 1\ et /,>-- 3 .._ / . 7i . .- rIlunc nog um. rnu NJ( In:n.\ Y STATE OF CO • � arAteb D0L0IM0 , ..II �y� .G,!Nei M MMA .Y--/ CERTWCATE OF DEATH • ry,`. .�� i - ._ 1. ! >S w•ai.r,weie4wn IMAM y, 1.. Milo October 25 2DOD . . a•tol p •S.tia! JA`.� ai^'a•� , :-. ,«. —' 444 . e �. I. 1451 Aver co �I ` rail 1 • • OS 05 . ` :b..v O • 010, Mom Ilisikbmia .. Sin 1 E3t1 :0 ilinalle y,..Ma ¢ 1I. ?,,. . „_...,.. Ie .:1•dr• tut m . _ •mow m.,Irrwwr `. r O,0 Auto +' .Msroi•d ' tr - 8 I sonc2 Y•intlr - .. •`�" g O G 11.. • e\>IOM •� rw IYIi n - n • • ewe e ` if w�pI- 1 12 G ��C in • 106.2 ~�. riaQr 0 Ij.' mini n - -- room..► '• ., `. re . =• - - eF ..I .an g min et 2ll am co rn poem. b moose.r.rl..Ir _aeuldoc r reator7f:. .w Molder. Colorado o C 1 -a .. �l1 NMI O O p.- .' 100 S. Ave.. lci 'tbn fir$ . ��mT ' 1 �a�010 - - . • - ll '�w.. 2b 8000 N �N V a '_ 1 . mac r. . . W..e w'4u •'..;'Yo• O ` l �rt�r rerourl.rnu armor '�+ ... wrulw��o•lr . .. m g itts. _r�ieo r.wrr. —et NN � Jr— l ' ._r .. �. r =MO C4 w t. '. ,, Ib .1.411• i _ 'G. CJ oGa/ Dry It . A.iO/2 p M.w.sn..w.M.aw.oaawwm.a.nr1. • A or ,. it��''�wYl• �r,t, ...w w.v nm_ P'� a=,,,. n~ .� I. ,1 erllrxlr,Ir o+Io.rrl 1 Orw p�.rr rem. a . . -` ' ! w ryry..trrawrrw w1e a 14 m of rd.-...s .1. N. vs wt.r w unto \ i •vn rr• ao . J Ae••.1JEPe.Ne �' THIS IS TO CERTIFY THAT THIS IS A TRUE AND CORRECT COPY OF THE OFFICIAL RECORDWHICH IS IN MY CUSTODY L.' DATE ISSUED ��/� tA.w_aurtYr.nu 2000 �nawtmA' i• the Colorado state :wilh veQ twldet displaying � Do.t .nser.PtF PENALTY 0 iNN,&itbn 25.2.1 la, Colorado Rated ';•',, SI aad *atom if a or enonthe lium. ve la Statutes, 1912, any person dten.tnw,camp m we or fuinis6w lO another�r IIOCiptl " any vital statistics record.NOT VALID IF PHOTOCOPIED.- , _ 1 r.. ti: . __ _ .__• :._ .. 'SKIM LO 172.20.16.49 WE 2817929-2001.001 SKLD LG SKL10422 WE 3282124-2005 . 002 • • 11111111111111111 IIII 11111111111111111 III !1111 IIII IllI 666 3709666 08/04/2010 10:49A Weld County, CO 1 of 4 R 26.00 0 0.00 Steve Moreno Clerk& Recorder Shared Well Water Agreement This Agreement,made and entered into this 26th day of July,2010 by and between Sandra S Wollert,who resides at 19676 County Road 8, Hudson,Weld County.CO 80642-9033, hereinafter referred to as the "supplying party," and Sandra S Wollert,who resides at 19676 County Road 8, Hudson,Weld County,CO 8O642-9033,hereafter referred to as the"supplied party". WHEREAS,the supplying party is the owner of property located at 19676 County Road 8, Hudson,Weld County,CO 80642-9033,which property is hereafter referred to as"Parcel 1"and is more fully described as follows: Lot B of Recorded Exemption#5027 Weld County Colorado (Put legal description of property here) WHEREAS,the supplied party is the owner of property located at 19692 County Road 8, Hudson, Weld County,CO 80642-9033,which property is hereafter referred to as"Parcel 2"and is more fully described as follows:Lot A of Recorder Exemption#5027 Weld County Colorado (Put legal description of Property Here) WHEREAS,the undersigned parties deem it necessary to provide a well system to service the parcels described herein,and an Agreement has been reached relative to supplying water for the well and sharing the cost of supplying said water,and WHEREAS,there is located a well upon the above described property of supplying party,together with water distribution facilities,hereinafter referred to as"water distribution system,and WHEREAS,it is the intention and purpose of the undersigned parties that the well and water distribution system shall be used and operated to provide an adequate supply of water for each of the properties connected thereto,for the domestic consumption of the occupants of said properties,and to assure the continuous and satisfactory operation and maintenance of the well and water distribution system for the benefit of the present and future owners,their heirs,successors and assigns of the properties connected thereto,and WHEREAS,the water from the well has undergone a water quality analysis from the State of Colorado health authority and has been determined by the authority to supply safe for human consumption;and WHEREAS,the said well is deemed by the parties hereto to be of adequate capacity to supply a single family dwelling on each of the parcels described herein with water from the well for all domestic uses of a single family residing therein;and WHEREAS,the parties hereto desire to enter this Agreement for the purpose of reducing to writing their respective rights and obligations pertaining to said well and water distribution system. • • I II11111111111111111111111111 III 1111111 III 11111 IIII IIII 3709666 08/04/2010 10:49A Weld County, CO 2 of 4 R 26.00 D 0.00 Steve Moreno Clerk& Recorder NOW THEREFORE, in consideration of the promises and covenants herein contained, it is agreed that the well and water distribution system situated on Parcel 1 shall be used by the parties to this Agreement,as wells as by all future owners and occupants of said Parcels 1 and 2, upon the following terms and conditions: 1. That until this Agreement is terminated,as hereinafter provided,the parties hereto(and their heirs,successors and assigns for the exclusive benefit of the respective parcels of said real estate,and for the exclusive use of the households residing thereon),are hereby granted the right in common with the other parties to this Agreement,to draw water from the well located on Parcel 1 for domestic use excluding the right to draw water to fill swimming pools or any type. 2. The owners or residents of the dwellings located on Parcels 2,as of the date of this Agreement shall: a. Pay or cause to be paid to the supplying party,an annual fee for this use of the well and water distribution system in the amount of$240.00 on or before the 15Th day of January each year,with the exception of this year whereby the amount shall be$ 100.00 and paid on the execution of this Agreement. b. Pay of cause to be paid promptly,a proportionate share of all expenses for the operation and maintenance of the well and water distribution system that may become necessary. Each respective share shall be determined by dividing the amount of each expense by two, it being understood that the supplying party and the supplied party shall pay an amount equal to one half of the total of such necessary repair or replacement.Shared expenses include the cost of electricity for pumping, repairs and maintenance on said well and water distribution system. 3. That the cost of any removal or replacement of pre-existing site improvements on an individual parcel necessary for system operation,maintenance, replacement, improvements, inspection or testing,damaged as a result of repair of the well or water distribution system maintenance will be borne by the owner of the affected parcel,except that costs to remove and replace common boundary fencing or walls damaged as a result of repair shall be shared equally between or among parties so damaged. 4. That each of the parties herby agrees that they will promptly repair, maintain and replace all water pipes or mains serving their respective dwellings. 5. That the consent of all parties to pay a proportionate share of costs shall be obtained prior to embarking upon expenditures for system maintenance, replacement or improvements,except in emergency situations. • • S 1 11110 1111 1 111111 1111 IIIIIlI III 111111I III 11111 IIII II II 3709666 08/04/2010 10:49A Weld County, CO 3 of 4 R 26.00 0 0.00 Steve Moreno Clerk&Recorder 6. That the supplied party shall pay to the supplying party his proportionate share for the cost of energy for the operation of the pumping equipment.This cost shall be determined by a separate meter upon each dwelling and for each parcel. 7. That it is the agreement of the parties hereto that the payment for energy cost shall be made not later than the 10`"day of each succeeding month during the term of this Agreement.In the event that any such payment remains unpaid for a period of 20 days,the supplying party may terminate the supply of water to the supplied party until all arrearages in payment are received by the supplying party. 8. That each of the parties to this Agreement does hereby grant to the other,his heirs,successors, and assigns,such easements over,across and through the respective parcels as shall be reasonably necessary to the construction or the well,maintenance of water pipes, pumping equipment, mains,electrical wiring and conduit consistent with the purposes of this Agreement. These easements are described below,to wit: (Describe easements,it any) 9. That no party may install landscaping or improvements that will impair the use of said easements. 10. That each party shall have the right to act to correct an emergency situation and shall have access to the pertinent parcel in the absence of the other.An emergency situation shall be defined the failure of any shared portion of the system to deliver water upon demand. 11. That only those parcels of real estate hereinabove described and the dwellings located thereon shall be permitted to receive water from said well and pumping equipment; and each of the parties hereto does hereby covenant and agree that he/she will not allow or permit other persons,other than household guests,to take,draw,use or receive water for the well, nor permit other persons to connect to the pipes or mains serving his/her respective parcel. 12. That in the event the referenced well shall become contaminated and shall no longer supply water suitable for domestic consumption,or shall no longer supply water adequate for the needs of all relevant parties, or in the event that another source of water shall become available to the respective parcels,then the rights and obligations of the parties created by this Agreement shall cease and terminate in accordance with the terms and conditions hereinafter described. 13. That upon the availability of such other source of water, it is contemplated that a reasonable time shall be allowed to effectuate the necessary connections to the new source. • r 110111 11111 111111 11111111111111111111 III 1111111111111 3709666 08/04/2010 10:49A Weld County, CO 4 of 4 R 26.00 D 0.00 Steve Moreno Clerk& Recorder 14. That the respective rights and obligations of the parties shall continue until the parties who wish to terminate their participation is the Well Agreement have executed and filed a written statement of termination at the Clerk& Recorders Office of the County of Weld and the state of Colorado. Upon termination of participation in this Agreement,the owner and occupant of each residence which is terminated from the Agreement shall have no further right to the use of the well.The terminated parties shall disconnect their respective lateral connection from said well system and shall have no further obligation to pay or collect for maintenance and related expenses incurred thereafter.The costs of disconnection from the well and water system shall be borne by the owner of the pertinent parcel. 15. That the term of this Agreement shall be perpetual,except as herein limited. 16. That the benefits and burdens of this Agreement shall constitute a covenant running with the parcels of land herein described and shall be binding upon the heirs,successors and title an assigns. Of the parties hereto. 17. Any dispute under this Agreement shall be required to be resolved by binding arbitration of the parties hereto.If the parties cannot agree on an arbitrator,each party shall select one arbitrator and both arbitrators shall then select a third,the third arbitrator so selected shall arbitrate said dispute.The arbitrations hall be governed by the rules of the American Arbitration Association then if force and effect. � ji/4/. Witness our signatures this the -/ day of /r tc„, �h c• ,2010. /1:11/1.1V94411 // 4 Jzi Lot 1 Lot 2 Subscribed and sworn to before me in the County of ,State of _this day of , 20 My commission exprires Notary Public eooK 955 R eneanJaa_.. ;..fl.�' Q ,r _Kg 7..5_1981 o ars Reception No..- . s �rizs- - -v '::,lee. ea CS T is DEEn. Nee!,this 4th ilat or December ,ro81 FILING STAMP between • TRCEt4�S A. BRUNGARDT `; 111111. enure-of Adams ..• •••.:...,,,,.,� . I Stab Documentary Fee 1.111.-xm,.111111,first earl.and Nat DEC 15 BPI HAROLD D. WOLLERT', JR. AND SANDRA S. WOLLERT 1 E_�-D_,___-s„. II O ••hese!mail address 19676 Weld County Rd., Hudson, Cc. ,. o .ux.e .. 111 the (eor.:: . Wald , , C.a.•ram,.of ere.. ..art: Mi . ft Cs, 1\'IT]E>SCTH.•!ul lhr.xi.+.nac:..i :_... ONE HUNDRED THOUSAND AND NO/1CD C. an.f..lbws n,nn.n..veinal!. on v. , nls Tithe - n,...o:l,.,.r .n. . . ...... . .. ,.:I°., .r.: r.m.l pa the 'unet of the I•. . .r , .pl aeo- f .. .:._ t L .>onl find.' ..and ._.: I s „ „ , , .:.1..l t -F r•d ,.. . .. .e r.... . ,. We__ ...,.._a ..rc•..,,r,:!o.o.,,;r, See Attached a` also,,nievo as.re,..ndnenv,e. 19676 Weld County Rd. Tel:ETHER ait h an.m:d singe:as:;•.::...,..t?an.e,:-,. . ..11 L ut thr. e...r eg,.,.,I kn:1.J .-. . ..h se-me-fez ,sees.. n fir.nrs or alt the .. x,;u n estate r xhiinterest.r: Fn' xn.i :nand ,+.C•rt part. nux' an.,:arn.nn - '" '' sr tinnily..,rem x s!, the . '.:.,r I. ,. TO HATE AND TO ROI.p the ssid prem.,: Ifh,laueta...mach and administrate,.aws eaeoziara.gehrz..;;seas era oars..ze iin.f zeal-the hainParties'4 the y their heirs on.;assigns. Ent at t dean ate....presents.t now.in jmiend h aL•ne rem-eyed.as of ewe'.cure.her L.w:.n,...;,:..,,:;.I eel..in:-:'-.. . n premises eood riebl.et:II power and lavfa:nal::nrry:.,gra:.:. - :::n .. :see haw-ii.n:unnen fad Corm a.andbra `.•non'es,.:;a:: ,,.seer,,iv..vl:-.le•s.tax, s seas ants and rind that the same ore free.end clhu..n..i..e.nom, .rl.n .r •. ,,Ln,y>m+.soles.liens.ta.ev,.assessments and enen^-oraiwemao'ha:ewer l„,J fir nag,:- except General Taxes for 1981 and sub- sequent years, easements, restrictions, reservations and covenants of record, if ar.y; Rights of way for County Roads recorded October 19, 1889 in Book 86 at Page 273, Condition contained in the United States Patent recorded June 12, 1906, in Book 131 at Page 163, an undivided 1/2 interest in all oil, gas and other minerals, as res- erved by John W. Maul & Lois T. Maul recorded April 6, 1959 in Book* and the above basseu,ed p,.mi,,,. n:he:lun. .n..11 :..sags w:sewn .. ,h thew rh•• pare, .. the PersO nl t twat.the lawfully oloin,-S i :h l L all and -I Pa ND L. FUREhEH OE FEND The s,nr - .a. II " P chat! p of WARRANT AND 1, ...n,l .1:. I: . the I..M:the singular.,n...F shall be apsikabie to alt render,. as, .fan,gender shave written. '1528 at Page 432, Oil & ease`recorce au dx> ,,.. o 6,0 lease gaso1ease, rey rd,' p`, S; Book E02 under Receptior. =1724356,Oil and gas lease, recorded ��Sept- S:a11ed.32, 1980,nod waw.i..n the P14,1•2::.,,t I ! :- 4- /' f._•&.•. ?s/:IgeALI ember 2, in Book 513, under ! TRCEt4AN A. BR ::GAR. ?� Reception_4.134.567, and Deed of •� 1 Trust recorded August 18. 1976 in I -- ""- Baok-.775_-under aecepti on 31696544 j - ...ISEALI which parties of the second part agree to assume and pay, STATE OF COLORA 00 I . (bunty of Adams 1l ever foregoing [4 A.' BRLNGA.D:ar 11.,.11 a,..:r.:= 4th .t.;or December .s 81. »>cn::,.an:a rife, February 24 ,u• 82,tri:ness.ne hand and official seal. -h�Cr4R a1`*4E"-q1 I I,E C0MPAMY•bcl..nix,•..,a•MAL)0 802116 ,s•-.4./-' ,,.,,J.iT An.9:'.l. l.raAtgn wan,.,..hilt buss-n::n,eu P.rine,r, n.a....:4ea.,..Gxxn :.Iry.Plan_Jap➢)qu_e.aa 5KLD LG SKL10422 WE 1877123-1981 . 001 hob L/ U9 11:Lfa S VV0118R 6W-009-Lib/ p.iu • • y, RMc Rtd%il Tan NW Mho ear:MOW the tleha P. 1 d7 COLORADO DIVISION OF WA] IRCES RELD INSPEC77ON REPORT !JUL 181996 ONkion 1 D;efot 2 DATE OP INSPECTION 7060996 nietain VSPECf1ON:UUE PEG. 0 REPLACEMENT O rr$n 077-IER: Redd98ane1 We ratema.how* APPIJCANr Senolre WoBsrt PERSON CONTACTED: same ADDRESS: 19676 WCR 8 WATER COMMtSSiONER ROBERT STAHL Hudson. CO 80842 PHONE 4 13031:867-0742 PHONE 303-836-4604 or 669.2383 EXJSTTNO WELL LOCATION: toy 1/4,NE 1/4,SECTION 22, TOWNSHIP.]), RANGE¢5W Pit DIST. 200' FROM N SEC.UNE. 1700' FROM E SEC LM/E COUNTY. WELD IF REPLACEMENT,GIVE DISTANCE ANDDIRECTION TO,t+WELL SITE- TYPE OF WELL: a ANY OTHER WELLS ON THIS PARCEL? 2 HOW MANY? _ PERMITS CAS28, USE? EST.DATE WELL CONSTRTED:a71 DATE OF FIRST USE 1911 EST. PUMPING RATE jQ GPM TOTAL 0 OF ACRES IN THIS TRACT/PARCEL: 1Q ACRES ADDRESS OF PROPERTY F DIFFERENT THAN ABOVE WA SUBDIVISION OR OTHER PARCEL INFO:N(g ACRES IRRIGATED(nothexempi/ago hr:) tE NAME OF AUG PLAN: a USE OF WELL: ®houoehakt use M 1 single Ien4 dweilng(e) ®wallahs of poetry dwneseo anima's []waSNMlp of iveskek one farm wrench-how many heed? ❑ bed Id-how many heed? ®Maui imam and garden hfgedon__ acres a 1000 sq R. fre prof ecOon ❑con merdel ❑ether(see consneMb) WERE 7flE USES CLAIMS ABOVE� IINNITIATED PRIOR TO MAY 8,19727 a SJGNED-` YAea�I�7(R/1 / DATE 7/16x1996 COL*tEWIS: PERMIT 94484__ //-" • PER SUPPLY INFORMATION SUMMARY Section 30.28-133,(d), C.R.S. requires that the applicant submit to the County,'Adequate evidence that a water supply that is sufficient in terms of quantity, quality and dependability will be available to ensure an adequate supply of water. 1. NAME OF DEVELOPMENT AS PROPOSED itJ0NG 2. LAND USE ACTION ,, �c ,"n J _ 3. NAME OF EXISTING PARCEL AS RECORDED SCk,-i u S t.J1,� SUBDIVISION FILING BLOCK LOT 4. TOTAL ACREAGE G) ; 5. NUMBER OF LOTS PROPOSED PLAT MAP ENCLOSED-El YES 6. PARCEL HISTORY • Please attach copies of deeds, plats or other evidence or documentation. A. Was parcel recorded with county prior to June 1, 1972? lk7 YES D NO B. Has the parcel ever been part of a division of land action since June 1, 1972? ❑ YES Di NO If yes, describe the previous action 7. LOCATION DF PARCEL - Include a map definiatinp the project area and tie to a section corner. Al U. 1/4 OF 1/4 SECTION .96 TOWNSHIP / );4 N ❑ S RANGE ,L, ❑ E a W PRINCIPAL MERIDIAN: 11 6TH ❑ k.M. O UTE 0 COSTILLA 8. PLAT - Location of all wells on property must be plotted and permit numbers provided. Surveyors plat ❑ Yes O No If not, scaled hand drawn sketch tai Yes O No 9. ESTIMATED WATER REQUIREMENTS - Gallons per Day or Acre Feat per Year 10. WATER SUPPLY SOURCE l EXISTING ❑ DEVELOPED ❑ NEW WELLS - WEL S SPRING PROPOSED AoLWEBS (CHECX ONEJ HOUSEHOLD USE # of units :a',/l- GPO AF WELL PERMIT NUMBERS 1 Lamm C UPPER ARAPAHOE O WPM DAWSON O LOWER ARAPAHOE COMMERCIAL USE # of S.F. GPO AF 17/ 4/ p y o LOWER OAWSON O LARAEALE FOX BOILS ❑ORRER O EMMA O MR IRRIGATION# C7 of acres GPO AF STOCK WATERING # of head GPO _ AF O MUNICIPAL O ASSOCIATION WATER COURT DECREE CASE NO.'S OTHER GPD AF 0 COMPANY ❑ DISTRICT TOTAL GPD AF NAME _ LETTER OF COMMITMENT FOR SERVICE 0 YES ❑ ND 11. ENGINEER'S WATER SUPPLY REPORT 0 YES 0 NO IF YES, PLEASE FORWARD WITH THIS FORM. (This may be required before our review is completed) 12. TYPE OF SEWAGE DISPOSAL SYSTEM SEPTIC TANK/LEACH FIELD ❑ CENTRAL SYSTEM - DISTRICT NAME • LAGOON ❑ VAULT - LOCATION SEWAGE HAULED TO • ENGINEERED SYSTEM fAtrach a copy at engineering design) ❑ OTHER COLORADO DIVISION OF WATER RESO ES Office Use Only • Form GWS-44(07/2009) DEPARTMENT OF NATURAL RESOURCES 1313 SHERMAN ST.,RM 818,DENVER,CO 80203 phone—into:(303)866-3587 main:(303)866-3581 fax:(303)866-3589 htip://www.waterstate.co.us RESIDENTIAL Note:Also use this form to apply fortivestock watering Water Well Permit Application Review form instructions prior to completing form. The form must be completed in black or blue ink or typed. 1. Applicant Information 6..Use Of Well (check applicable boxes) Namemepplicant _—--_ _.__—. _. See instructions to determine use(s)for which you may qualify Eft S 0 A.Ordinary household use in one single-family dwelling _Si: om,—.�+-'�'./— Jrdi outside i use) mailing eddre L . --�-- pp'� [ B. Ordinary household use in 1 to 3 single-family dwellings: cil� ��62_---��snta n— Zip nee -------- Number of dwellings: n - --_ !,[�[J $��l -20 3,1z ® Home gardeMawn irrigation,not to exceed one acre: Telephone# E-mail(opnnn�) , area irrigated ✓6 n ® sq.ft.0 acre dog) 999-leG 92 6ra7nr/4P ('4 ,9o! (erg IR Domestic animal watering—(non-commercial) 2.Type Of Application (check applicable boxes) 0 C.Livestock watering(on farm/ranch/rangeipasture) ❑Construct new well 0 Change source(aquifer) ❑Replace existing well 0 Reapplication(expired permit) 7.Well Data (proposed) 0 Use existing well 0 Rooftop precip.collection Miednum pumping rate , i Annual amountj el to be withdrawn or increase use ..O (Wmther - - I acre-feet Total depth Aquifer 3.Refer To(if applicable) 4/j feet A//G P ! 4----- -- . Well permit ft Water Court case# Y999 I 8.Water Supplier ------------ Designated Basin DeternsnatiOn# Wet name or* Is this parcel within boundaries of a water service area?OYES 2 NO If yes,provide name of supplier. 4.Location Of Proposed Well(Important! See Instructions) 9.Type Of Sewage System County T-IN i — — - ---- - - Al 14) tt4 kale Net v4 ® Septic tank/absorption leach field section ship N or s Range E or W 1 Principal Nadeau 0 Central system:District name: 2 I /___0❑ 1. XO.7 CI 53 I 4 _______ 0 Vault:Location sewage to be hauled to: Distance of wet horn section tees(section Ines are typically not property lines) p _,200/ Ft,from lgt N❑S j ,, FL tragic E❑W ❑ Other(attach copy of engineering design and report) For replacement wells only—Stance and draaonfram old well to new well 10. Proposed Well Driller License#(optional): feet direction 11.Signature Of Applicant(s)Or Authorized Agent well location address(Include City.State.Zip) 5t Check Ifwell address is same as in Item 1. The making of false statements herein constitutes perjury in the second / 6 /n / / O 8_n/ y 2 degree,which is punishable ast a Bass 1 misdemeanor pursuant to C.R.S. (O C_k Er /1/4./5477/� 24-4-104(13)(a). I have read the statements herein,know the contents Optional: GPS well location irdamation in UrM format CPS unit settings are as follows: thereof and se on that they are true t0 my knowledge. _—. Sign here(Musk W original signature) i Date Format must be UTM 12 or CI Zone 1 3 Easting:Units Datum mast Meters Northing: /(�Mnm&"e /' '1... 1� /�y� -I10///10_'._.e • Unit must besett°true north Sant—f/-a 3 `-`-Jo /(OF. 7- 6 C /7 .0 r was GPS met checked for above? 0 YES I Remember to set Datum to NAD65 Office Use Only S.Parcel On Which Well Will Be Located uses map name------------- DwR map no. Surface elev. __(YOU MUST ATTACH A CURRENT DEED FOR THE SUBJECT PARCEL)- I -- A.You must check and complete one of the following: Receipt area only O Subdivision:Name Lot Block Filing/Unit O County exemption(attach copy of county approval&survey): Name/# Lot# 2 Parcel less than 35 acres,not in a subdivision,attach a deed with metes and bounds description recorded prior to June 1,1972,and a current deed ❑ Mining claim(attach a copy of the deed or survey):Name/it AOUAMAP ❑ Square 40 acre parcel as described in Item 4 WE D Parcel of 35 or more acres(attach a metes and bounds description or chewy) uvR O Other(attach metes&bounds description or survey and supporting documents) (JNCB B.#at acres in pared ! C.Are you the owner of this parcel? /OI ®4E5 0 NO(if no—see instructions) TOPO D.Wa Via be the only well on this parcel? ®YES 0 NO(if no—list other walls) M1•LAR _ SSG DN_ WD_ BA_ MD E. State Parcel lD#(option): Form STATE OF COLORADO For Office Use Only No. OFFICE OF THE STATE ENGINEER G\VS-I 1 818 Centennial Bldg., 1313 Sherman St., Denver, CO 80203 1;2009 Phone—Info: (303) 866-3587 Main: (303) 866-3581 Fax: (303) 866-3589 http://www.water.state.co.us CHANGE IN OWNER NAME/ADDRESS CORRECTION OF THE WELL LOCATION Review instructions on the reverse side prior to completing the form. Name, address and phone of person claiming ownership of the well permit: ti NAME(S): Sa hdt`-Q S G,J0 )l,, kJ-- Mailing Address: / ) (p ") Z C 1 si City, St. Zip: Nudsaft ( 7 S-o6 (l2- �JD53 Phone: ( Qaj ≤2/L -�sc 9 E-mail (optional): SQ n /h o 00/, re),i This form is filed by the named individual/entity claiming that they are the owner of the well permit as referenced below. This filing is made pursuant to C.R.S. 37-90-143. WELL LOCATION: We Permit Number: //4/17/9(�/T Receipt Number: Case Number: County `J /c/ Well Name or#(optional) (Address) (City) (State) (Zip) 1/4 of the 1/4, Sec. ,Twp. ❑ N. or❑ s., Range O E. or❑W., P.M. Distance from Section Lines: Ft. From ❑ N. or❑ S., Ft. From ❑ E. or❑ W. Line. Subdivision Name Lot , Block , Filing/Unit The above listed owner(s) say(s)that he, she (they) own the well permit described herein. The existing record is being amended for the following reasons: M Change in name of owner❑ Change in mailing address ❑ Correction of location for exempt wells permitted prior to May 8, 1972 and non-exempt wells permitted before May 17, 1965. Please see the reverse side for further information regarding correction of the well location. I (we) claim and say that I (we) (are)the owner(s) of the well permit described above, know the contents of the statements made herein, and state that they are true to my(our) knowledge. Signature(s) of the new owner Please print the Signer's Name &Title Date 4)61---6--,77—r ) / 1,-.9k -f 02-/e2 .0 t is the responsibility of the new owner of this well permit to complete and sign this fdrm. Signatures of agents are acceptable if an original letter of agency signed by the owner is attached to the form upon its receipt. For Office Use Only State Engineer By Date • May 25. 1996 DWR 1313 Sherman Room 621 Denver, CO 80203 Attn: Al Eckerman Ref: Water permit # 44494, issued to Herbert J. Dorn in February 1971 Dear Al ; I am requesting a written confirmation from your department stating that our water permit # 44494 has no conditions on it and will allow us to add a second dwelling on our property. We are trying to put an "Accessory Farm Dwelling" on our property for a retired couple to help us with our horses & cattle. Also for security purposes since we are gone quite frequently showing horses. I am in the process of getting a copy of the well permit and the form for change of ownership_ I am enclosing a self addressed stamped envelope for your convenience. Thank you in advance for your help in this matter. My husband & I are the current owners: Harold D Wollert, Jr. & Sandra S. Wollert Our address is 19676 W.C.R. 8 Hudson, CO 80642. Our home phone is (303) 536-4604. My work phone is (303) 659-2383. Sincerely, Sandra S Wollert enc. • • WR.-5-b9 DIVISION OF WATER RESOURCES, DEPART ENT OF NATURAL RESOURCES 101 Columbine Bldg., 1845 Sherman S1r et, Denver, Colorado 80203 ----A-23‹.-- / _ / A PERMIT 0 USE GROUND WATER �� r LA---1.- A PERMIT TO CONSTRUCT A WELL �;. 4.51)'015µ, 'y APPLICATION FOR: /—"7 REPLACEMENT FOR NO. �y�,,?�-`' .'1''.O re... A PERMIT TO INSTALL A PUMP ,c,\:‘ 5'1o,6:jI,;,:1< I F-7.1 OTHER �� 6 `d� PRINT OR TYPE LOCATION OF ''''' F LL s" '� ` APPLICANT _ "/$/#_ ' COUNTY 14,4)1 � `.! .. ,V0 yY Street Address 2PGC) 0) 4, of the ikAr w, sec. a_O X10 -�- C i ty & State , j get& T. /n/ , R. 4.≤ 2) , eo P.M. Street or Use of ground water /00,01eSleC--- Lot & Block Owner of land on which well City or is located Subdiv. Filing Owner of irrigated land Ground Water Basin Number of acres Water Management to be irrigated District Legal description of irrigated land LOCATE WELL ON THE BACK OF THIS SHEET Driller e',er- ...5-,41, No. 416? Other water rights on Driller's this land Address .. l,�e'� 4$'144 l,�re ge-"Zi Aquifer (s) ground water is to be obtained �� from . . ,yf Signature of Applicant Storage capacity AF 1..ON.DIIIOhS _0E. _AP_PRO LAL_ ANTICIPATED PUMPING RATE ,-20 GPM ' AVERAGE ANNUAL AMOUNT OF GROUND WATER TO BE APPROPRIATED Acre-feet ESTIMATED WELL DATA Anticipated start of drilling �. v619`7l Anticipated start of use A74,!/6 ? 19 71 Hole Diameter: Q 17 in. from Q ft. to $/s. ft. ( APPLICATION APPROVED: in. from ft. to ft. VALID FOR ONE (1) YEAR AFTER DATE ISSUED UNLESS EXTENDED FOR GOOD CAUSE SHOWN TO Casing: I THE ISSUING AGENCY Plain e;.- in. from a ft. to 2.47t. PERMIT NO. 44494 CONDITIONAL / / (.2c in. from 2.0 ft. to 3....1 ft. DATE ISSUED FEB J 8 1971 r � Per f. 3' in. from 45 ft. to /5 ft. in. from ft. to ft. - -9•/ STATE ENGINE R ESTIMATED PUMP DATA 9� �v Outlet BY Type HP ( Size _ ( APPLICATION MUST BE COMPLETED SATISFACTORILY BEFORE ACCEPTANCE (OVER) • • THE LOCATION OF THE PROPOSED WELL SHALL BE SHOWN ON THE DIAGRAM BELOW WITH REFERENCE TO SECTION LINES OR GOVERNMENT SURVEY CORNERS OR MONUMENTS. feet from (North or South) section line feet from (East or West) section line IF WELL IS FOR IRRIGATION, THE AREA TO BE IRRIGATED MUST BE SHADED OR CROSS-HATCHED. This;- i agram represents nine (9) sections. Use,thecCENTER4QUQR,,(oe r section) to indicate the' Potation of"Yie well . +--1 Mile 5. , - , , I I I - + - ± - + - + - + - + - I I I I I I - + - + + - + - + - + - I Iy3 I I - + - + - + - + - N ` I I I I .d 2 I I I I - + -- + - + - + - - + - ± - I I I I I I - + + - + - + - + - + - THE SCALE OF THE DIAGRAM IS TWO INCHES EQUALS ONE-MILE • • wkJ_2s-J0 _ STATE OF COLORADO Index No. cl�:2.3 . •_ DIVISION OF WATER RESOURCES IDWD 1—2✓ OFFICE OF THE STATE ENGINEER • A. -Cemplisticn 1 - 1 Y" /1/�✓I/ • Yield - MAP AND STATEMENT FOR WATER WELL FILING V.' :-:. r • • Checked By : . :> -, .� PERMIT NUMBER 144444 ,. :,, ; STATE LOCATION,,:;; • OF COLORADO 1 SS CLAIMANT (s) Herb Dorn Weld _County NW % of NE '/,, sec. 20 being duly sworn upon oath deposes and says that he (they) is (are) the owner (s) of the well describeehereon; the total number of acres T. 1N R. 65W 6 P.M. of land irrigated from this well is INDICATE WELL LOCATION ON DIAGRAM work was commenced on this well by actual construction on the NORTH 30 day of March 19 71; the sustained 1 T I I I yield from said well is 10 gpm, for which claim is hereby made I x domestic for purpose (s); • 1 I __ d stic I the average annual amount to be diverted is - 1"___ I- --- acre-feet; this map and statement is filed in compliance with law; I I m he (they) has (have) read the statements made hereon; knows the I ( I content thereof; and that the same are true of his (their) own knowledge. I I I ., .. I I I Signature(s) I I. i SOUTH Address: 533W Briarwood. Littleton, Colo.80120 WELL SHALL BE LOCATED WITH REFERENCE TO GOVERNMENT SURVEY CORNERS OR MONUMENTS, OR SECTION LINES BY DISTANCE AND BEARING. SubsCribetf and sworn to before me on this day of , 19 _ ft. from section line. (North or South) My Commission expires:•. (Seal) _ ft. from _ section line. (East or West) • Notary Public Ground Water Basin Water Management WELL. DATA District Date Completed !March 30 Domestic wells may be located by the following: Static Water Level 17' _ LOT , BLOCK SUBDIVISION Total Depth of Welt 431 FILING # ACCEPTED FOR FILING IN THE OFFICE OF THE STATE ENGINEER OF COLORADO ON THIS DAY OP _ , 19 STATE ENGINEER FORM TO BE MADE OUT IN QUADRUPLICATE: WHITE FORM must be an original copy on both sides and signed. WHITE AND GREEN copies must be filed with the State Engineer within 30 days after the well is completed or within 7 days WELL LOG WELL DATA From To Type & Color of Material Water Loc. Type Drilling rotary 0 14 sand HOLE DIAMETER; 14 28 clay sandy 28 31 gravel x 8 in. from 0 ft. to 43 ft 31 43 clay in. from ft. to_ ft in. from _ft. to ft CASING RECORD Plain Casing • Size 65$ kind steel from 0 ft. to 20 ft • Size5_, kind Pies from 12 ft. to 23 ft Size—, kind from ft. to ft _� Perforated Casing Sizes, kindPl9S from 23 ft. to 43 ft Size—, kind from ft. to ft Size_, kind from_ ft. to ft GROUTING RECORD Material cement Intervals constant Placement Method pumped GRAVEL PACK RECORD • , Size a Interval no t.yg+ TEST DATA Date Tested March 30 Type of Pump bailed Length of Test lhr Sustained Yield f Metered) 10 Drawdown 4.n' WELL DRILLERS STATEMENT The undersigned, Jbeing duly sworn, deposes and says: he is the,drHler of the well hereon described; he has read the statement made hereor knows the content thereof, and the same is true of his own knowledge. Use additional paper if necessary to complete log. X % le, S A01•State of Colorado, County of ) ss License No. 403 • Subscribed and sworn to before me this day of , 19 My Commission expires , 19 . Notary Public �-�„ • • WELD COUNTY HEALTH DEPARTMENT 1517 16TH AVENUE COURT, GREELEY, CO 80631 (970) 353-0635 EXT 2225 FAX (970) 356-4966 Permit # : SP-9600382 Sec/Twn/Rng: 20 01 65 PERMIT Permit Type : RNEW C=commercial, R=residential i NEW, REPair, VauLT Applied: 07/11/1996 Parcel No: 1473 20 000017 Expires: 07/06/1997 Location: 19676 8 CR 20-01-65 Legal Desc : 10804C PT NE4 20 1 65 BEG S1D04 'W 30' & E822 . 65' 19676 8) CR APPLICANT WOLLERT HAROLD D JR & SANDRA S Phone : (303) 536-4604 19676 WCR 8, HUDSON CO 80642 OWNER WOLLERT HAROLD D JR & SANDRA S 19676 WELD CO RD 8, HUDSON CO 80642 Description: HOUSE Commercial (Y/N) : N Residential (Y/N) : Y Acres : 10 . 00 Number of Persons : 2 Basement Plumbing (Y/N) : N Number of Bedrooms : 3 Bathrooms-> Full : 2 3/4 : 1/2 : Water Public (Y/N) : Utility Name : Water Private (Y/N) : Y Cistern (Y/N) : Well (Y/N) : Y Water Permit No: � Percolation Rate : /,0, S Limiting Zone :7 b/ ft _ in Desc : Ground Slope : / Dir: C Soil Suitable (Y/N) : / Engineer Design Req' d (Y/N) : // In 100 Yr Flood Plain (Y/N) : ,4✓ From the application information supplied and the on-site soil percolation data the following minimum installation specifications are required: Septic Tank: .1C-CO gallons, Absorption Trench 5-g= sq. ft . I.1 '^�'�rd or Absorption Bed 7 / / sq. ft . Z3 ,JI( In addition, this permit is subject to the following additional terms and conditions: Ate_ &Jctn Cuhiy 2 D . zauc 4Tio+1 4,,j/ NOTICE This permit is granted temporarily to allow construction to commence. This permit may be revoked or suspended by the Weld County Health Department for reasons set forth in the Weld County individual sewage disposal system regulations including failure to meet any term or condition imposed thereon 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 not transferable. Before issuing final approval of this permit the Weld County Health Department 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 Health Department. X �f ''c//'u 7/896 "" , f2, ronmenta pecialist Date # # WELD COUNTY HEALTH DEPARTMENT 1517 16TH AVENUE COURT, GREELEY, CO 80631 (970) 353-0635 EXT 2225 FAX (970) 356-4966 Permit # : SP-9600382 Sec/Twn/Rng: 20 01 65 Status: ISSUED Permit Type : RNEW C=commercial, A=residential + NEW, REPair, VauLT Applied: 07/11/1996 Parcel No: 1473 20 000017 w�2 �7 Issued: 07/18/1996 Vo 2 0 Finaled: Location: 19676 8 CR 20-01-65 Legal Desc : 10804C PT NE4 20 1 65 BEG S1D04'W 30' & E822 . 65' 19676 8 CR APPLICANT WOLLERT HAROLD D JR & SANDRA S Phone : (303) 536-4604 19676 WCR 8, HUDSON CO 80642 OWNER WOLLERT HAROLD D JR & SANDRA S 19676 WELD CO RD 8, HUDSON CO 80642 Description: HODS r/t.,DLZle Commercial (Y/N) : N Residential (Y/N) : Y Acres : 10 . 00 Number of Persons : 2 Basement Plumbing (Y/N) : N Number of Bedrooms : 3 Bathrooms-> Full : 2 3/4 : 1/2 : Water Public (Y/N) : Utility Name : Water Private (Y/N) : Y Cistern (Y/N) : Well (Y/N) : Y Water Permit No: Percolation Rate: 10 . 5 Limiting Zone: >08 ft 00 in Desc : Ground Slope : 1 Dir: E Soil Suitable (Y/N) : Y Engineer Design Req'd (Y/N) : N In 100 Yr Flood Plain (Y/N) : Minimum Installation Septic Tank: 1000 gal Absorption Trench: 522 sq. ft . Absorption Bed: 711 sq. ft . Actual Installation Septic Tank: 1OOD gal Absorption Trench: ' sq. ft . Absorption Bed: l(p sq. ft . 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 not transferable. The Weld County Health Department 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 Health Department. X , Enwi on ntal Specialist Date WELD COUNTY HEALTH DEPARTMENT 15th Street and 17th Avenue P. O. Box 1227 No. Greeley, Colorado Application for Permit to Install, Construct, Alter or Repair Individual Sewage Disposal System. Owner or Sponsor Address Phone Address of Site f c,: , r.yt, X .te la -C, jt9 T/' 1 g,y-A Mailing Address General Information Septic Tank / 1. Living Units 1. Liquid Capacity 9t? u, , Gallons 2. No. of Bedrooms _-� 2. Dimensions W L D 3. No. of Baths /-4„.4.- 3. Material 4. Basement Drain 4. Type Inlet r 5. Automatic Dishwasher --p _ Type Outlet 6. Garbage Disposal / 7. Automatic Laundry e'/.%"'" Secondary Treatment £eocb Uelb 8. Size of Lot tr- _'- ,- 9. Type of Soil -.-- * - 7 /.._ - Field L / S Bed 10. Percolation Test 7,/ 4' '`"" I i 1. No. of distrib t' n lines 11. Water Supply E5 9- "" 2. Trench: Width Length 12. Lot Grade 3. Type Filler Material 13. Water Table Depth 14. Other 4. Depth of Filler Material 5. Gravel Size 7 1 7G C " 6. Type Tile 7. Depth of Cover 8. Other The Permit is to remain in full force and effect for six (6) months from date, until revoked for non-compliar This system will be constructed in accordance with the above specifications and regulations governing n municipal sewage disposal systems, in accordance with Regulation No. 1 of the Weld County Health l partment. o i Date: �` ' - �' / l' Applicant: k`Fi1,r` i > c" i t%" The plans and specifications as shown are approved, pending paym permit fee. l Sanitarian �� -� - .'!�` ti.�-'� y /y Date: /cc? /9 /"(.7 The above system inspected and found to comply with the plan and description.ti 77 Installed by ^,'✓y`:, / �' �i---„!%, ,_ Date: �: ��S//�f/i , Sanitarian--7,4, " s t E,-',/.." Cuv7 c_% PERMIT FEE $ rf 't Received by f / Date �L/' f Please use reverse side for Plot Plan or use separate sheet of paper. • STATE OF COLORADO OFFICE OF THE STATE ENGINEER Division of Water Resources . Department of Natural Resources 1313 Sherman Street,Room 818 \t‹.(113914 Denver,Colorado 80203 Phone(303)866-3581 FAX(303)866-3589 Roy Rarer Govemor lames S Lochhead Executive Director June 27, 1996 Hal D.Simpson State Engineer Sandra S Wollert 19676 WCR 8 Hudson Co 80642 Re: Your Letter Regarding Permit No. 44494 Mrs. Wollert: I apologize for the delay in responding to your letter. It may be possible for your existing well to serve one additional dwelling if the following conditions can be met: 1) You can prove that your parcel of ground was in existence prior to June 1, 1972, or when Weld county adopted SB35 rules. 2) Your parcel of ground has not been involved in a split of land after June 1, 1972. 3) Lawn and garden Irrigation does not exceed 1 acre. 4) The septic system for the additional dwelling is of the non-evaporative type. 5) You provide a field inspection report from your water commissioner (Robert Stahl, 303-857- 0742) reporting on the existing uses of the well. If you can meet the criteria above then complete the enclosed application form and return it to this office with the required field inspection and $60.00 filing fee. As with all applications your request will be considered In accordance with the date received. Call the information desk of this office at 303-866-3587 If you have any questions.asjoARichard A. raise Engineering Technician Hello