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Home My WebLink About20093470.tiffvt Fs &one' 1471-20-1 RE -4890 7O LJXEMPTION RECORDED A PART OF • (d)99'b l9 M„c 1, 10.005 I (a)68'b l9 M„LS,L0.00S � T 8 P ANN an o a - b ^_O2m 0 OF CC t.4 w co vol'cow 'al cocaz c400 d▪ 05 ka E. oo 97. 0 1 O ▪ N N 0 7 w 6 b 8 m 9C9moos —C ow coZ dd(0 E.° qo _. 0 .4 tad o V HO C 8 uT0 I N a as 90 AYH (d)LL'SLL M..ac.Lo.0os 1(a)c9'S LL M.,LS.Lc.o0s C. 10A05 Nv A 8 y8 J,�� HS2i0N N 8 W 8 Kt U o (a)LcLCSo.00s (d)Lb'8zcL M„z,Co.00s S _2 EPA452 CC I.- N 0 00 nn nn hi )..0 oD I - coa h� mm z z e S dpip y3 rk8OND s 3 O 0 0 a z z U a x m a ain -w N3 Z CO Lai V 0 z of l=C wo �z m M 0 0 D 0 O CO a < W ow ➢ATE, 3/10/09 ,9609-3`/70„ • • WI`Dc. COLORADO DEPARTMENT OF PLANNING SERVICES RECORDED EXEMPTION ADMINISTRATIVE REVIEW Applicant: Virginia and Vernon Thomas RE -4890 Planner: K Ogle Legal Description: Lot B RE -930; NW4 NE4 Section 20, T1 N, R66W of the 6th P.M., Weld County, CO. Parcel ID #: 1471-20-0-00-094 Lot A Size: 5+/- acres Lot B Size: 25.6+/- acres Water Source: Lot A: Well Permit 237447 Lot B: Proposed Well Sewer System: Lot A: Septic # G-920050 Lot B: Septic # SP -0800144 Yes No X X X X X X Criteria Checklist 1. Conforms with Chapter 22 of the Weld County Code and any adopted municipal plan. 2. Compatible with the existing surrounding land uses. 3. Consistent with the intent of the zone district. 4. Consistent with efficient and orderly development. 5. Complies with Recorded Exemption standards in Section 24-8-40 of the Weld County Code. Provides for adequate protection of the health, safety, and welfare of the inhabitants of the neighborhood and the County. Narrative The Assessors Record indicates that there are five (5) structures on the property; one residential structure constructed in 1978 described as a bi-level frame stucco dwelling, situs address 13750 CR 8; a second residential structure constructed in 1924 described as a Ranch one story, situs address 13516 CR 8 and a third residential structure described as a Dairy Milking Parlor constructed in 1965. Two outbuildings are on premises, including a 1258 SF Barn constructed in 1980, and an unknown date of construction metal skinned cattle shed. There is an existing Special Use Permit on premises, SUP -218 for a Dairy aoog-3g1O • I 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. 2. The applicant has proposed a well as the source of adequate water for Lot 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, 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. 1471-20-1 RE -4890 B. The applicant shall submit a sketch of the existing septic system in relation to the proposed lot line to the Weld County Department of Public Health and Environment. Evidence of approval shall be submitted to the Department of Planning Services. C. The applicant shall submit written evidence from the Colorado Division of Water Resources that the single family residence located at 13516 County Road 8 has a permitted well from the State Engineers office. D. Lot A of RE -4890 and Lot A of RE -903 shall share an access as no additional accesses shall be granted. The access road shall be graded and drained to provide all weather access. Accesses shall be placed in such a location as to have adequate sight distance in both directions, shall not be placed below the crest of a hill or where physical obstructions are present and shall be a minimum distance of 75 feet from any intersecting County or State roadway. A 30 foot wide joint residential access and utility easement, for the benefit of Lot A of RE -4890 and Lot A of RE -903 shall be shown clearly on the plat. The joint easement shall be dedicated for the use as shown using the language set forth in the Weld County Code, Appendix 24-F.2. Lot B shall use the existing residential / agricultural / oil and gas / ditch road access points necessary for agricultural operations as no additional accesses shall be granted. All approved accesses shall be clearly shown on the plat. The applicant shall contact the Weld County Department of Public Works to determine if a culvert is necessary at any approved road access point. If a drainage culvert is required, a 15 inch Corrugated Metal Pipe (CMP) is Weld Countys minimum size. If the applicant chooses to place a larger culvert please contact the Weld County Department of Public Works to adequately size the culvert. County Road 8 is under the jurisdiction and maintenance of the City of Fort Lupton. The applicant shall verify the existing right-of-way and the documents creating the right-of-way. 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 the City of Fort Lupton. H. The applicant shall attempt to address the requirements (concerns) of the Fort Lupton Fire Protection District, as stated in the referral response dated February 16, 2009. Evidence of such shall be submitted in writing to the Weld County Department of Planning Services. I. The applicant shall address the requirements (concerns) of the State of Colorado, Division of Water Resources, as stated in the referral response dated January 30, 2009. Evidence of such shall be submitted in writing to the Weld County Department of Planning Services. J. The applicant shall submit a letter requesting the vacation of SUP -218 for a Dairy, s the dairy has not been on site for several years. The shall be submitted to the Weld County Department of Planning Services. K. The applicant shall address the requirements of Weld County School District RE -8 as stated in the referral response dated January 29, 2009. Evidence of such shall be submitted in writing to the Weld County Department of Planning Services. L. All vehicles located on the property must be operational with current license plates, or be screened from all adjacent properties and public rights of way, or be removed from the property. All other items considered to be part of a noncommercial junkyard must also be removed from the property or screened from adjacent properties and public rights -of -way. M. 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. N. 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. O. 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 permits, the applicant shall submit evidence to the Department of Planning Services that Lot B has an adequate water supply of sufficient quality, quantity and dependability. 6) Prior to the release of building permits, the applicant shall submit evidence to the Department of Planning Services that Lot B has an adequate water supply of sufficient quality, quantity and dependability. The existing well on Lot A, permit number 237447 can not be shared. 7) Prior to the release of building permit, the applicant shall submit evidence of approval from the Fort Lupton Fire Protection District to the Weld County Building Department. 8) The Applicant has proposed a well as the source of adequate water for Lot A and Lot B. Lot A and Lot B may not share a domestic well. 9) Potential purchasers should be aware that Lot 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. 10) 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. 11) Potential purchasers should be aware that approval of this Recorded Exemption does not guarantee that well permits will be issued for the lots. Any lot may be deemed non -buildable if the lot owner is unable to obtain a well permit. The State Division of Water Resources issues all well permits. 12) 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. 13) 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.B.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. 14) 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) 15) 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) 16) Potential Purchasers are hereby notified that an industrial campus with ancillary structures and operations is located 0.5 miles south of the intersection of County Roads 8 and 27. Off -site impacts that may be encountered include noise from trucks and equipment, transient light, odors and associated activity. 17) Prior to the release of building permits on the proposed Lot, the Lot owner shall verify with the nearest Town/City or Sanitation District to determine the location of the nearest sanitary sewer line. In accordance with the Weld County Code, if a sewer line exists within four hundred (400) feet of the property line and the sewer provider is willing to serve the proposed structure, a septic permit cannot be granted by the Weld County Department of Public Health and Environment. Evidence of such shall be submitted in writing to the Weld County Department of Planning Services. 18) The property owner acknowledges that mineral owners and lessees have real property interests that entitle them to surface use in accordance with Colorado State Statutes and applicable Colorado oil and Gas Conservation Commission regulations. (Department of Planning Services) 19). WELD COUNTY'S RIGHT TO FARM: Weld County is one of the most productive agricultural counties in the United States, typically ranking in the top ten counties in the country 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 long-standing 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 areas: 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; hunting and trapping activities; shooting sports, legal hazing of nuisance wildlife; and the use of pesticides and fertilizers in the fields, including the use of aerial spraying. It is common practice for agricultural producers to utilize an accumulation of agricultural machinery and supplies to assist in their agricultural operations. A concentration of miscellaneous agricultural materials often produces a visual disparity between rural and urban areas of the County. 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. Water has been, and continues to be, the lifeline for the agricultural community. It is unrealistic to assume that ditches and reservoirs may simply be moved "out of the way" of residential development. When moving to the County, property owners and residents must realize they cannot take water from irrigation ditches, lakes, or other structures, unless they have an adjudicated right to the water. Weld County covers a land area of approximately four thousand (4,000) square miles in size (twice the size of the State of Delaware) with more than three thousand seven hundred (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. 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. People 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, and open burning present real threats. Controlling children's activities is important, not only for their safety, but also for the protection of the farmer's livelihood. 5. The applicant shall submit two (2) 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 maps(a�co.weld.co.us. 8. The Weld County Department of Planning Sterns 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 le 0 Planner Date March 2, 2009 • Kim Ogle From: Sent: To: Subject: Laurie Exby Wednesday, March 18, 2009 11:35 AM Kim Ogle; Lauren Light RE -4980 All Environmental Health conditions have been met for RE -4890. I received the fax from Gary Hammer, Hammer Land Surveying sent a drawing which shows the location of the septic system on lot a RE -903. Both systems have permits and were verified on Accela. • I #Atcft COLORADO March 2, 2009 Subject: Recorded Exemption (RE -4890) Dear Applicant: DEPARTMENT OF PLANNING SERVICES 918 Tenth Street GREELEY, COLORADO 80631 WEBSITE: www.co.weld.co.us E-MAIL: kogle@co.weld.co.us PHONE (970) 353-6100, EXT. 3549 FAX (970) 304-6498 The Department of Planning Services• has reviewed your application and related materials for compliancy with the Weld County Code. We find that your proposed Recorded Exemption meets the intent of the Code and it has been conditionally approved by staff. We have enclosed our comments for your case. If applicable, please address all issues identified in the staff comments. Prior to submitting the Mylar, please submit two (2) paper copies of your plat for review by the Department of Planning Services• staff. Upon approval of the paper copies please 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 after the date the Administrative Review was signed or after the date of the Board of County Commissioners resolution. There is an eleven (11) dollar recording fee per Mylar sheet that you will be responsible for paying to record the plat. If you need any further information, please feel free to contact me at the above address, telephone number or e-mail address. • flOit COLORADO January 23, 2009 S DEPARTMENT OF PLANNING SERVICES NORTH OFFICE 918 10TH Street GREELEY, CO 80631 PHONE: (970) 353-6100, Ext. 3540 FAX: (970) 304-6498 Virginia & Vernon Thomas c/o Gary Hammer 4350 Hwy 66 Longmont CO 80504 Subject: RE -4890 - A Recorded Exemption located on a parcel of land described as Lot B Am RE -903; Pt NW4NE4 Section 20, TIN, R66W of the 6th P.M., Weld County, Colorado. Dear Applicants: 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 the 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 Brighton and Ft. Lupton Planning Commission for their review and comments. It is recommended that you and/or a representative be in attendance at the Brighton and Ft. Lupton Planning Commission meeting to answer any questions the Commission members may have with respect to your application. Please call Brighton at 303-655-2000 and Ft. Lupton at 303-857-6694, for further details regarding the date, time, and place of this meeting. If you have any questions concerning this matter, please call me. • • WELD COUNTY, COLORADO DEPARTMENT OF PLANNING SERVICES 918 10TH STREET GREELEY, CO 80631 PHONE: 970-353-6100, EXT. 35401 FAX: 970-304-6498 Date: '— , 20 • Received From: Receipt No. 1 4 9 c, ^ Permit Type No. Description Fee 4221-RE/SE , '~r ,\ 1 - ' 4221-ZPMH 4221-USR 4221 -SITE PLAN REVIEW 4221 -CHANGE OF ZONE 4221-PUD 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. —v-^ cu CHECK NO. .._.'t•' .' TOTAL FEE Receipted By: /;/?..- DL# : ' -11- Exp. ‘Pitt WliDc COLORADO • • APPLICATION FLOW SHEET APPLICANT: Virginia & Vernon Thomas CASE #: RE -4890 REQUEST: Two -Lot Recorded Exemption LEGAL: Lot B AmRE-903; Part NW4NE4 Section 20, Ti N, R66W of the 6th P.M., Weld County Colorado. LOCATION: South of and adjacent to CR 8; approximately'/ mile west of CR 29 PARCEL ID #: 1471 20 000094 ACRES: 29.5 +/- Acres Date B Application Received Application Completed 01/21/09 KO Referrals listed 01/23/09 KR Vicinity map prepared 01/23/09 KR File assembled I Dig IO'I K Case logged in computer Letter to applicant mailed Referrals mailed C. Field check by DPS staff Administrative Review decision: c:cwp,n i.roL- 34-OCi Ica Board of County Commissioners hearing Of applicable) County Commissioners Hearing Date Date B y Surrounding property owners notified Presentation prepared CC action: CC resolution received Date By _ Plat recorded and filed Overlay Districts Zoning Agricultural MUD Yes_ No_x_ IGA Yes_ No_x_ Airport Yes No_x_ Geologic Yes_ No_x_ Flood Hazard Yes No_x_ RECORDED EXEMPTION (RE) APPLICATION FOR PLANNING DEPARTMENT USE RECEIPT/AMOUNT # /$ APPLICATION RECEIVED BY DATE RECEIVED' CASE # ASSIGNED' PLANNER ASSIGNED' Parcel Number / y 7/- 2o -O- 00_09 z7 (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 Lora i CORO. EXEMpr PE- 1903, Section 20, Township / North, Range hWest Has the property been divided from or had divided from it any other property since August 30, 1972? Yes X 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: VIROW/A L.' /1/40/14.45 410 VRNOA/ T /WO /I/731-5 Work Phone # - Home Phone # - Email Address Address. /37SO CR 8 City/State/Zip Code ,' ,CTLUP7DA) CO 'o La/ I APPLICANT OR AUTHORIZED AGENT (See Below: Authorization must accompany all applications signed by Authorized Agent) Name: /7/r7/17FP L,i0 SgRvey/dc /67€y //ire.nE� Work Phone #970-535-93/8 Home Phone #'970-y9l-7592 Email Addressh(fmnya)5akfy/r4G00)0957:4 Address 41350 H'/ k'h/r9/ Flo City/State/Zip Code LONL&f190NT C'O 81601 Lot A Smaller Parcel Lot B Lot C Lot D Water Source Gt%EZ-L- Gt7.rte_ Type of Sewer SE/O77C SE,7%C Proposed Use M5: //9y Acreage 5- 2 5 . (o Existing Dwellings? If Yes, list address below: /3750 If Yes, list address below: /,35/6 If Yes, list address below: If Yes, list address below: e property is vacant or unimproved write proposed water source and proposes sewer system for eacn parcel in the blanks above. 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 ofCountyCommissioners. 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 - fee owners must be included with the application. If a corporation is the fee owner, notarized ev'.ence m = • - included showing the signatory has to legal authority to sign for the corporation. Authorized Agent Date Signature: Owner or Authorized Agent Date (4( Virginia L. Thomas Vernon T. Thomas 13750 Weld County Road 8 Fort Lupton, CO 80621 (303) 857-2093 January 11, 2009 To Whom It May Concern: Virginia L. Thomas and Vernon T. Thomas authorize Gary Hammer of Hammer Land Surveying to act as our agent in the matter of working on the exemption with Weld County for our property. Sincerely, Virginia L. Thomas Vernon T. Thongs 7 March 10, 2009 Weld County Department of Planning Services Attn. Mr. Kim Ogle 918 Tenth Street Greeley, CO 80621 Re: RESPONSE TO THE FORT LUPTON FIRE PROTECTION DISTRICT RECORDED EXEMPTION RE -4890 IN THE NW 1/4 OF THE NE 1/4 SECTION 20, TOWNSHIP 1 NORTH, RANGE 66 WEST. To Whom It May Concern: Virginia L. Thomas and Vernon T. Thomas agree to display the 4" address numbers at the entrance to the property and on the existing house at 13750 County Road 8. The driveway is already an all-weather access being constructed of crushed road base and is capable of supporting fire apparatus. No structures exist within 100 feet of the existing gas well. No new residence is being proposed for Lot A at this time, but client agrees to provide the Fort Lupton Fire Protection District with a sketch showing a proposed location, when and if in the future a new residence is built. Hopefully this will address all concerns of the Fort Lupton Fire Protection District. If you have any questions I can be reached at 970-535-9318 Ext. 113 or my cell phone at 970-481-7592. My email is hammersurveying@comcast.net Sincerely yours; Gary K. Ham Hammer Land Surveying, Inc. yr fort lupton, Colorado March 11, 2009 Administration Office www.ftlupton.k12.co.us 301 Reynolds Street Ph: 303-857-3200 Fort Lupton, CO 80621 Fax: 303-857-3219 Kim Ogle Weld County Planning Department 918 10`° Street Greeley, CO 80631 RE: Weld County Referral Virginia & Vernon Thomas Recorded Exemption Case Number RE -4890 Weld County Planning Department GREELEY OFFICE MAR 1 7 7R09 RECEIVED The purpose of this letter is to inform you that Virginia and Vernon Thomas have satisfied the District's request for cash in -lieu of land dedication fee on the recorded exemption noted above. Weld County School District Re -8 has no objection to the issuance of building permits to the partnership or the purchaser of the lots. We appreciate your cooperation on this issue of great importance to the School District. If you have any questions or need additional information, please do not hesitate to give me a call at (303) 857-3210. Sincerely, n iitc Brenda S. Johnson Business Manager cc: 'Yt�6'lCly-� Virginia & Vernon Thomas 13750 WCR 8 Fort Lupton, CO 80621 A community united for student success...college ready! Una comunidad unida para el exito de sus estudiantes... iListos pars la universidad! s Hoar 2iS /c/ ;140,44%1\A WP491it.,41441VZ,3 BLBto • a March 13, 2009 Weld County Department of Planning Services Attn. Mr. Kim Ogle 918 Tenth Street Greeley, CO 80621 Re: RESPONSE TO STATE OF COLORADO DIVISION OF WATER RESOURCES REFERRAL DATED JAN. 30, 2009 RECORDED EXEMPTION RE -4890 IN THE NW 1/4 OF THE NE 1/4 SECTION 20, TOWNSHIP 1 NORTH, RANGE 66 WEST. To Whom It May Concern: Virginia L. Thomas and Vernon T. Thomas will use well permit no. 238210 to supply water to Lot B. Lot A will use the existing shared well agreement with Lot A of RE -903 under well permit no. 016533-F. Well permit no. 237447 has been canceled. Owners do not at the present time desire to re -permit the well under permit no. 238210 to reflect the change in acreage by the creation of the new Recorded Exemption. The owners plan to sell Lot B and would rather the new owner(s) re -permit if they so desire. Hopefully this will address all concerns of the Colorado Division of Water Resources. If you have any questions I can be reached at 970-535-9318 Ext. 113 or my cell phone at 970-481-7592. My email is hammersurveying@comcast.net Sincerely yours. Hammer Land Surveying, Inc. • • March 10, 2009 Weld County Department of Planning Services Attn. Mr. Kim Ogle 918 Tenth Street Greeley, CO 80621 Re: RECORDED EXEMPTION RE -4890 IN THE NW 1/4 OF THE NE 1/4 SECTION 20, TOWNSHIP 1 NORTH, RANGE 66 WEST. To Whom It May Concern: We Virginia L. Thomas and Vernon T. Thomas being the sole owners of the property described as Lot B RE -930, being a part of the NW 1/4 of the NE 1/4 of Section 20, Township 1 North, Range 66 West do hereby request the vacation of SUP -218. The dairy that was included in SUP -218 no longer exists on this site. Sincerely yours; Virgini) Thomas Vernon T. Thomas • Tax Account • • Page 1 of 1 Tax Account Summary Account Id R0102587 Parcel Number 147120000094 Owners THOMAS VIRGINIA L & THOMAS VERNON T Address 13750 CR 8 FORT LUPTON, CO 80621 Situs Address 13516 8 CR WELD 80621 13750 8 CR WELD 80621 Balance $0.00 Legal PT NW4NE4 20-1-66 LOT B REC EXEMPT RE -903 (.50R) SITUS: 13516 8 CR WELD 80621 SITUS: 13750 8 CR WELD 80621 Inquiry Payment Date 03/18/2009 Payment Type Q First O Second ® Full Total Due $0.00 Update Value Tax Area Area Id Mill Levy 2501-2501 60.918000 Actual Assessed AG -FLOOD IRRRIGATED LAND -4117 12,579 3,650 FARM/RANCH RESIDENCE -IMPS -4277 283,474 22,560 OTHER BLDGS.-AGRICULTURAL - 4279 11,030 3,200 Total Value 307,083 29,410 Taxes $1,791.60 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=R0102587 3/18/2009 i • January 12, 2009 RECORDED EXEMPTION (RE) QUESTIONNNAIRE VIRGINIA L. AND VERNON T. THOMAS 1. a. Water will be provided by a well permit#'s 237447 & 237090 b. Water rights were sold on this property last year. 2. A copy of the existing Septic Permits and appropriate copies (#G-920050 & SP-O8OO144) are included with the application. 3. The parcel has one farmhouse and one rental house, one barn and one loafing shed. The westerly portion is dry -land pasture with 2-4 horses. There is a tank battery and a gas well head in the southeast portion of the property. 4. The new lot will be approx. five acres in size and located west of the east boundary and south of Lot A of RE -903. It is being created for a single family dwelling site. 5. No unique physical characteristics exist on the site. 6. No additional buildings are planned at this time. 7. N/A Tax Account • • Page 1 of 1 Tax Account Summary Account Id Parcel Number Owners Address Situs Address Balance Legal Inquiry R0102587 147120000094 THOMAS VIRGINIA L & THOMAS VERNON T 13750 CR 8 FORT LUPTON,CO 80621 13516 8 CR WELD 80621 13750 8 CR WELD 80621 $0.00 PT NW4NE4 20-1-66 LOT B REC EXEMPT RE -903 (.50R) SITUS: 13516 8 CR WELD 80621 SITUS: 13750 8 CR WELD 80621 Payment Date 12/29/2008 Payment Type ® First 0 Second 0 Full Total Due $0.00 Update Value Area Id Mill Levy Tax Area 2501 - 2501 59.583000 Actual Assessed 4117 12,579 3,650 4277 283,474 22,560 4279 11,030 3,200 Total Value 307,083 29,410 Taxes $1,752.34 E The amounts of taxes due on this page are based on last year's property value assesments. https://www.weldtax.com/treasurer/treasurerweb/account. j sp?account=R0102587 12/29/2008 Name: Virginia & Vernon Thos County Attorney x Health Department _Extension Office Emergency Mgt Office - Ed Herring Sheriffs Office x Public Works _Housing Authority _Airport Authority x Building Inspection x Code Compliance Beth _ Kim Ogle (Landscape Plans) _Lin (Addressing Change of Zone) Ambulance Services State x Div. of Water Resources Geological Survey _Department of Health x Department of Transportation _Historical Society Water Conservation Board Oil & Gas Conservation Commission Division of Wildlife _South Hwy 66 (Loveland) _North Hwy 66 (Greeley) Division of Minerals/Geology Soil Conservation Districts Big Thompson/ FTC Boulder Valley/Longmont _Brighton/SE Weld Centennial _Greeley/West Greeley _Platte Valley _x_West Adams Little Thompson Federal Government Agencies _US Army Corps of Engrs _USDA -APHIS Vet Service Federal Aviation Admin (Structures over 200 ft or w/in 20000 ft of Pub Airport Federal Communications Comm REFERRAL LIST Towns & Cities Ault Berthoud x Brighton Dacono Eaton Erie Evans Firestone x Fort Lupton Frederick Garden City Gilcrest _Greeley Grover Hudson Johnstown _Keenesburg _Kersey LaSalle Lochbuie _Longmont Mead Milliken _New Raymer _Northglenn Nunn Pierce Platteville Severance Thornton Windsor Counties Adams Boulder Broomfield Larimer Other x School District RE -8 Central Cob. Water Cons RR _Ditch Company Art Elmquist (MUD Area) Case #: RE -4890 Fire Districts Ault F-1 Berthoud F-2 _Briggsdale F-24 _Brighton F-3 Eaton F-4 x Fort Lupton F-5 Frederick Galeton F-6 Hudson F-7 Johnstown F-8 LaSalle F-9 Mountain View F-10 Milliken F-11 Nunn F-12 Pawnee F-22 Platteville F-13 Platte Valley F-14 Poudre Valley F-15 _Raymer F-2 Southeast Weld F-16 Union Colony F-20 _Wiggins F-18 Windsor/Severance F-17 Commissioner Name: VI 661Y1At V1thIt) 4y671 VA County _Attorney _X Health Department _Extension Office _Emergency Mgt Office - Ed Herring Sheriffs Office Public Works _Housing Authority _Airport Authority X Building Inspection sLCode Compliance _N. -Ann 4S -Beth Kim Ogle (Landscape Plans _Lin (Addressing Change of Zone) Ambulance Services State XDiv. of Water Resources _Geological Survey Department of Health Department of Transportation _Historical Society _Water Conservation Board Oil & Gas Conservation Commission Division of Wildlife _South Hwy 66 (Loveland) _North Hwy 66 (Greeley) _Division of Minerals/Geology Soil Conservation Districts _Big Thompson/ FTC Boulder Valley/Longmont _Brighton/SE Weld Centennial Greeley/West Greeley Platte Valley X West Adams Little Thompson Federal Government Agencies _US Army Corps of Engrs _USDA -APHIS Vet Service Federal Aviation Admin (Structures over 200 ft or w/in 20000 ft of Pub Airport _Federal Communications Comm REFERRAL LIST Towns & Cities Ault Berthoud X Brighton Dacono Eaton Erie Evans Firestone X Fort Lupton Frederick _Garden City Gilcrest _Greeley Grover Hudson Johnstown _Keenesburg Kersey LaSalle Lochbuie Longmont Mead Milliken _New Raymer _Northglenn Nunn Pierce Platteville Severance Thornton Windsor Counties Adams Boulder Broomfield Larimer Other �C School District RE- A p Central Colo. Water Conservancy Dist RR Ditch Company, _Art Elmquist (MUD Area) Commissioner 7 Case #: _ 4,00 Fire Districts Ault F-1 Berthoud F-2 _Briggsdale F-24 _Brighton F-3 Eaton F-4 X Fort Lupton F-5 Galeton F-6 Hudson F-7 _Johnstown F-8 LaSalle F-9 _Mountain View F-10 Milliken F-11 Nunn F-12 Pawnee F-22 Platteville F-1 3 _Platte Valley F-14 _Poudre Valley F-15 Raymer F-2 Southeast Weld F-16 _Union Colony F-20 _Wiggins F-18 Windsor/Severance F-17 Legal Ltd- bilm, cj t Pi- AIUJ% fVt Parcel ID# 1411 0666634 Zone Acres? }%. 5 - USDA R'iryLL, Airport AID Geo Haz AI D FP? /VD Parrel-#— IGA? t—C�-- MUD? 641) Weld County Referral IUDc COLORADO January 23, 2009 The Weld County Department of Planning Services has received the following item for review: Applicant Please Reply By Project Legal Location Parcel Number Virginia & Vernon Thomas February 23, 2009 Two -Lot Recorded Exemption Case Number RE -4890 Planner Kim Ogle Lot B AmRE-903; Pt NW4NE4 Section 20, T1N, R66W of the 6th P.M., Weld County, Colorado. South of and adjacent to CR 8; approximately 1/2 mile west of CR 29. For a more precise location, see legal. 1471 20 000094 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 X 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. Gnmmantc ` miQ.t.z Ml \ l xAYt -G\/ 1 E4 l- rift f LS \A6Naki an° loch.. octal Signature Agency a-a.CA Date +Weld County Planning Dept. +918 10t Street Greeley, CO. 80631 +(970) 353-6100 ext.3540 +(970)304-6498 fax (t\ WF�YG COLORADO Oil County Planning Department GREELEY OFFICE FFR 1 R 9nn0 • RECENEWeld County Referral January 23, 2009 The Weld County Department of Planning Services has received the following item for review: Applicant Please Reply By Project Legal Location Virginia & Vernon Thomas Case Number RE -4890 February 23, 2009 Two -Lot Recorded Exemption Planner Kim Ogle Lot B Am RE -903; Pt NW4NE4 Section 20, T1 N, R66W of the 6th P.M., Weld County, Colorado. South of and adjacent to CR 8; approximately 1/2 mile west of CR 29. For a more precise location, see legal. Parcel Number 1471 20 000094 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. NI 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. Cl See attached letter. ❑ Please notify me of any public hearings regarding this request. f nmmenic. Signature Agency h 74 e a Cta - lid a ! (ten+ wa, A tkcf P'eh ICI ivy? Date +Weld County Planning Dept. 4918 10th Street Greeley, CO. 80631 ❖(970) 353-6100 ext.3540 4(970)304-6498 fax COLORADO Weld County Planning Department Weld County Referral GREELEY OFFICE FFR n R 2nn4 RECEIVED January 23, 2009 The Weld County Department of Planning Services has received the following item for review: Applicant Virginia & Vernon Thomas Case Number RE -4890 Please Reply By February 23, 2009 Planner Kim Ogle Project Two -Lot Recorded Exemption Legal Lot B Am RE -903; Pt NW4NE4 Section 20, T1 N, R66W of the 6th P.M., Weld County, Colorado. Location South of and adjacent to CR 8; approximately 1/2 mile west of CR 29. For a more precise location, see legal. Parcel Number 1471 20 000094 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. Cl See attached letter. ❑ Please notify me of any public hearings regarding this request lnmments Signature Agency c13,/y /L ,?A--/2 ivy Date +Weld County Planning Dept. +918 10'" Street Greeley, CO. 80631 +(970) 353-6100 ext.3540 4•(970)304-6498 fax • { Wilk COLORADO Weld County Referral January 23, 2009 Tne Weld County Department of Planning Services has received the following item for review:. Applicant Virginia & Vernon Thomas Case Number RE -4890 Piease Reply By February 23. 2009 Planner Kim Ogle Project Two -Lot Recorded Exemption Legal Location Lot B AmRE-903: Pt NW4NE4 Section 20. Ti N, R66W of the 6th P.M.. Weld County, Colorado. South of and adjacent to CR 8: approximately 14 mile west of CR 29. For a more precise location. see legal. Parcel Number 1471 20 000094 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 teemed 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. J We have reviewed the request and find that it does /does nor comply with our Comprehensive Plan J We have reviewed the request and find no conflicts with our interests. J See attached letter. J Please notify me of any public hearings regarding this request. '-ocaments Signature Agency Date •:•`Held County Pianr n , Dept. X918 Greeley. CO. 80631 S•,9%0. 35'3-61C.0 ext.3540 •.._:70%30--6.96 `ax • 440crifr Wi�Yc. COlARAOO i Weld County Referral JAN 272009 January 23, 2009 The Weld County Department of Planning Services has received the following item for review: Applicant Virginia & Vernon Thomas Case Number RE -4890 Please Reply By February 23, 2009 Planner Kim Ogle Project Two -Lot Recorded Exemption Legal Lot B Am RE -903; Pt NW4NE4 Section 20, T1 N, R66W of the 6th P.M., Weld County, Colorado. Location South of and adjacent to CR 8; approximately'% mile west of CR 29. For a more precise location, see legal. Parcel Number 1471 20 000094 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. Id See attached letter. ❑ Please notify me of any public hearings regarding this request. f:nmmentc Signature Agency Date 4Weld County Planning Dept. ❖918 10th Street Greeley, CO. 80631 4(970) 353-6100 ext.3540 ❖(970)304-6498 fax • • Weld County Planning Department GREELEY OFFICE MEMORANDUM FIR 2 4 9mno RECEIVED TO: Kim Ogle, Planning Services DATE: February ua23, 2009 FROM: David Snyder, E.I., CFM, Public Workse SUBJECT: RE -4890, Virginia & Vernon Thomas The Weld County Public Works Department has reviewed this proposal. Our comments and requirements are as follows: REQUIREMENTS: The applicant shall utilize the existing accesses to this parcel. WCR 8 is under the maintenance and jurisdiction of the City of Fort Lupton. 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. This area IS NOT in a Special Flood Hazard Area (SFHA) as determined by the Federal Emergency Management Agency (FEMA). PC: RE -4890 file M:\PLANNING — DEVELOPMENT REVIEW\RE-Recorded Exemption\RE-4890.DOC Email: Planner -Kim Ogle • • 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#: Other Case #: laggi A rdrr/Fo /,5/4mn7Ec &An/o cSnn✓yntya - Foe 1. Applicant Name t/,Q6/AEA Address /375o cQ 2. Address or Location of Access Section 20 Township / Weld County Road # e 3. Is there an existing access to the property? Yes_X No L • THaMA-5 Phone 4170 (18 7S9Z City /Ct.-ZWPTOA) State Zip 8 062-/ Z3?cYo C/2 Range lr 4' Subdivision Block Lot Side of Road -5-6/27-774 Distance from nearest intersection O M //-a- 4. Proposed Use: ( Permanent ( esidential/Agricultural > ( Industrial ( Temporary ( Subdivision ( Commercial # of Accesses J ( Other ♦****************************************************************************************************************************** 5. Site Sketch Legend for Access Description: AG RES O&G D.R. O A = Agricultural = Residential = Oil&Gas = Ditch Road = House = Shed = Proposed Access = Existing Access OFFICE USE ONLY: Road ADT Date Road ADT Date Drainage Requirement Culvert Special Conditions Accidents Date Accidents Date Size Length Installation Authorized Information Insufficient Reviewed By: Title. (7 ( i County Planning Department GREELEY OFFICE W��Pc COLORADO FRP 277111Q Memor.' C&' TO: Kim Ogle, W.C. Planning DATE: February 26, 2009 FROM: Laurie Exby, W.C. Department of Public Health and Environment CASE NO.: RE -4890 NAME: Vernon Thomas x. Environmental Health Services has reviewed this proposal to exempt 5.0 acres south of Lot A of RE -903. Proposed lot A will consist of 5.0 acres with a proposed residential use. There is an existing residence and a rental house on proposed lot A which is served by a permitted well (#237447) and a permitted individual sewage disposal system (#G-920050). Proposed Lot B will consist of 25.6 acres with a proposed agricultural use. There is a home and carport on proposed lot B which is served by a permitted well (#237090) and a permitted individual sewage disposal system (SP0800144). The following condition is recommended to be part of any approval: 1. A Weld County Septic Permit is required for any proposed facilities septic system and shall be installed according to the Weld County Individual Sewage Disposal Regulations. Please note, the lot owners shall verify with the nearest Town/City or Sanitation District to determine the location of the nearest sewer line. In accordance with the Weld County Code, if a sewer line exists within 400 feet of the property and the sewer provider is willing to serve the proposed structure, a septic permit cannot be granted by the Weld County Department of Public Health and Environment. 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 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 be need to be enlarged. COLORADO Weld County Referral January 23, 2009 The Weld County Department of Planning Services has received the following item for review: Applicant Please Reply By Project Legal Location Virginia & Vernon Thomas Case Number RE -4890 February 23, 2009 Two -Lot Recorded Exemption Planner Kim Ogle Lot B AmRE-903; Pt NW4NE4 Section 20, Ti N, R66W of the 6th P.M., Weld County, Colorado. South of and adjacent to CR 8; approximately'/ mile west of CR 29. For a more precise location, see legal. Parcel Number 1471 20 000094 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. U We have reviewed the request and find that it does /does not comply with our Comprehensive Plan ❑ Ye -Dave reviewed the request and find no conflicts with our interests. Er See attached letter. U Please notify me of any public hearings regarding this request. Comments. Signature Agency CieteS eat /(114,7* 1v /ec it) LA Date 3--3-f @Weld County Planning Dept. :•918 10t Street Greeley, CO. 80631 ?(970) 353-6100 ext.3540 +(970)304-6498 fax DEPARTMENT OF PLANNING and BUILDING SERVICES Weld County Administrative Offices 918 10th Street Greeley CO 80631 WEBSITE: www.co.weld.co.us Phone (970) 353-6100 Ext 3540 COLORADO Applicant: Virginia & Vernon Thomas March 9, 2009 Case Number: RE -4890 Project: Two -Lot Recorded Exemption Legal: Lot B AmRE-903; Part NW4NE4 of Section 20, Ti N, R66W, of the 6th PM Weld County, Colorado. Location: South of and adjacent to CR 8; approximately'/ mile west of CR 29. Parcel Number: 1471 20 000094 There is one building permits on record for this parcel and it is final. 1 A building permit application must be completed, and two complete sets of engineered plans bearing the wet stamp of a Colorado registered architect or engineer must be submitted for review. A geotechnical engineering report preformed by a registered State of Colorado engineer shall be required. 2 A plan review must be approved and permit issued prior to a change of use or start of construction or alterations. 3 New construction shall conform to the requirements of the 2006 International Building, Residential, Mechanical, Plumbing, Fuel Gas and Energy Conservation Codes, the 2008 National Electrical Code and Chapter 29 of the Weld County Code. 4 Setback and offset distances shall be determined by the 2006 International Building Code and Chapter 23 of the Weld County Code (Offset and setback distances are measured from the farthest projection from the structure). 5 Buildings located within a 100 year flood plain require a Flood Hazard Development Plan. 6 A letter is required from the fire district to ascertain if a permit is required. Sincerely, Robert Powell Plans Examiner II Service, Teamwork, Integrity, Quality 02-17-09;08:19AM; ;303 857 88'9 # 1/ 2 4Acti 111k COLORADO sing Weld County Referral January 23, 2009 The Weld County Department of Planning Services has received the following item for review: Applicant Virginia & Vernon Thomas Case Number RE -4890 Please Reply By February 23, 2009 Planner Kim Ogle Project Two -Lot Recorded Exemption Legal Lot B AmRE-903; Pt NW4NE4 Section 20, TIN, R66W of the 6th P.M., Weld County, Colorado. Location South of and adjacent to CR 8; approximately h mile west of CR 29. For a more precise location, see legal. Parcel Number 1471 20 000094 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. Ar See attached letter. ❑ Please notify me of any public hearings regarding this request. rnmmenty Signature Agency /1 4/1 Pre- n,��c-n -- Date /017 +Weld County Planning Dept. +918 10th Street Greeley, CO. 80631 .(970) 353-6100 ext.3540 +(970)304-6498 fax 02-17-09:08:19AM; • i ;303 857 6819 # 2/ 2 FORT LUPTON FIRE PROTECTION DISTRICT PLAN REVIEW REPORT and PERMIT Plans submitted to FLFPD are reviewed for compliance with the fire code as adopted and/or amended. This report is intended to provide the submitter with the status of plan approval, and any comments that may require further information, verification or action for approval of plans. All plans may be subject to field inspection and/or testing for final approval prior to sign off on a Certificate of Occupancy or Certificate of Inspection. The approval of plans constitutes a permit to commence work where required by the fire code, and is subject to the conditions as may be noted in the comment section below. Project: Virginia and Vernon Thomas Address: 13750 WCR 8 Plan Description: New 5 acre lot for single family dwelling Submitted by: Hammer Land Surveying Submitter Phone #: 970-535-9318 Submitter email: hammersurveying@comcast.net Permit #: RE -4890 Submittal Date: January 24, 2009 Approval Status: Approved with comments Reviewed by: Michael Dittman Date: February 16, 2009 Comments: 1. Driveways for fire department access must be designed and maintained to support fire apparatus and be surfaced to provide all weather driving capabilities. 2. Address numbers must be posted on the house and also at the driveway entrance off of WCR 8. Numbers must be at least 4 inches tall, '/z in width, and be on a contrasting backboard. 3. No structures can be within 100 feet of any gas well. It is unclear on the submitted drawing where the proposed house will be located. This will have to be verified before final fire department approval. W school' district fort lupton, colorado January 29, 2009 Administration Office www.ftlupton.k12.co.us 301 Reynolds Street Ph: 303-857-3200 Fort Lupton, CO 80621 Fax: 303-857-3219 Kim Ogle Weld County Planning Department 918 10th Street Greeley, CO 80631 RE: Weld County Referral Virginia & Vernon Thomas Recorded Exemption Case Number RE -4890 Thank you for referring the Virginia and Vernon Thomas exemption to the School District. Based upon expected student generation rates from what appears to be the possibility of one new single-family unit residential lot approximately five acres in size, the new home would generate approximately 1 new student to be accommodated within district. Bus transportation would likely be provided. It is understood that approval of the proposed new lot does not yet add residential units to enrollment potential. However, certain school issues should be considered at this important juncture, including school site planning, transportation access and facility capacity. The current facilities that would serve this lot are Twombly Elementary or Butler Elementary, Fort Lupton Middle School and Fort Lupton High School. Capacities and enrollments of these schools are: Seats Student Enrollment Available School (Grades Served) Capacity (10/1/07) (Short) Twombly Primary (K-5) 530 642 (112) Butler Elementary (K-5) 668 636 32 Fort Lupton Middle School (6-8) 890 502 388 Fort Lupton High School (9-12) 770 653 117 The District is on record as not opposing growth so long as the growth is planned and is manageable from a student enrollment d of t. This development coul ,impact all levels of A community unitedtorstudent success...conege read. Una comunidad unida para el dxito de sus estudiantes... iListos para la universidad! schools. In addition, even without this project, completion of other previously approved developments would generate more students than can be accommodated by the existing schools. As the volume of developments increases with no alleviation of the existing capacity conditions, the ability to provide the same quality education for these new students becomes increasingly difficult. Weld County School District RE -8 requests the cooperation and participation of the developer to provide cash in -lieu of land dedication fee, (currently $939 per new lot), to address the need for future school sites. Further, the District requests that the County assist with monitoring residential growth working and consider facility capacity impacts upon the schools in determining whether a new project should be approved. We appreciate your cooperation and the opportunity to comment upon the issues of interest to both the County and the School District. We ask that the recorded exemption not be approved until the applicant demonstrates that the cash in -lieu of land dedication fee has been paid, or that arrangements have been made with the School District. If you have any questions or need additional information, please do not hesitate to contact me at (303) 857-3210. Sincerely, A Brenda S. Johnson Business Manager DEPARTMENT OF NATURAL RESOURCES DIVISION OF WATER RESOURCES January 30, 2009 Mr. Kim Ogle Weld County Planning Department 918 10th Street Greeley, CO 80631 Weld County Planning Department GREELEY OFFICE Re: Exemption from Platting for Virginia and Vernon Thomas Case No. RE -4890 NW1/4 NE1/4, Sec. 20, TIN, R66W, 6th P.M. Water Division 1, Water District 2 Dear Mr. Ogle: FEB 05 mOPl RECEWED Bill Ritter, Jr. Governor Harris D. Sherman Executive Director Dick Wolfe, P.E. Director We have reviewed the above referenced proposal to create by exemption two lots of 5 acres (Lot A) and 25.6 acres (Lot B). Water for the two lots will be supplied by two existing well permit nos. 237447 and 237090, however it is unclear which well will supply Lot A and which one will supply Lot B. 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. 237090, was late registered in accordance with C.R.S. 37-92-602(5) on October 25, 2001 for the historical use of this well, being a well producing 15 gallons per minute and used for ordinary household purposes inside one single-family dwelling and fire protection. The ground water shall not be used for irrigation or other purposes. Well permit no. 237090 may be used to serve one of the lots in this proposed exemption however, note that well permit no. 237090 was canceled upon issuance of well permit no. 237447. Well permit no. 237447 was issued on November 7, 2007 pursuant to C.R.S. 37-92-602(3)(b)(II)(A) as the only well on a residential site of 30 acres described as part of the NW1/4 of the NE1/4 of Section 20, Township 1 North, Range 66 West of the 6th P.M. Well permit no. 237447 was permitted for a well to be constructed into the not nontributary Arapahoe Aquifer. Due to the lack of water into the Arapahoe aquifer, on December 12, 2001 the applicant applied to construct a new well into the nontributary Laramie -Fox Hills aquifer. Upon issuance of the new well permit no. 238210 (for the Laramie -Fox Hills aquifer) well permit no. 237447 was canceled. Since a well was not constructed under permit no. 237447, the status of the original well permit no. 237090 will remain as a pre May 8, 1972 well. However, before well permit no. 237090 can be used to serve one of the lots in this recorded exemption the applicant will need to submit a written request to reinstate this permit. As mentioned above well permit no. 237447 is also canceled and the valid permit for this property is well permit no. 238210, which was issued on December 13, 2001 pursuant to C.R.S. 37-92-602(3)(b)(l). Well permit no. 238210 is currently permitted so that it claims 1 acre-foot of water in the Laramie -Fox Hills aquifer underlying the 30 -acre property that is subject to this exemption: The use of the ground water from this well is ordinary household purposes inside one single-family dwelling and the irrigation of not more than 14,000 square -feet of home gardens and lawns. Although well permit no. 238210 does not claim the entire amount available in the Laramie -Fox Hills aquifer underlying the 30 acres, we recommend that permit no. 238210 is re -permitted to claim 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 Virginia and Vernon Thomas January 30, 2009 S Page 2 only the water underlying the 25.6 acres (proposed Lot B). The ability for the existing well on proposed Lot B to be re -permitted will be evaluated at the time that the well permit application is submitted. Should you have any questions in this matter, please contact loana Comaniciu of this office. Sincerely, a Williams, P.E. Resource Engineer JMW/IDC l • 17 01 N66W 20 • • Lai 911 0 In § Li- LIJ ci O RSk tsi §§ m 2 [ \ CO °\ § aL PROJECT: 08036 00 0 • • co O z O U N 911 z �V)W O W W I O col M Q 0 0 J n n rn a rn 0 W N cn z a U Z. a z } Z F w 0 � S0 IC! In co 6a9 J O. o 3 M M east i-0 ww Cn CV 0 Z Q O it I— w =0 -OZ oZD rn_0 I M d U O Q _ CD W CL Et Z O 0OI-0 PROJECT: 08036 CO 0 O) 0 N W r) CV m cO cO O U F .a°DF 14 a zLO 0a H 0 z Road File #: 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 Date RE # : //--' Other Case #: 49rzy igvvirnE ./ //virvirv1{/Z �rit-O 5K21VeyItVO— F0/Z 1. Applicant Name VR4/A)/4 L . TOMgs Phone 970-(181'7S9Z— Address /375o G2 f ciry /.2T .70A) stated zip 8 O 2- / 2. Address or Location of Access /3 760 CW re Section 20 Township Range 7°4, Subdivision Block Lot Weld County Road # i:S Side of Road Snar7A Distance from nearest intersection— e 3. Is there an existing access to the property? Yes X No # of Accesses 3 4. Proposed Use: ( Permanent ( esidential/Agricultural ( Industrial ( Temporary ( Subdivision ( Commercial ( Other ***********************************************************************************1,t»»************** * ** * * * * ****ki****1,t»t 5. Site Sketch Legend for Access Description: AG RES O&G D.R. O A = Agricultural = Residential = Oil & Gas = Ditch Road = House = Shed = Proposed Access = Existing Access OFFICE USE ONLY: J 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 STATE OF COLORADO COUNTY OF WELD WELD COUNTY DEPARTMENT OF PLANNING SERVICES The UNIFIED TITLE COMPANY OF NORTHERN COLORADO 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: Lot B Recorded Exemption No. 1471 -2O -1 -RE 903 recorded July 21, 1986 in Book 1120 at Reception No. 2061640, being the Northwest Quarter of the Northeast Quarter of Section 20, Township 1 North, Range 66 West of the 6'h P.M., County of Weld, State of Colorado. CONVEYANCES (if none appear, so state): • Reception No. 3103924 Reception No. 3089332 • Reception No. 2891993 N4 Reception No. 2422413 Reception No. 2074743 • Reception No. 2061640 • Reception No. 1710933 Reception No. 1700836 Reception No. 1700835 • Reception No. 1613505 Reception No. 1613504 Reception No. 1562397 ▪ Reception No. 1560730 Reception No. Reception No. , Book , Book , Book , Book 1475 , Book 1133 , Book 1120 , Book 789 , Book 779 , Book 779 , Book 692 , Book 692 , Book , Book 639 , Book 1572, Page 185 , Book 1557, Page 47 The certificate is made for the use and benefit of the Department of Planning Services of Weld County, Colorado. This certificate is not to be constructed as an Abstract of Title nor an opinion of Title, nor a guarantee Title and the liability of UNIFIED TITLE COMPANY OF NORTHERN COLORADO, is hereby limited to the fee paid for this Certificate. In Witness whereof, UNIFIED TITLE COMPANY OF NORTHERN COLORADO, has caused this certificate to be signed by its proper officer this 7th day of January, 2009, at 5:00 PM Company: UNIFIED TITLE COMPANY OF NORTHERN COLORADO By: Authorized Signature Unified Title Company 3690 W. 10th Street, 2nd Floor Greeley, CO 80634 1 I STATE OF COLORADO *2ND AMENDED 7/25/03 #1 per morcuary.ts HOLD TO LIGHT TO VIEW WATERMARK STATE OF COLORADO So O CERTIFICATE OF DEATH 2ND AMENDED-- " e DECEDENTS NAME ifurt *Virginia 4. SOGa, SECURITY NUMBER 522 14 3010 L WAS DECEDEWrEVER IN ea 0 5. AGE - Last Bathday (Yea .1 U.S. ARMED FORCES? O Y.. HOSPITAL- 7WNo -t(Mn CLAb IA0 87 D U ▪ 1YtAR 011.1 Se. PAClllmn MENInol Mwl lmn, Em Urn( and owner) Boulder Community Hospital lo. DECEDENTS USUAL • 'AOON tot,,.mea HMacwa do mo,lofnoNryMe nnl Clerk t3..`' m NCESTATB Colorado 13e. INSIDE 13L ZIP •DE CCITY IMITS? 80621 THOMAS DER I DAY O DOA A WAS DECE. NT •1 HISPANIC ORIGIN? IRWpVestaw. Nell No or RbnrMcl pecM Capin, %No Con SPeNtr: STATE FILE NUMBED 200.30146864, Female fl DATE OF BIRTH• (MOWN Day Thal October 28, 1915 3. DATEOE DFAIH (Month, D.y, I•nn June 25, 2003 ]. BIRTHPLACE (City .00 Slam a ForeignCowo,l Henderson, Colorado • OTHER 0 Nunino±lonAl o R.,ld.,c. n Other !specify, SC. CITY, TOR'µ OR LOCATION OF DEATH 04. COUNTY DF DEATH Boulder Boulder 11. MA'. L' - (Awned Nem Mimed. Divorcee 1.1”.tM °eel Widowed AND NUM9 ■ 13750 WCR #8 RA E. Americen Pees. Meek WSEl, Me. ISp401 EN compild ElemeCED NTS ntary w aetcoy McYnly pAe.1 S eras through IN College 11315,000 i too 17+1 White 12 • SE IN wilt pl. ' .4Vn n..>+1 cram H. Thomas aril Peter Latorra IS MOTHER'NA Edna Smiley MOM L..1 (MPS. Nasal 0' NT -NAME nit nl lbn.Np to demand. Virginia L. Thomas- Daughte Ea. MEI HOD OF DISPOYTN)N utte( OOmelet., O RammN Iron Stale o Donenm 0wnnlswdM DO PLACE CF DISPOSITION (Name of c.m.IeoC [mail° h., Pun) Highland Memorial Gardens OFTLF5RAL I IICGTOH OR PERSON Ac PI AS 500 ME •b DEATH 124. DATE June TOE CO IS 25 TO EE COMPUTED ONLY It CLRTIFTIMD MYEICIA 215. NAME AHD ADDRESSOF FACILITY'. LOCATION City of To,m,3Mte Thornton, Colorado Olinger Highland Mortuary 10201 North Grant St., Thorntonz160 60229 2003 1400 d To Y2 •I �M,iljt, a Nl E O6umd.115.4me. ME.nd FJect .M N.le 1 3e. DATE STONED IMonlq Oar nail 230 0 IINAT John E. Meyer MD, Deputy Coroner, Boulder County Coroner P. 0. Box 471 Boulder, CO ae 80306 31. NAME OF ATTENDING PHIEC W1 IF OTHER THAN CERTIFIER IType/Rifti On M Item OAS AMU Was. in /S, 'a nuy S: u � 1eµ °smfM Mme July 7, 2E 03 4 33. MANNER OF DEATH ?l. U Nature, 0 Pending 5 _ hwasitpation X Ac40.nl O S5'c1M CM MTfnIn5 3x 1,J SL OF OE AT f a Homicide DATE OF INJURY 'Moab\ Cap VW 6/14/03 330. THE Of INJURY 0800 M 33d PJIMY AT NORM? CV.. Y;do h MeL tam,MM Residence CAN MbNM MwM IenM nit Jnp Un�nown andde detrain onseta dolls 136. DESCRIBE HOW INJURY OCCURRED Fell In bedroom while walking LOCATIONand — Swots, or Rural Rdy xsOM. OW. CpM. LM3 13750 WNd Co. Rd. 8, Rural Wald County, CO 34. MMLDMTECAUSL MNTLA CMLYONICAUS6 PERLWIF0R(µ NA AND (RI Do note oe mode o•*Ins $40MdHCtlMiEal( MnM)Mw,. PART IM Complications of Right Hip Fracture CN CDITIDN6 DIIE0 [MAFIA CONSEWENCE LM IF ANY WHICH DAVE RISE TO IM MMINSTATING THE THTUETO OR AS A CONSEDF NCE OF' UNDERL LAST (1)INGGVSE .6i k) 14 PART OTHERSIGWFCANTCONDITIOHS-Contlllms.°SIt.EICMdEMNSW es le CWM II PART I is. Pe4RN abuse. oMMN. M'CAM).. Thomas Virginia 1561.03-B Grist THIS IS TO CERTIFY THAT THIS IS A TRUE AND CORRECT COPY OF THE OFFICIAL RECORD WHICH IS IN MY CUSTODY s , -L No MnM bet and Amain SS. AUTOPSY St F reE MN 'finding WoMNed 0'.. W$ 4YIRW,F eau.MdW" U CC 4H ",S at o — 0 = X90 �3 m any CO a 0 co �Y- o o G a CM OD OCC ✓ N N X074 - 04, DATE ISSUED by !, 4y JUL 2 5 2003 RONALD S. HYMAN STATE REGISTRAR Do not accept unless prepared on security paper with engraved border displaying the Colorado stale seal and signature of the Registrar. PENALTY BY LAW, Section 25-2-118, Colorado Revised Statutes, 1982, if any person alters, uses, attempts to use or furnishes to another for deceptive use any vital statistics record. NOT VALID IF PHOTOCOPIED. REV 01/03 Ylu IIII 11111111 III IIIIIII!11 III 11111 1111 1111 l 3103924 0910812003 01:03P Weld County, CO 2 of 2 R 11.00 D 0.00 Steve Moreno Clerk 8order EXHIBIT "A" VIRGINIA THOMAS DOCUMENTS TO BE RECORDED: • CERTIFICATE OF DEATH RECORD TO THE LEGAL DESCRIPTION LISTED BELOW: TOWNSHIP 1 NORTH, RANGE 66 WEST, SECTION 20 WELD COUNTY, COLORADO 8/19/03 CERTIFICATION OF VITAL RECORDS. STATE OF COLORADO *2ND AMENDED 7/25/03 d1 per mortuary.ts SO ' 2ND AMENDED HOLD TO LIGHT TO VIEW WATERMARK STATE OF COLORADO CERTIFICATE OF DEATH I. DECEDENTS NAME Trull. Mme.. LEO ti -r -gin -,a- *Virginia e` May (Yes A 87 4 NUMBER SECURITY 522 14 3010 a WAS DECEDENT EWER IN U.S ARMED FORCES? D Pm )0po SA FACILITY NAME V In n N rol PPE 'AAP', SA UNDER DAY Da M„ M. PLACE Oi 6EATH ICI O pnlvon0 XOYPITAI: • OTHER MgINN C ER/Oulpellen, O DOA j CNOWry Nem 0 ROId.Me fI VINr/SRe[iAl THOMAS E0. UNDER I YEAR a f BIRTH We lb Dap V..I October 28, 1915 7. BIRTHPLACE ION ,nll CNN A VorMMpn 01 Henderson, Colorado' STATE FILE NUMBER 2003014686 sex Female 3 DATE OF DEATHIMnnu DPP Poi June 25, 2003 Boulder Community Hospital 10e DECEDENTS USUAL DOC PATION lane 4El AEAdo...d ring moil somingli Clerk 13e. Rf,SIDENCE.STATE Colorado 13A INSIDE LIMITS? ID Am i to 7.. FATHERNAME I .M/dthe. Lml Peter Latorra 201 METHOD OF DISPOSITION nu" 0 Cle"Sloe C R.mnNlvn State D Douai! on o ome upeal$ 1SA, COUNTY Weld 131. ZIP COOL 60621 Bc. Clive IOWN.OR LOCATION OF DEATH ICA KIND OF BUSINESS/INDUSTRY Retail ISO. 4lrr.TPWN.OR iocsrmN Fort Lupton 14 WAS DECEDENT OF HISPANIC ORION? 1.d No 1. VII V. II Ye% elm*Cub. Riede Rai rE 'C NO O Ale. I—li Boulder II MARITAL .STATUS. LItlovotl. DNacedlspecnll Widowed 9e. COUNTY OF DEATH Boulder 12. SPOUSE Of WIe, gM m,lden En* Hiram H. Thomas ISd STREET AND HUMMER 13750 WCR #6 II RACE Mines. Indian. III DECEDENTS EDUCATION ISOECIIF OPPYn 15551 BALK WORN, ARC.(Sp ocnA White IS MOTHER -NAME IFmt.M,pole. LEN WASP Hamel) Edna Smiley 206 PLACE OF DISPOSITION (NNE, Al anl.IWK cremator. Won EAR) Highland Memorial Gardens O lle pIIP 31 CoMpe 113 Mr,A0Vr l e II I Tt) 12 II INFOQMANT NAME end Minna. lo dement Virginia L. Thomas- Daughter Za. LOCATION Cy A To., SIT. Thornton. Colorado STONATUIIE oPnpreeML IIRECTOSOR PERSON ACTING AS SUCH EgJ�611MRaaIOlufMe Areal- 5tH t!. ATCF Muolll June lb. NAME. AND ADORERS OF FACILITY Olinger Highland Mortuary 10201 North Grant St., Thorntonzl60 80229 Rd yu 25 2 3� 1400 FILED IMAM. A CoMrF�^`ratell 3 Cor oER gflNC�ito?Yes z(�c)/� 3 CALITr OP CLOTH TO IS COMPUTED ONLY BYCERr11YING PHYSICIAN 6 Toe.,butTIN,. ned.dMie idea .tEwree Mme IIRAA NN and ARRA and Solo *AMP* D. 211 DATE SIGNED WRnn.a1 Year, TOLE CONSISTED SY CORONER 27. Ina �: AM demA ',NMMutlo II tcthinf'y'441**O .. steed MsuAd at Re Swamp. 25. DATE AGNEDI July 7, 2003 30. NAME• IRE AND MAILING RDDRE5509 CEpnFLpRORONEN Iivoe/ I John E. Meyer MD, Deputy Coroner, Boulder County Coroner P 0. Box 471 Boulder, CO ZIP 80306 SI NAME OF ATTENDIND PHYSICIAN IF OTHER THAN CERTIFIER INN/Pro >32. MANNER OF DEATH El NAM.. M¢Idvn O buckle o Hemlock O MIPRIORS o umeN,m;,ed Mnne, 3M DATEOF INJURY IMAM on Y,u, 6/14/03 33Ar EMMK 0800 M 33c. %V AT o Tel OPyKINO 334. RACE WINAM n NOM.lenn. skeet MAMA AMP Me1�Kr Residence ma summer NOW INIIMYDCCIDNRD Fell in bedroom while walking 331. LOCATION I*M1 and NAMA M INS Ram N. Dry. CANS Mail 13750 Weld Co. Rd. 8, Rural Weld County, CO 34...MEDITE CAUSE (ENTER ONLY ONE CAUSE PEA LIMEFORM OL AMD All DOAI Me. AMA of frIng GVAY4 or RMPL.N4 M,.AnMAL M"bneA.np'M PAIR AR Room Complications of Right Epp Fracture Unknown DUE tO OR ABA CONSEEIILNCE OF IMAM Deimos OIWI mid MMIN IM CONDITIONS IF MY WNCH OAVE OEE CO STATING THE UNDERLYINGCAUSE LAST 'I PART OTHERSIGNIFICANTCONOITNNIS. CEndiIondceMAP IIlp OAdMa RA ON reOed b Paso in II PARTI Me. SAADI abuse %Maly. emoLt. 14 DUE 10 OR AS A CONSEOUE NCE Of Thomas Virginia 1561-03-B Grist - THIS IS TO CERTIFY THAT THIS IS A TRUE AND CORRECT COPY OF THE OFFICIAL RECORD WHICH IS IN MY CUSTODY. RS AUTOPSY M On No M IF YES Wen ds4rnAIng suu,ham e MdtilIO a, CC ed =d 0 V 0 a a3 X32 5y 0 _a47o F00 a♦� CM X00 --Cq0 To aCC gr — co O T — Dos,,,., DATE ISSUED JUL 2 5 2003 RONALD S. HYMAN STATE REGISTRAR Do not accept unless prepared on security paper with engraved border displaying the Colorado state seal and signature of the Registrar. PENALTY BY LAW, Section 25-2-118, Colorado Revised Statutes, 1982, if any person alters, uses, attempts to use or furnishes to another for deceptive use any vital statistics record. NOT VALID IF PHOTOCOPIED. REV 01103 magoanartilD 15 A. 4 I IIIIII IIIII II11111 III 111111111111 III II 11111 IIII IIII 2891993 10/15/2001 02:22P JA Suk ukamoto 1 of 2 R 10.00 0 0.00 Weld County CO IMO0)1muiu1 _ Mee. Lain CERTIFIER 2 1. DECEDENTS Nam: IFi . SOCIAL iECURITY NUMBER 522—01-6810 STATE OF COLORADO CERTIFICATE OF DEATH L -G 35x-7 STATE FILE NUMBER Hiram. Henry Se. AGE -Last se. &MeaylreMN Mon 85 w. PLACE OF DEATH ICheck entire HOSPITAL UNDER I YEAR vs Sc. UNDER Ti0MAS _Male DAY NM . NIAs 2. SEX & DATE OF BIRTH IMMIh. Oar. YAW December 10,1909 3. DATE OF DEATH pleats, Dan Oar) December 20, 1994 7. BIRTHPLACE ICPy Me Stale or fM g CoonpN Beatrice,Nebraska L WAS DECEDENT EVER IN U.S. ARMED FORCES? OVea ar No ep FACILITY NAME IN not nlatdulme, pis MAW IM nuaOed r m iasma ❑ ER/OulpMle Platte Valley Medical Center OTHER ❑ 00A J 0 Nursing Nome D Rniallce D OtherISPtli, e6 CITY, TOWN, OR LOCATION OF DEATH Oa. DECEDENT'S USUALOCCIIPAIION 1Op KIND OF BUSINESS/INOUSTRY (Wye imam mei doneaunnp met of NOMmgFte. Do use ntireal Heating Contractor I3a. AESIDENCE.TATE Colorado 13e. INSIDE CITY LIMITS? ❑ Yes MNo 130. COUR Weld Heating Company x CITY, TOWN, OA LOCATION Fort Lupton Brighton 11. MARITAL e ma� marred. W1d0Ned. Never Merced (Soap's Married '3d. STREET AND NUMBER 13750 Weld County Road 8 oa. COUNTY OF DEATH Adams 12. SPOUSE III ea. phe ASSAM Mme, Virginia Latorra 21 80621 se. WAS DECEDENT OF HISPANIC ORIGIN? ISPealy No or Yes -11 vat MleCily Gan. Mexican. Puerto Rican. slid dNo Oyes Send", IS. RACE A nen an laden. Wan While, CI61SDeerim White 17. FATHER. NAME IFint AARON. List) Francis H. Thomas 20a METHOD Of DISPOSITION i{ Buried O Cremation O Removed Irem Sale ❑ Donation O Other (Simone enl MASS UN (Carden MMH)I Lydia Leah Folden IS. DECEDENTS EDUCATION Opener MNhtflaa, grade comPatet Elementary 01 M aeodery 10 Prawn 12)College (I3 thrown 16 or I Tt) 10 t INFORIAANT-NAME and MMIKINNip he deceased. Virginia Thomas -Wife 200. PLACE OF DISPOSITION (Nara of cemerer% crematory. M *Per pad) Highland Cemetery 206 LOCATION - City or Town, Slate Thornton, Colorado 216 SIGNATURE OF FUNERAL DIRECTOR OR PERSON ACTING ASSUCH 216 NAME AND ADDRESS OF FACILITY v 23. M OFOEATH 10:25 P M e. tit:SS eAr MOM Day Decen, er Zo Moore Howard Mortuary 800 E. 17th Avenue Denver, CO or80218 �L,(2EG DATE FILED DEC. 2 Year) U �! 12L EWIASGICO•RONER NOTIFIED? SRN Now Wet or MCI, /799 is ; 25P. TO SE COMPLETED ONLY EY CERTIFYING PHYSICIAN TO IS COED SY CORONER 26. tTa ton Deal M my MloWeede. eGl eate e0nad at she e, limdale use Mace. aanddue Ia on OYWNa Sipnatute DATE SIGNED YMIn. "" Y Teen26. Y. SO. NAME. ITC A DMA. 6;20 D 1� 330. TIME OP INJURY 33e. INJURY AT OYee 0 N 336 DESCRIBE HOW INJURY OCCURRED pat MI 27. On M• bass el emnenalion lM/M,nveNlaadon, In myopinlen death ramrod et the (bee. done and pace, and EPa to the esteem) and manner...tow, ale, D- J C')RQNFR SlgMluse oj� 21. DATE SIGNED IAaltn. 0 Year) .Lea .APL O 199x/ 32. MANNER OF DEATH ('Natural OhMwa mmietWIIM O Accident o avenge O Homicide 0 UMoWntened Manner •n. DATEOF INJURY Wont* Das Yea M 33e. PLACE F INJURMAt Mae.lMIR MM ,Llastery, Mese PLACE rJ N 33L LOCATION Seel and NMMat or NUM Rauh NeWMCCEY.cMmly. SOHO ,34..MMEDIATE CAUSE EN TERONLVONE Ca SE PER PLINE taL 10>N0MJOo n renar e el CMO MME Cardiac et RaaoNUn Fermat) edo0ANO f,e/ r' CONDITIONS U bb ✓Rn6A CON33E0uriNC OF IF ANYWHICH MICR PART GAVE RISE TO (M IMMEDIATE CAUSE DUE TO OR AS A CON $EOUENCE OF STATING THE UNDERLYING CAUSE LAST ICI ICI PART OTHER SIGNIFCANTCONOITIONS- Cenci commuting to deed out not reeled o caws in If PART I le.d. alconol apnea, abeut?. awoken. Interred S and death ImwM1al between mIM and Sete Inane Donna onset end death 35. AUTOPSY 3E. IF YES W eed (IMlnaa oansida and (Yea or Nil M determining cause d death? No STATE OF COLORADO. TRI-COUNTY HEALTH DEPARTMENT - United States of America I hereby certify CRIS doCuREDt is a true and correct copy of the record in ny custody. Issued this 26th day of December 1994 A.D. This is not valid unless prepared by blue basketweave paper and impressed with the raised seal of Tri-County Health Department. l� ,n 0 .vl , PENALTY BY LAW if any Person alters, uses. attempts to use or furnishes to `�' S •i ( 1.t' ,‘4 a0 H. H. Rohrer.il.T . Registrar Adams. Arapahoe and Douglas Counties Ini: L sctunttt, Deputy Rag straf' IIID 1111111IIIII1111111111111111111111111111111111111111111 2891993 10/16/2001 02:22P JA Sukl Tsukamoto •`.2 of 2 R 10.00 D 0.00 Weld County CO EXHIBIT "A" Attached to Certificate of Death for Hiram Henry Thomas, the following refers to the legal description covering mineral rights owned by Hiram Henry Thomas, aka Hiram H. Thomas at the time of his/her death: Township 1 North, Range 66 West, 6th P.M. Section 20: NE/4 Weld County, Colorado m2%22413 2_ 3 4 5_ CAUSE OF DEATH e. SOCIAL SECURITY NUMBER 522-01-6810 IL SEIN MED FORCES' USAR Ova OUR) Rb. FACILITY NAME in n011111.1 o n, pin 110,1? an.d numb.rl STATE OF COLORADO CERTIFICATE OF DEATH • STATE FILE NUMBER I. DECEDENT'S NAME IIn.I. Maid.. Lis° Hiram B rinds), rv•Aarsl 85 Henry 5b. UNDER I YEAR Mo, Days TiOMAS Sc UNDER I DAY HIT B.. PLACE OF., EATH IC1./I only one) HOSPITAL SEX Male e BIRTH DATE OF MAO December 10,1909 3 DATE OF DEATH Worn!). Day. veal December 20, 1994 T. BIRTHPLACE 1Glr Ana Stem or Forman BIR Beatrice,Nebraska p Inpatient 0 ER/OvIPflnl Platte Valley Medical Center ID.. DECEDENTSUSUAL OCCUPATION bpin b14 Pl wan don. punn0 mot101 WOOF1104 I.?. lyr au 05(1011.1 Heating Contractor T31 RESIDENCE -STATE Colorado I3e CITY C LIMITS? oTo too I. FATHER.NAME 1111111. Middle, Lull Francis H. Thomas a. METHOD OF DISPOSITION H Donal 0 CNImlbon C Removal Nom Stela n Can.1lon O OmM (Speedy) III COUNTY Weld . OTHER 0 DOA 1 0Nursinp Hon* 0 Reopen. U OIMr(Spoof yl Sc. CITY, TOWN.OR LOCATION OF DEATH III KIND OF BUSINESS/INDUSTRY Heating Company lac CITY. TOWN, OR LOCATION Fort Lupton Brighton IT Never Mr STATUS �.eaia a. Onwa.d 150/11,1 Married 13d. STREET AND NUMBER 13750 Weld County Road 8 Id. COUNTY OF DEATH Adams 12 SPOUSE III will. give tampon 0.m.1 Virginia Latorra 131. ZIP CODE 80621 WAS DECEDENT OF HISPANIC ORIGIN? Mpa<Bn Pulnb Id A.Ye c, ""Ca I No DYea SP.mlr. 16 RACE rnatizan Mac., White. ME. 1555th? White II MOTHER -NAME ?trot, fiddle, Lul IM.le.n N.meA Lydia Leah Folden 16 DECEDENT'SEDUCATION 'Specify OnlyniEM,l 51====m, 10 II. INI ORMANY-NAME.nd nbllon,MP 10 ae/BMed. Virginia Thomas -Wife 200. PLACE OF DISPOSITION Win?. al Gen»,Ann Annular , II ether dace Highland Cemetery 215 SIGNATURE OF FUNERAL DIRECTOR OR PERSON ACTING AS SUCH u OFLE 10:25 P M 20c. LOCATION • Gay or Town. 51.1e Thornton, Colorado lb NAME AND ADDRESS OF FACILIN: )h "lei-/ Moore Howard Mortuary 800 E. 17th Avenue Denver, CO zip:80218 23b DATE FILED( DECmo, 2 Yun d / D 2 8 IDSt �pVJj/lI//y/I,�r adL y IS. WAS CORONER NOTIFIED? µ0l1111 EPPONVVN ED Day I/ 1Yrl w Nol Day Dec-ern1.ex ao /9E/ 1ot25HouP TO BE COMPLETED ONLY BY CERTIFYING PHYSICIAN TO BE CO LETEO BY CORONER 26. Is IOON an'In edo. n a s the tone 011...504 Pl.c. . rA au. IS 5,pn.I r. 26. DATE SIGNEDIMonm 1 ' /17 •.k,-4" 2119vy en Mg rOMNTY, CnLnp4D0 30. NAME. A DM AIE,J0 ALfiRESS ERTIF'EAICORONER ITYP./Pnnll �/1./.if I / OF 3I. NAME OF ATTENDING PHYSICIAN IF OTHER THAN CERTIFIER hype/Print ai Om 41116 M geco. inl0(a*lo INS ca Wiui :^eF4nnpa Ynl d Tuned Nlna SOP . l., 1.Y LLO.Ji wI II. DATE SIGNED ,1151 psat >32. MANNER Of DEATH XM11uIM Clnr SIIl&Ilon o law.nl 051/1. C Mpniud. PAST 336 YAanln DIEAwl yb TIME OF INJURY 33e INJURY AT WORE? O Yea ONO 334. DESCRIBE HOW INJURY OCCURRED !lU agile m .4 634. PLACE OF INJURYAl hom.Inm Brat, IMSY. 0X104 bdldlop..11. 150401111 311. LOCATION1Srell 1.d Number co Rurel Ram NuAt.. CIM. County, Iwo 34. IMMEDIATE CAUSE ONLY ONLY ONE C.AAVSE AEA LINEFO IBA TEL ANOl4.la i.1/e'.s.od.Waring (OM Cardillo; Or R.w1I.ISN M1x11.MN. lab ( "'fr., % �/ / /�!� /...%� 7.;;L4e DU& TO Oytf A CONNSEOUENCE OF CONDITIONS IF ANY WHICH GAME RISE TO IMMEDIATE CAUSE STATING THE UNDERLYING CAUSE LAST NI Ill ml .nta 4112:767n441 between onset and a..m DUE TO OR AS A CONSEOUE NCE or / PART OTHER SIGNIFICANT CONDITIONS C0na.uon4 cnnNmdluq to aeelhbui nq rotnolo cause In i i Y1 IiATE OF hereby certify tifD IRIS DOauTCOL.HIstaB trueandUnited copYsoft America the record Ey. eustoey. Issued this nth day of December 1994 A.D. This is not valid unless prepared by blue besettwea.e paper and impressed with the raised seal of Tri-County Health Department. PENALTY BY LAY if any Person alters, uses, attempts to use or furnishes to another for deceptive use any vital statistics certificate. 2422413 H-1475 P-322 01/10/95 03:46P PG 1 OF 1 Weld County CO Clerk NL Recorder RU I.B. uoan0,.buse,a0.a1s.. Tun. 36. AUTOPSY Ir.. °Not No l bel.e.n prat•nd1..6.am pa' IF YES Ana a..nn? H. H. Rohrer. 11,6.: Registrar Adams, Arapahoe and Douglas Counties Lois L Schmitt, Deputy Reg sire REC DOC 5.00 AR2074743 - B P REC 02074743 10/27/86 12:41 x6.00 1/002 - F 3 MARY ANN FEUERSTEIN CLERK & REC R WELD CO, CO WARRANTY DEED I THIS DEED. Made dm 21st ua.,d t( r • .8 • ic 86. ler.een I HIRAM H. THOMAS, VIEGINTA THOMAS, VIRGINIA L. THCri4AS and VERSION T. TRia1AS • Counts held earl Stine of li is Colorado. pran:ur. and Darlene Lindsey, also known as Darlene Mary Lindsey nh,:..le=,laddr..,in 13746 Weld County Road #8, Fort Lupton, Colorado 80621 ul the [ 1 r held and Sion: l Colorado. raillee, 1NTNESSErH Thai paaior i '1 the sinnol TEN DOLLARS AND OTHER GOOD AND VALUEABLE CbNSIDERATI(A•z D(li M<S. therector and LieToo...I„ hien is booby alma lodged. Ivo pranteii. harpahmd. sold nl enn.e'e J..,nJMlhe.e pit nu. di icy peal s. limp:tin. v-0. ,coo n Lind cenlirn. 111110 m:'lee Ink heirs and assigns Meier. all the real 'in pooh lopeill:r„ilnimpuncmenn.d any. .n„wv. lcnla and seine in the said Dunn. ,., Weld an,' Scne,n Colorado deal -died a 0,.. ed . 1;01. . lot A recorded examrtion No. 1471-20-1-RE903 being a part of the Northeast one - quarter of the Northwest one -quarter of Section 20, Township 1 North, Range 66 I West of the 6th P.M., Weld County, Colorado as per map recorded July 21, 1986 in Book 1120 as F ception # 2061640; together with 25% share of all water 6 ditch rights belonging to or used in the irrigation of the parcel of land described in exhibit B which is attached hereto & incorporated herein by reference & particularly 7 shares of the capital stock of Fulton Ditch; and together with an undivided 25% interest in and to all of the oil, gas and other minerals in and under and that may be produced fran the parcel of land described in said exhibit B attached. Ln,.nn m .toed and rmummd.m 13746 Weld County Road #8, Fort Lupton, Colorado 89621 IpGETIIER ',ill, all and .insular the ',credinmmn. and onlme len:ere. thereto lahm^hl:_. Lim in :uyn is aplwn:,inine, and the xeer,lml and rescissions. ron.unJer and remainder., runts. issues and pn'm. fi'.ernn. ,nJ'all dm ..rue 'iii. ink. dnb e.l. Chilli :M il al dental.' ',Ind sinner or file pool ing. either in L.. or wain. e,1: in and to the aline b:n;:uucd pu,ling.. nil, dhc hcredll.,m,cats and appurtenances. nnenances. TO IIA\ E AND lD HOLD the said prenivs :those harcalued grid dc.ai4,I. "itb the :d`p:nterunce.. unto the ,none. his heirs :nd:n.iun. harmer. And mecranu¢ for hin,.eln his heir.. and personal rgve.nnaum.. does e,nenull. Arun. hanynul..,uda ree to and with the grantee. his heir. and ., v... that an he iitnc ui the etn,aline and Jell'en of [WW.c p: e.enn. he n odl.eiaaJ of lie remises aline u,u,emed. has i,,,nt. are. lenton absolute and mdeiuv ble estate l inhoru'.nee. in la,,. in tev.minle an,I ionn,,dn.dn. lull pone, and lass lid ndentp to.pun. h:npoin. sell and .:un.o' the aatna xv,:inne, andt aligethd. and the lice I cling fm .ill lli mgr and odiei l ate tales. lienk. iae,, assessments. I encumbrances a and restrictions , I aI,, l,..r kind or Mann "'doer. escepl for 1986 taxes due and payable in 1987 and subsequent years, easements, restriction, covenants, reservations and rights of d way of iewrd if any. The pramor shall andail! nAKR\NI ANU 1pk liV R DEFEND the all h 1, d premises inti quiet ad peoceitIlle possession ofthe prance his heirs d assie apainso' l and even persiin or persons L claintinpd whole any part thereof. The singularn inher :dui II include cep loci I. the plural heh. and IIg r app de hell he applicable a ally der.. IN WITNESS WHEREOF' die tinging en,nm has e.euuted ten deed on the dote .el I,lh educe �/7 ) HiramH.anal Vi5girna Thomas r • 'i I_. Thomas A� C+ dclXXC1.G ernon T. Rhoras Virgin'a '1tEdmas .Ifni ui' [bin IRAD° Counts Weld t' 1 The lore,goiny Imm,menl ,v. actin, Indeed Mellow rue in the Said Colorado. chi. 21st daunt Octohor N86 Vernal T. Thomas and Virginia L. Thomas I.f. eocImi..lon e.pire. February 20, .' 90 . uciMie..,n, h,MJ aces ,out; I:d .dace , o [luny Weld = ran 'j ®;,F'` b,. Hiram H. Thomas, Virgir�.a IPB 1133 RE02074743 10/27/86 12:41 $6.6 2/002 F 0224 MARY ANN FEUERSTEIN CLERK & RECORDER WELD CO, CO LC;f..t DESCRII'1IO:; The Northwest 'Juarter (NwP.,)'of the Northeast Quarter (NE's) of Section 20, Township 1 .^,orrh, Range 66 West of the 6th P.M., Weld County, Colorado, being more particularly described as follows: Beginning at Cho North Quarter Corner (N's COR) of said Section 20, and considering the West line of the NO; NE1 of said Section 20 as bearing South 00°15' l5" West, and with all other bearings contained herein relative tlu,reto; thence .South WISP 16" West, along said West line, 1328.36 feet; Thence South 89°54'48" Cast, 1330.31 feet; Thence North 00°13'36" East, 1330.37 feet; Thence North 90"00'00" West, 1329.67 feet to the North Quarter Corner (N. COP) cf said Section 20. said point being the Point of Beginning. Said described. parcel of land contains 40.588 acres, more or less, and is subject to any rights -of -way or other instruments of record or as now cnstin9 or said described parcel of land. A'2061640 r RECORDED EXEMPTION NO. 1471 -20 -1 -RE 903 N 1/4 Cor. Sec. 20 TIY, RBSW i m W.C Fugala38 sevigo N89°48'24`E _ 34.97 re 1329.43 NE Cor. NW 1/4 NE I/4 , See 20 LOT A CONTAINS: 10.000 Ac. x WOeraCE aid H° LOT 8 CONTAINS: 30.583 Ac. 10' I eee-eew_ m �cr se°eaS, I I er S2, a a I e N ▪ n O O '- e O a O I O O O N N89°41'1r*-493.14 N89°I4'17•WMOD 999°°42Cw LtS.S6 B 1120 REC 02061640 07/21/86 13:46 $6.00 1/002 F 1647 MARY ANN FEUERSTEIN CLERK 6 RECORDER WELD CO, CO SW Con. NW 1/4 NE1/4, Sec 20 SE Cot. NW 1/4 NE 1/4, Sec. 20 n 9B9°53'5d'W 1330.b7. SCALE:1"= 200' .°n aN. 9 A . 5 . Lot e " ° _y ' ' a j/: J. � ) el a .eso 1 1'•- VICINITY tie SCALE: Ib=2OOO' LOT A — 10.000 Ac. DDT B — 30.583 Ac. TOTAL— 40.583Ac.* OWnier5: Hiram H. and Virginia Thomas Virginia L. Thomas Vernon T. Thomas 13750 W. C. Rd. 8 Fort Lupton, CO., 80621 Prepared by: Alpha Engineering P0. Box 392 Fort Lupton, CO., 80621 April 28, 1986 pile Ne.tb-iNS-ul PAGE I OF2 B 1120 REC 02061640 07/21/86 13:46 56.00 2/002 F 1648 MARY ANN FEUERSTEIN CLERK S RECORDER WELD CO, CO RECORDED EXEMPTION NO. I471 -20 -I -RE 903 LEGAL DESCRIPTION: The Northwest one -quarter of the Northeast one -quarter of Section 20, Township 1 North, Range 66 West of the 6th County, Colorado. i! LEGAL DESCRIPTION OF LOT A: % 471re A part of the Northwest one -quarter of the Northeast one -quarter of Section 20, Township 1 North, Range 66 West of the 6th Principal Meridian, more particularly described as follows: Beginning at Weld County, Colorado, more particularly described as follows N89°48'24"E on an assumed bearing along the North line of said Section 20 a distance of 634.87 feet to the True Point of Beginning; thence continuing N89°48'24"E along said North line of Section 20 a distance of 694.56 feet to the Northeast corner of the Northwest one -quarter of the Northeast one -quarter of Section 20; thence S00°01'51"W along the East line of said Northwest one -quarter of the Northeast one -quarter of Section 20 a distance of 614.89 feet; thence 589°48'24"w parallel with said North lipe of Section 20 a distance of 125.58 feet; thence 500°49' 23"W a distance of 10.00 feet; thence N89°14'17"W a distance of 75.00 feet; thence SOO°07'34"W a distance of 9.30 feet; thence N89°41'15"W a distance of 493.84 feet; thence NOO°01'51"E parallel with said East line of the Northwest one -quarter of the Northeast one -quarter of Section 20 a distance of 628.57 feet to the True Point of Beginning. Contains: 10.000 Acres more or less. Reserving the North 30.00 feet thereof for Weld County Road 8. And Reserving the East 30.00 Menef for o non-ncwwve awns rood eaeeeent, SURVEYOR'S CERTIFICATE: I hereby certify that this plat was prepared under my supervision and that the same is correct to the best of my knowledge and belief. Principal Meridian, Weld 14�_ Ce rl R. Crowe, P.F.. 6 L.S. 12330 KU Iiu j.,.. J'. o 4 Q , • ▪ OA4ffaJ.11 itle3.0‘ PROPERTY OWNER'S APPROVAL: We, the undersigned, being the sole owners 'in fee of the above described property / do hereby subdivide the same as shown on the attached map. 04,tan %a',e'r Hiram H. Thomas ..l!21�I �d c Virginia Thomas V P� (AX�.1eir— Thomas Virginia L. Thomas ernon T. Thomas The foregoing certification was acknowledged before me June A.O., 19 86 , My Commission Expires: February 151988 Notary Public: t f 2Q.4k((I-` VlL1� j.6Y1 Witness my hand and seen/ Address: 3 North Main St. 1 Brighton, Co 80601`. This plat is accepted and approved for filing. Department of Planning Servic s Director The foregoing certification was acknowledged before me this day of f], A.D., 19%k,, . My Commission xpires: '4 :a'amrzr face � d mr Notary Public: gr\."-1p, •aa Witness my hand aid seal. 1 1L' Vitt t: ti CO, <ra PAQE 2OF2 I - ROOM 789 • 0o- Recorded of _ /�.--- o'clock Rec. Na 1710933 Mary Mn P.u.raloln, R.cord.r )— IN THE UNITED STATES DISTRICT CCVRT c I FOR THE DISTRICT OF COLORADO - IN RANxiiuFx FFgff In the Matter of ) 1'�iP7C% F IN /woo er RUSSELL LOUIS ROSALES, JR. o 73161+2 ) Bankrupt ) • M FEB 91977 PDQ ORDER CONFIRSIBG SALE Upon conelderation of the Report of Sale and Application to Confirm Sale with Exhibit A attached, attached, filed on$pr.�n 2e, 1276 , the Court finds and NI'T d� i tf a ee a mesa a tpra�pei�eale tot`ThOY6. i Vncgn [. Thian coot a ee a far the of ��'.�' and that said sale should be approved E and confirmed, it ix, with no-adverseinteteet being represented, ORDERED, that said sale to said purchaser is approved and confirmed; that the Trustee shall make, execute and deliver such documents as may be necessary or proper to evidence such sale and that the purchase price shall be forthwith deposited by the Trustee in the designated depositary for•tfle funds of this estate and the property affectedby.. this order is deacribed as follows: The Last half (1y) of the Northeast yu_ar"t�or C$%%) of the Northeast quarter (e E%) of Section 20, Township 1 North, Rapp 66 West of the 6th F.M., Wald County, Colorado end 30 shares in the Felton Irrigation Ditch Cempeay. baled: I or, September 29, 1976 ❑y THE CQIRT:, I cmR/iY III/4 111E PAP 5 to WHICH IRIS f LII 1-111 13 lino' 19 A 15111 too CoPII I. I'5r'1 Pt 1, PAN NN I.,i AND P. H 1'I 1NE MNRNIIPICY PPM: (IISO it .rill,.MEM I,Y DIE 'U9INN IINPON Mil "II I AM AN IMPI PYn Of III' P Zvi ! IVRY COMM A11111oI11r+P to II It ll.I'; CISIFICAIIPN Ill P(111 Coltl • Nlr5rn TN G1 lir ft.lYjw� x1 U ✓ pMWRI PICY ASS S'nnI Pe"'eree 1n Uanhtruptcy MODU[11Ca 3adz.; r r.J ( C. Recorded et... .... .'17008 itecnptiotlon No 1700836 OW_ 7197F; ......MMLY.JNpL FEUf3tF_ /-/ Tres DEIID, Lade the 28th ecyaf September as 74wtw.m RUSSELL ROSALES, an unmarried person of the County of Weld and Etat. of Colorado, of the first part, and HIRAM H. THOMAS, VIRGINIA THOMAS, VIRGINIA L. THOMAS and VERNON T. THOMAS of the Chanty of Weld and Etat, of Colorado, of the second pert: WITNESSETH, that the mid party of the first part, for and in emmldeatlsn of the sem of FORTY—FIVE THOUSAND AND it 0/100 -DOLLARS, In the mid party of the first part in band paid by the said partite of Os mead part, the receipt whereof le hereby anteteed and acknowledged, has granted, bargained, sold end conveyed, and by them presents do rants bargain, sell, eraser and confirm ante the said Nutlet of the homed part, their helm sad eels forever, not in tenant' in common Mot in Joint tray. N the following described lot or parcel of land, tweet,. lying and being in the County of Weld and Etats of Colorado, to wilt The West 1/2 of the ilarthwest 1/c oP. tiro 1ior,tketeast 1/4 of Section 20 in .Township 1 North,. of Range 4 West r¢ the tth P.N., Weld County, Colorado - Recorder. RECORDRR'S STAMP State DocumentaryFee 1 D+e;a. OCTS._._7197_fi__. .... 3.A..r£_ o .....».._..- (Reserving unto the Grantor all Oil,Ins e..^.C +')`her minerals in, uadef and that may be produced from th•., above property.) also known as street and number 13746 Weld County Road. TOGETHER with all and singular the hereditament and appurtenances t areante belonging, or in anywise apperte dng, the menden and rmrsioos, remainder ad remainders, rents, bean at I profits thereof: and all the estate, Slat, side, interest, claim end demand :Meteors of the said part/ of the tint part, either in law or nald, of, in end to the above bargained premises, with the hereditements and apperteutneen TO HAVE AND TO HOLD the wild premise, above bargained and described, with the appurtenances, unto the mid part's, of the second part, their heirs and assigns forever. And the said party of the first part, for sel heirs, executors, and administrators do covenant, grant, bargain end agree to and with the said parties of the second part. their heirs and Assigns, that at the time of the ensoaiied and delivery at then peas ants well seized of the premise. above conveyed, us of good, sure, perfect, absolute and indaicosibie estate of inheritance, in law, in fee simple. sod he good right, full phnsr and lawful authority to grant, bar- gain, sell and convey the mine In manner and form eforaesid, and that the some are free and clear from all former and other grants, bargains, sides. liens, taxes, assessment end encumbrance, of whatever kind or nature weever. except general taxes for. 1976 and subsequent years, restrictions, easements and right of ways of record and the above berdained predate in the gat and peaomlde poasgmloo of the said pertly. of the .eeoed part, their win and aesigns, ageing a0 and every potion or sermons lawfully elaim)ng or to ofafm the whole or any part thereof, the mold part of the first part than and eat WARRANT AND PONEVER DEFEND. IN WITNESS WHEREOF the said fart y of the first part has berme% est his hand aid seal the day and year first sien coral sign. Sealed and Deiinnd 1k". pretence of ETA'i'E of COLORADO. RUSSELE ROShtHG, an uni:a aif::i p,; r acs ffllfAL7 county of Weld '. The foregoing Inetammt was acknowledged befnne an this 28th to 7pbya HUSS.LL.. ROSALLr,, on unman tire;: peruen My commission expires dycf September , le. . Wltn•re ,re head and loco rlei seal. w, t', e.t,On No. 021 art p[[ r r r r •Irhf 1 IN 1 1 i + i Ir-YI tunnyl I IC fill no. n Y f l Ilu 1 ! n 1 P^ ur fp„rel+lnn e. Miming ff-l+.iulme all In f a 1 f11. lew9 , t,.1 Y 1 .Y ,1••, •ffl, ,w .1 , .lrinn irlermenl. Man lIn9.1+.'I,r,•, 11•.," MIM.in, 149 '729 James P. Danahey of the Estate of Russell Louis Rosales, Jr. , Bankrupt, hereinafter referred to as the seller, end Hiram H. Thomas, Virginia Thomas, Virginia L. Thomas and Vernon T. Thomas, as Joint tenants with right of survivorship. WITHESSEfH, that hereinafter, regardless of number, referred to. as the buyer, WHEREAS, in a proceeding pending in the. United States District Court for the District of Colorado sitting in bankruptcy, an order was duly made and entered entitled "ORDER CONFIRMINGSALE", of which a certified copy is hereto annexed and by this reference made a part hereof, and DEED OF IUSTEE IN BANKRUPTCY This Deed made this &9rb _ day or'C.pr.mh.r . 1978 between , as Trustee in Bankruptcy WHEREAS, pursuant to said order, and in consideration of the payment to the v seller by the buyer of the sue of. - a Forty-five Thousand Ono/100 -dollars ($45,000.00 ), the receipt whereof by the seller from the buyer is hereby acknowledged, the seller sold and the buyer purchased the real property hereinafter described; NOW, THEEES:ME, in consideration as aforesaid, the seller has sold and conveyed and by these presents dapssell and convey unto the buyer, and unto the heirs, executors, administrators and assigns of the buyer, all of the right, title, intere:( claim and estate of the seller as Trustee of the bankruptcy estate above named, in and to that certain real estate in the County of Weld e State of Colorado and described as: The East .hal£•(Et).of the Northwest quarter OW%) of the Northeast quarter (NEt) of Section 20, Township 1 North, Range 66 West of the 6th P.M., Weld County, Colorado and 30.shares in the Fulton Irrigation Ditch Company Sine Documemaul' Fee Day, OCT i B7e (SEAL) e True ee in Bankruptcy' of a Estate of uesell Louis Rosales, Jr. Bn upt. Bankiaptey,No. 75-B-4142 e 0 a N O O i-' A STATE OF Colorado ) City & - ) County of Denver - The foregoing instrument was acknowledged before me this _Zttja day of 4 r 1976 , by James P. Danahey , as the Trustee in too' litsiiltkleg. , Bankrupt •' the Estate of Russell Louie Rosales. Jr. gyp. My 1: .I ''' • Ii 1775 y, pp,�,iGgspyl edl•on expi ree ___ y m- oFC040 .. - -(01<«INDtary. rubT1 .13 -I s� MAY 18157' pees sarsMl .a_.—�Q/.mow G�. Y. 692 a.avae N. 1613503 TANN an. Tads Dsso, NW.ud. 16th laid May .is73, batmen RUSSELL ROSALES of the Countycf Weld Wstsn.t Celerede, et the tint pert, and RUSSELL L. ROSALES, JR. of the County of Wald and state of Colorado, of the anaed part WITNESSETII. That the said Party of the first aertfee and la aonslderatlen et abs seal of Other Valuable Consideration and Ten and No/100 to the asi pony of the first part n hand paid bs the said party of the aacetd Pan. the recelpt wasted Is hereby confessed and arbmdn' .d. ha s remlad, released, son. :emend and QUIT CLAIMED. ale by meat pre.nte de ea remise, release, ref, coney end QUIT CLAIM 11,t0 the and party of the nomad part. his helot, successors end aaalpna, toner. W the right title, iotenat clank and demand which the said party of the first part has In sad to the following described lot or pastel of land Moan. bin. and being in the county of Weld end Mote of Coronae, to wit: The 2% of the NW% of the NE/ of Section 20, Township 1 North, Rang., 66 West of the 6th P. M., Weld County, Colorado (FOR TITLE PURPOSES ONLY - NO CONSIDERATION) TO HAVE AND TO HOLD the same. together with all and angular the appurnuaew and taking* ihaseenm halwn,.Ing nr In w r ow th.r.+Tfw anpMaMlnn, widen the n.ren. right, CUP, Interest end Rahn ^Ph,•=^r. M Mt add tarty of the find put either in law or unity, In the any proper use, benefit and behest a W add part of the eased Iran, his heirs and wins forever. IN WITNESS WHEREOF. The sow part! of the first pas{ ha 5 hereunto M his hag and aid the day and year first above written Signed. Sled and Dalirsred la the Presence of STATE OP COLORADO. County of Weld 1- 1C terse-cei J ? d tee-✓ _IssAL] Russell Rosales --MEAL) ISSALI The tangoing natrament was aelmnwlelgd btora ma this 16th day of May is 73 ,hr Russell Rosales Sept. 25 , n 76. mew my had awl nadlatai in it: oN "as _ itYparrawgs wo wt mow u saes.I � ., seth. r .wn.munrs ar urea atstraw. a, San at= ploser der wyaw,eaq t Of utie' oft rs f aa,ra awpn lairs u, W a— nattMire aaaaaw nag awaa Siena Na1., 1 1^a' Ne.pb. sun cute pass— system rummagees. on men mew Dan. adwW r.. • emj �Y181878 �gyyf� a.ewd a ymw14.. y.. _. UOMr W.eptlw No, 1613504__ —...__._ 'Fuss DEED, Made this 16th data May • u 77. between RUSSELL L. ROSALES, JR. I of the County of Weld and Mao of Colorado, of the first part, and RUSSELL ROSALES of the County of Weld and Nate a Colorado, of the second part, for and b consideration of the of WITNESSETIL That No said part y of the first pert,� �• Other Valuable Consideration and Ten and No/100 to the pout part y of the first pert in hand pald by the sold party of the second part, the receipt whenot In hereby eenfeencd and e.kuvnkdg,d, hos remised, released, sole. convoyed and QUIT CLAIMED, and by these presents ,1.05 romlw, release, sell. mosey end QUIT CLAIM unto the sold part y of the eteond part, his bairn, nutemeure and seems, forever, all the right, title, on -amt, claim and demand which the said part y of the fire pail be a In and to the following Merited Slotate of C pared r dlorao to aid: Irving in tau f land situate. WOE and of County Weld The WM of the NWy of the SEM of Section 20, Tonwship 1 North, Range 66 West of the 6th P. M., Weld County, Colorado (FOR TITLE PURPOSES ONLY NO CONSIDERATION) TO RAVE AND To 1101011,o same, together with ell and Angular the appurtetsutee end privilege* amount* belonging or in anywra thereunto apperWuing. end mu the relate. right, title, Stored endhn whamming, el ..hl raid oat y of the that mot. eltb., iii L. leave way, Wile war p,opee nee, L iiL al Petty of the second part, his hales end malign. forever. IN WITNESS WHEREOF, The said party of the first part had, hereunto rt his bad and seal the day end year float above written. 1 'L .cgae1t .f c.:I�. & .Russell L. Rosales, Jr. &Pratt, dated awl Delivered In the Prwnew of STATE Ole COLORADO, in Cowl of Weld The 1pg Russell t woo Rosales, sd halos con tins 16th dray of IP7l .b L. Jr. A.l , IP 7S Witnoea my hand and ufflrld sal. * goemWELt expire* Sept. 28 ift101it!/�' /� �. O' A O P _.. _... .LP G 4,. P.ea. ., dU@�IC;�a ter: ..:�o , 0' c 0b°" .__[IEAL) IPRALI [REAL] WSW May • con n M 1anneenlxra w erIYW r a 1 ,Ili d "ii ion I Iry _.. ear a earvni wow w w.'n, re* lust xw,r n .cowl �f,.r Wn"n ,us 3 1 allryr• q,e4 W n 1XM1 nww ell Ww"n Y twat allw�l e,I�� • �, ullaam W wY MNMa.11u . amulet 14— nINYMen Ano . lam urea. idea. edi gainrea, ttNt au.eurvio iti4�— tql w N.,fPl. VII CLAIM sea Iwreeeh.wua,w w. mlalueY ea x,.lw.r.rwee+ u I i hod 'rd, baby =IRO ad amMyte to__Lissay raaea96Y to , '. try oyOadA ..and the Mato of nix ed. ry +s a Nal oaps thoCoMds d_.____._ a. _ - aM lhlas or tbta.do, 0 TM northeast quarter of the northeast Quarter (fit 116 a liNi ra 0 of fetfSae Tracey (20), reeeship Ono (1) notch, LE W ffaty- di sSa (66) nest of the 6th P.M., Veld Comfy, Colorado wIhalt tts apemtasasass andworant(q thatMY to this abject to lll1.,talcs doa eM warn 1a 1972; rosotsatfoes, rostrletlons and slyhco of ray. If y: M1,_aad bee Lasso dad-1arf1 1e. 197Q rMrordad 11x1+ 21 1974: IA task n2& sarp Is+ 8 Corse, aaslyeod July 10.. 1?.73, r16aidAq,. ..1470. L leak 616 hsa ptisn n=. 1557837. Sired tdo Aar of lisssr2_ .. A. DASD — In tb Pre sees of Otto Ciwswf,. scw u - RAS O1 COLORADO,oran }It a The Moho hrUmass was actorsald ba/No as to Ufa .day d __. As••- • 168-. - 4 Olllol- C' 4 - i474 •- 5, • A y�7t Recorded at._.. ..G..O P _-I_-:..._._tiTl.1.------ tP3b' 639 Reception No iiiar 31) •....... Nei gi .__JNmNer. snow all Men hg throw frrsettts, That a MARY LOUISE NORDELL and ono cuR„ENCSB WORp!LI. Wheat address la P9rt.-LULRn..._.._......"_......._. ....._.__.._.._.... County of. 7 l end State of. .._.._.ce9.1.91149.__-..._.._.._..._...__.._....-Jot the consideration of Ol'0ER GOOD AND YAW AWt,F... glIctg x.I. t.A1?P..SRa. in hand paid. hereby sell(s) and convey(s) to......Reie15=RLL eetES C -find..BNSSYLL.1....8QSALES...JB- . whose address la...._. Port Lupton and the state d Colorado Weld ... sod State of Colorado. County of.__. _. weld following real property In the County 97 to-wlt: The Northwest Quarter of the northeast Quarter (Wi1 1141/4) of Section Twenty (20). Township One (1) North, Range Sixty - sty (66) West of the 6th 1.N.. Weld County, Colorado the Las. p mry F�9119 Li L. 2._7.x___.._-- dpe _.tawaod_gZnbla ......` . non .ta appurtenances and wamW(a) the ride to the same, subject tai971 taw in 1972; reservations. restrictions and tits, WS,. ifs--.gy7.G_9;.L."U)-pa+?-(s4P4a d.F.!Q_Aorf1..10.1.9.7.Q,..tecorded_epri1.31«.1410._Sn..Lerch-f issue -121 Weli.Smac7. Records, nsigmd July 10, 1970, recorded Novsaber 2. s_137.Q,_in..SWAA--434 Reception Wo. 15578]7. rasa won M Jesnary A. D. DM__ In the Presence o1 1 yon J _ .adatra?- "{Pi#�j " es • If Otto Lree • Wardnll140 e2._.._ STATE OP Cam. t Y. Ceotyd wad. f The fongo4C t stri= rt was atmwvladted bdon me tab Silk day of.. JAIMICK._.._.._.._......_..., Ian.-. Maly Louise Nordell end Otto Clarence Wardell.,--„_......_.._ Witness sty Hand and °Meld Sea. -• My Commission Expires -1g' ' - E 74 Mahn address for I444-91'1..1.% future Tea Notices w Pr ni 15721. 185 I .KNOW ALL MEN BY THESE PRESENTS, That Op Antra( CI at C �� o'eleck Z M. Hecepticn No. 1842711) Recorder. IDA N. NAU= L\�',_t,rof the Cr.unty of weld , end State of Colrraldo, 31 y fcr the consideration of other vlweblo eons d ten-..-- Dollars. • -. LOOM hind paid, hereby sell and ccnvey tr MARY lOONOeOLLL sea Coro CWIOICS SMALLt. joist tassel. with right of .eevisos.Hp eat sot se amass is oars sls of the County of Meld , and State of Cnl,radr. ,she following real property, situate In the County .f Weld \and State of Ccicrado, to -wits An undivided one -halt lutenist in d tea the Northwest Quarter of the Northeast Quarter (Nwtiek) of section sweaty (20). Townehip Owe (1) North, Rana Sixty-six (66) hest of the 6th p. M., taptther with thirty (30) shares of the capital stock of the Fulton trrisetinp Ditch Ce asy. alth all its ap,-urtenances, and warrant the title to the sate, 5etkiel-LS Zioned and Eel iveren this let day ci Noveoher O. I.) 60. Ida N. Nouse Y..E TAU OF COMM In the presence of • . instrument was acknrwleIgid bolero ice this liege andofficial seal. expires h day rf J ,If AT N.,ra.LL OCM•ON OR PCM•0M] testi.. 'Meter Mast on wesce1 ,r ♦ nano.. .c.. NO 4r'e,tCtre. •IVr OR OrelrleL CLPACITT 011 SS *TTOeNtY-IM4*CT, ?RCN INetsT NANt nr flaw'N Lt Fairview, •1.o.,v- .N-r.rr no OTHER OLP*CIlV 011 DCIMIPTIONC IF ow OCCICCO Or CORPORATION, TNC4 INRrQT wa.{ rr s .„re. •t. Oe Ottittes, AS ?RC PPC•IOENT 0e OTMCO OYFICtwt Or SuCN co*POa.1r0N, r ING Irv- Fr • .lr ArrAvitroovve, Sr551 fA 10{7. �taaeL'TT 0Ct7 -- STATUTE'S,' rose v-0 -"I 8 if 6[00 09'6Z -*ON Yen 1,[(r;1 Cewadta .1 4 noon W +tld. I. nog any ail SO aril nit std ya naldyteAa elf no of Seem 444, ses4HA4,004 -Tr"— -ten r O limit.4344p is add yon fad, Nw se.* Weigel(is as" il.:wlawadadtet an , natant a aa$l...p r1, an w tnee a proms de e, ,....___ am amen .ssa )0,ais PM Lea, a eft oa*aad pan. their Mils iut ante., -hW is at oven al w,g, aka mhs sod lain to me Cony of WM di:: %Whet Qnhat'til..a'. Ufa iftrirthesdet Qaelatst (Nick) .f TWawty (&).Tesstelp game (4) Moak :.h®, tthty.etn (U.) that .lath n, K -2 ,F44‘0&& F44{ 4"%t with this (i4 calzes of as scant aS the felts terigatffiuy flit,!,-CSay, (3.&traaa c.C.,sae"ttnttaet tees t9am 4 Le MidWwtd Sollars) sCX_,R"„£'.t9t. with all act Rite khe hwMtaazs• and aapertn nn thereunto bcL.&zss or is any r>;t+ aryptelhlaisg, awl dee rnaramn sad tasaeainny neadaphte end earaaia . rata, issues and rota. Olrreof; and a 44 WtiuI' ran tiff tea,.:iac r gam+ `—^,- :f the 554 Weir of the lint part either in lax or vo.&h, pie h+ mod to the aloe, herwhaa2 onetime. wen eke brardt fiesta sad apamteesseea. TO WANK AND TO %OLD So all Matthew share bara.leed sod detaibed, with appurtenances, sea hie Xia sttI $&at of tat uw at rot tints ban lad rains (,river. And the said hest y of 11w Ome on kir 3tiE waits IaTt taeo ftdlattEll anti admaaabasstarti da Ott comsat grant, bnada and agree ra ta] c$,h the ewe in et @A Mina lacy, thetas &firm eat ewer, that at the time of the en- tea4ae asst dn&wg a1 eine write,. no is an seised a9 Its -maws above zeueet+ai. as a gw:, no oar- iesk aia.€aaa r,m vbkr4,io" ,yata utgw .a 4d--o—o.. is 4w as ass ¢$5214, aat fah a good .%tt. ES soate sad lawful nrs howhy sat deem ink% atilt tag smarty the one Mar sad SS atoege . had that rho ran an Inc 'sat e—" hoes c grantor anti ee)s, eats fsbt&i.. Oates, tnw Sues, asaw etr and lataanhr ncea of whatever thud or mien seam genhm, in enc.. sat b9 yea ,Stt t': a..44Wea (i ,lit aait foul tea of tt t ntecd part, 2ant 9 re r n4i sad rare Vets e — teaufrgly eywalag . or so cteiee the whole or say part tae fall p it a y :d e4:a any #a+-.. „ will WARBAk8T MID FOeat?VSt DAFEND. al Sbttti:'YA5 W4'f ?*,;.,;::P. T d the the tan hai I:;rcunro ace frax hand and thu d3Y east laps 9Y" ? aitv:ac 'Fr .a. d DEEL,VIZA io ats-a tciar'a ut Y �,ton t,4 tS � Cll'SSC -(SEAl.) (SEAL) c as eckne.Ftiaed burs cat Wt. . _.-fit .. cry nA 99.x3 trp 3 3 2.tv l..._ kTi S Form No. OFFICE OF THE STATE ENGINEER ' GNs-25' COLORADO 3 DIVISIION13 Sherman St., oOFrWATER. Colorado oRESOURCES 818 3 (303) 866-3581 APPLICANT VERNON T THOMAS 13750 WCR 8 FT LUPTON, CO 80624- (303) 857-2093 PERMIT TO CONSTRUCT A WELL 857 WELL PERMIT NUMBER 238210 - DIV. 1 WD 2 DES. BASIN MD APPROVED WELL LOCATION WELD COUNTY NW 1/4 NE 1/4 Section 20 Township 1 N Range 66 W Sixth P.M. DISTANCES FROM SECTION LINES 180 Ft. from North Section Line 2580 Ft. from East Section Line UTM COORDINATES Northing: Easting: ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT CONDITIONS OF APPROVAL 1) This well shall be used in such a way as to cause no material injury to existing water rights. The issuance of this permit does not assure the applicant that no injury will occur to another vested water right or preclude another owner of a vested water right from seeking relief in a civil court action. 2) The construction of this well shall be in compliance with the Water Well Construction Rules 2 CCR 402-2, unless approval of a variance has been granted by the State Board of Examiners of Water Well Construction and Pump Installation Contractors in accordance with Rule 18. 3) Approved pursuant to CRS 37-92-602(3)(b)(I) and policy of the State Engineer under the following conditions. 4) The use of ground water from this well is limited to ordinary household purposes inside one (1) single family dwelling, and the irrigation of not more than 14,000 square feet of home gardens and lawns. 5) Production from this well is restricted to the Laramie Fox Hills aquifer, which corresponds to the interval between 660 feet and 910 feet below the ground surface. Plain casing shall be installed and grouted to prevent production from other zones. 6) The maximum pumping rate of this well shall not exceed 15 GPM. 7) The annual withdrawal of ground water from this well shall not exceed 1 acre-foot. 8) The use of this permit hereby cancels permit no. 237447. 9) The return flow from the use of this well must be through an individual waste water disposal system of the type so that not less than j% of the total amount of water withdrawn is returned to the same stream system in which th II is I�ted. 10) This well shall be constructed not more than 200 feet from the location specified on this permit. 2 f Q I APPROVED JLV ,Receipt No. 0485439 State Engineer DATE ISSUED DEC 112001 e EXPIRATION DATE DEC 1 3 2033 FORM NO. Gus•32 11/90 PUMP INSTALLATION AND TEST REPORT STATE OF COLORADO, OFFICE OF THE STATE ENGINEER For Office use «,y RECEIVED SEP 2 0 2002 WATER RrsOURrtS STAR!(RGIRIIP Rece-'p1- tso• o'-ISRTA/3q 1. WELL PERMIT NUMBER or�.7C) aI ® 2. OWNER Mailing City, Phone NAME(S) \/Grnon -r. Thomas Address IS-75pwet 2 s St. Zip Fort L,'pitn /'s, 810424 (303 ) 851-01093 3. WELL LOCATION AS DRILLED: MO 1/4 /.)e 1/4, Sec. ZO Twp. / •1/4./ , Ranged & S,L_. DISTANCES FROM SEC. LINES: ft. from Sec. line. and ft. from Sec. line. FILING(UNIT) SUBDIVISION: STREET (north or south) (ems or west) LOT_ BLOCK ADDRESS AT WELL LOCATION:• 4. PUMP DATA: Type S(ibmt9r;ii/c, Installation Completed '7 l IS / 52 - Pump Design Pump ADDITIONAL Manufacturer R Anoicts Pump Model No. 14.530 • GPM ID at RPM 8vS0 , HP 2A.W2 , Volts ZZo , Full Load Amps IL. S • Intake Depth A Iiti f Feet, Drop/Column Pipe Size I gun Inches, 'Grid tit/. INFORMATION FOR PUMPS GREATER THAT 50 GPM: /^ t/k • TURBINE Design DRIVER TYPE: S Electric O Engine ❑ Other Head feet, Number of Stages , Shaft size inches. 5. OTHER EQUIPMENT: . Monitor Tube Installed Depth ft. Airline Flow Meter Installed ❑Yes Id N"oI� Orifice Depth ft. ❑ Yes ❑ No, Meter Mfg. } Meter Serial No. 0 • q/ � Readout ❑ Gallons, ❑ Thousand Gallons, ❑ Acre feet, ❑ Beginning Reading 6. TEST is submitted on Supplemental Form. 7'r%j!oi. DATA: ❑ Check box if Test data Total Static Date Date Well Depth OS I Time oZ hys Level Rate Measured 1 1$ 6L Pumping (GPM) /n Lvl. 1� r� f 7. DISINFECTION: Type i-iTFt 0hl6r"r neAmt. Used 8. Water Quality analysis available. ❑ YesNo 21 9. Remarks '0. I have [Pursuant degree CONTRACTOR Mailing read the statements made herein and know the contents thereof, and that they are true to my knowledge. to Section 24-4-104 (13)(a) C.R.S., the making of false statements herein constitutes perjury in the second and is punishable as a class 1 misdemeanor.] Sputa'," Se'tvtce Inc. Phone O03 ) 659-1584 Lic. No.7/5 Address 202/ WC2 27 ft. Lupton, Lo. 80621 Name/Title (Please type or print) Torn W. Sputa Pna4tdeat Signature .. , pj'".'ems Date vi i Or o a 12/12/2001 13:09 970353 R R WELL PUMP PAGE 02 COLORADO DIVISION OF WATER RESOURCES DEPARTMENT OF NATURAL RESOURCES 1313 SHERMAN ST.. RM 818, DENVER, CO 80203 phone — info: (303) 8663587 main: (303) 866-3581 lax: (3031 868.3589 http://www.water.state.ce.ue RESIDENTIAL Molt. Also use this form to app* for livestock wawdna Water Well Permit Application Review Instructions on reverse side prior to completing folic(. The form must be completed in black ink. 1. Applicant Information Naar of ainaani Vernon T. Thomas Meiling sedreu 13750 WCR 8 arFt. Lupton Mtn hone . 1303 1 857-2093 2. Type Of Application (check applicable boxes) ❑ Construct new well IN Replace existing well ❑ Change source (aquifer) ❑ Other. 3. Refer To (if applicable) Ws' e- 7b1Li M1t enaced e..in Oewrrnewien Wee I Zip cow CO 80624 ❑ Use existing well o Change or increase use ❑ Reapplication (expired permit) Wear Court ewe f well sew at f Office Use Only Form GWS-44 (1/2001) RECEIVED DEC 12 2001 WATER AE1E EScitNGES 6. Use Of Well (cheek applicabl%fixes) See instructions to determine awls) for which you may qualify G A. Ordinary household use in one single-family dwelling (no outside use) B. Ordlftery household use in 1 to 3 single-family dwellings: I Number of dwellings: ® Home garden/lawn irrigation, not to exceed one acre: area irrigated O sq. ft. O acre ❑ Domestic animal watering - Rion -commercial' O C. Livestock watering Ion farm/ranch/range/pasture) taicco 4. Location Of Proposed Well Canty Weld Union 20 °Wane of well from settee tins!Metlan ero an typically not property enasr NW tfaw ore NE Vs 7. Well Data (proposed) Maxine. ocarinas rots 15 gem Turd Woes / 0 feet 8. Water Supplier Is this parcel within boundaries of a water service area? Li YES ® NO If yes, provide name of supplier: 9. Type Of Sewage System ruuwr recant to so wkxe.wn 1 acre-feet Ayer AMU If/4 FWN ILL Town.na Noel ® C Acne. Esc w 66 OO .mess Me Shat 6th 180 n.wen ®N❑s 2580 ftnv ®EDW p« magaaa n.et was mw -distance and di.c4«a hee de wet to nee fest will too Ilea cadre.. W .pNins•l direction VI Saone tank / absorption leach field ❑ Central system: District name: O Vault: Location sewage to be hauled to: ❑ Other (attach copy of engineering design and repen) Cogent GPS well location Information in UTM format Required wettings for CPS units we as follows: format nun be GTM Zone man 1.13 Unlw Tull Ola Mahn Oman moot p NAD37 ©NUS Udt court be MIS MM nit wore pcMM,.wr.e.dl O YES O w 5. Parcel On Which Well Will Be Located Northing testing A.You must check and complete one of the following: ❑ SubcCvision: Name Lot Block Filing/Unit ❑ County exemption (attach copy of county appioval & survey): Name/s Lot a ❑ Parcel less than 35 earas, not in a subdivision, attach a deed with metes and bounds description recorded prior to June 1, 1972 ❑ Mining claim Tweet a ceps or the ate at .wveyl: Name/0 ❑ Square 40 acre parcel as described in Item 4 ❑ Parcel of 35 or more acres l.wen. mates cat tauten oeenc.bn as uwyr Other Owen mews 6 eeunds NsenptIen re wows arse atpeo.eng decvmea ! 9.. or yaw w paves I C. we yes tee awns re We owed! 3 0 , ® TES D No le es -.M Nimmons; O. we tie Sc OW phi wen en We OWN! O YES ED Nd Ill no - en em., welt Son lwe MM04 be WOWelW/M,WN .7 • Weee nu,. we Vernon T. Thomas Office Use Only DOGS mop we-. 10. Proposed Well Driller License #(optional): 11. Signature Of Applicant(s) Or Authorized Agent The melting of false statements herein constitutes perjury in the second degree. whch is punishable as a cless 1 misdemeanor pursuant to C.A.S. 244104 (13)(e). I have read the statements hereiuk know the contents thereof end state that they are true to my knowledge. Del. ,!2 -11 -of e. Saw Petrel es Iapwnea. Receipt area'only Invoice 8 485439 12/13/81 — 1:29:11 P8 Cashier ID; 81 $ 68.88 Credit Card Purchase -- None micro OIV_ WO BA MO __ FORM NO. GWS-3 I 10/94 1. WELL CONSTRUCTION AND TEST REPORT STATE OF COLORADO, OFFICE OF THE STATE ENGINEER 1313 Sherman St. Rm 818. Denver. CO 80203 WELL PERMIT NUMBER 238210 2. OWNER NAME(S) VERNON T. THOMAS Mailing Address 1375n WCR A City, St. Zip FT LTIPTQN ro Rf(74 Phone ( 303) 857-2093 JUrLCl0�C8 2002 wATkNraz r $TALE EaR wan IIoy83-y3f 3. WELL LOCATION AS DRILLED: NW 1/4 NE DISTANCES FROM SEC. LINES: ft. from Sec. line. and -man ur suuml 1/4, Sec. 20 Twp. 1 N , Range ft from Sec. line. OR teast or wesq 66 W SUBDIVISION: LOT BLOCK FIUNG(UNIT) STREET ADDRESS AT WELL LOCATION: 4. GROUND SURFACE ELEVATION ft. DRILLING METHOD ROTARY DATE COMPLETED 7-1-02 . TOTAL DEPTH 805 ft. DEPTH COMPLETED 805 5. GEOLOGIC LOG: Depth Description of Material (Type, Size, Color, Water Location) 0- 14 clay 760-800 sandy shale 14- 22 gravel 800-80s shale 22- 40 clay 40-210 shale 6. HOLE DIAM. (in.) From (ft) To (ft) 9 7 R 0 30 7 7 R 30 50 6 50 805 210-215 sandy 215-255 shale 255-257 rock 257-285 shale 285-286 rock 286-395 shale 395-397 rock 397-915 shale 415-418 coal 418-575 shale rock coal sand 575-576 red sand 571-600 shale 600-615 sandy 615-617 coal 617-635 shale 635-637 coal 637-640 shale 640-760 sand foxhills REMARKS: 7. PLAIN CASING OD (in) Kind Wall Size From(ft) To(ft) 658 steel 188 0 40 4' steel 188 40 660 PERF. CASING: Screen Slot Size: 4 steel .045 660 805 8. FILTER PACK: Material Size Interval 9. PACKER PLACEMENT: Type Depth X 10. GROUTING RECORD: Material Amount Density Interval Placement cement 35 14.5 0-660 pumped 11 DISINFECTION: Type HTy _ Amt. Used 2LBS 12. WELL TEST DATA: u Check box if Test Data is submitted on Form No, GWS 39 Supplemental Well Test. TESTING METHOD AIRLIFT Static Level 520 ft. Date/Time measured 7-1 -n9 9AM 11 AM , Production Rate 7 gpm. Pumping level 650 ft. Date/Time measured7- 1 -02 9AM-1 1 AM , Test length (hrs.) 2hrs Remarks 13. I have read the statements made herein and know the contents thereof and that they are true to my knowledge. [Pursuant to Section 244.104 (13)(a) C.R.S., the making of false state '4 heroinynaynree peq :ry „ tsrsecond degree and is punishable as a class I misdemeanor.) CONTRACTOR ROGER SCHOCKE WELL rDRILLING INC; Phone ( 303) 288-5474 Lic. No. 403 . Mailing Address 9875 BRIGHTON RD HENDERSON CO. 80640 Name/Title (Please type or print) SignatusDate ROGER SCHOCKE PRES 7-6-02 • WRJ-5-71 SLOttAIJO DI VISION OF WATER RESOURCE. 1 "_ 101 Columbine Bldg., 1845 Sherman Street, Denver, Colorado 00201 TYPE OR PRINT IN BLACK INK. APPLICATION MUST BE COMPLETED BEFORE ACCEPTANCE. GROUND WATER TO BE USED FOR: 5( DOMESTIC (1) �( MIVESTOCK (2) UNICIPAL (8) OTHER APPLICATION FOR: A PERMIT TO USE GROUND WATER A PERMIT TO CONSTRUCT A WELL REPLACEMENT. FOR NO.. A PERMIT TO INSTALL_A PUMP OTHER APPLICANT e—RIJ c c c i t Ass 91e 7R Street Address`RT"t ') r-/1: City & State fl TAN'ow) Cola . 53oG,nI Telephone No. (6,.4'9 97 NAME OF AQUIFER GROUNDWATER IS TO BE OBTAINED FROM: Fn i PROPOSED TOTAL DEPTH OFTWELL- ESTIMATED MAXIMUM PUMPING RATE „co ere, e AVERAGE ANNUAL AMOUNT: OF. GROUND WATER TO BE APPROPRIATED sa s ,�, 900 Ftt. Rr tr mi9/rmrn monlrm- mrn1: l,g Material Intervals r...E'm-c al T" - 4en"' • Place/tient Method /Inn 1'1 u ate tit Acre-feet I t%L-VVr r 4V SARGIURCES T COLA COMMERCIAL (4) INDUSTRIAL (5) IRRIGATION (6) WELL LOCATION COUNTY Well) /l,) (d) y of the A) E 4 of Section . C) T. / Ne(7ir B. GG (ACCT, P.M. IN ADDITION TO THE ABOVE, THE WELL MUST BE LOCATED WITH REFERENCE TO GOVERNMENT SURVEY CORNERS, MONUMENTS OR SECTION LINES BY DISTANCI AND BEARING (DOMESTIC WETJS MAY BE LOCATED BY LOT, BLOCK, & SUBDIVISION.) 300 ft. from n)„p TId section li: (North or South) /i/3,4-" ft. from rR.S7 section lii (East or West) LOT BLOCK FILING # SUBDIVISION --7--Ground Water Basin PROPOSED CASING: Plain 6a/R in.. f tott:. Q' ft. to X70 D ft. in.. fromr., . ft. to ft. Perf.. i/ J/1 in.. from ?no ft. to <Inn ft. in. from ft. to ft. Driller f-Ce A) Abp ry 4 "PU T Z Veg. T4.RN?lkht DR. Address 1 J o. c Tm z.1,C 7v. R C'mit 'ape.?o IF WELL IS USED FOR IRRIGATION, BACK SIDE OF THIS APPLICATION MUST BE COMPLETED. e3 'f',j / FOR OFFICE USE ONLY CONDITIONS OF APPROVAL APPLICATION APPROVED: VALID FOR ONE (1) YEAR 1) ELECTRIC LOG.THEEOPEN HOLE PRIOR TO INSTALLATIONAFT"R DATE ISSUED UNLESS EXTENDED FOR GOOD OF CASINGS AND SUBMIT`A-COPY OF THE LOG TO THE DIV.CAUSE SHOWN TO THE ISSUING AGENCY. OF WATER RESOURCES:.. 2) INSTALL TOTALIZING FLOW METE ON THE WELL.. 3) MAINTAIN AND SUBMIT TO THE PERMCT.NO. DI � WATER RESOURCES RECORDS OF ANNUAL EX Water Mgmnt. Dist. 19 7a Anticipated drilling date /Z1V a y Owner of land on which well is located: Other water rights on this land c 11 S Arprc n1 %Tc rJ T77rN 1. erc. — rsmc c r.rc (Jell No. 7 Signature of Appli ant - aDATE ISSUED D TRACl'ON OF GROUND WATER. 01.6533-F OCT 31872 . LOr-/- f. THIS AGREEMENT, made this/(2-2:27- y of October, 1986, between Hiram H. Thomas, Virginia Thomas, Virginia L. Thomas and Vernon Thomas, hem einafter called the first party and hereinafter called the secdJid party. THE RIGHT TO USE THE WATER FROM A WELL, (as long as there is water in present well), said well is located on tract of land situated in Weld County and State of Colorado, to wit. The NW 1/4 of the NE 1/4 of Section 20 in Township 1 North of Range Sixty -Six West of the 6th P.M. The well is owned 3/4 by the first party and 1/4 by the second party but it is further understood that each party agrees to pay 50% each for the upkeep and maintenance of the well, repairs and whatever should arise as long as said well is in existence. It is further understood that the first party agrees to pay $15.00 monthly to the second party for the electricity to operate the well. In WITNESS WHEREOF, said parties have hereunto set their hands and seals the day and year first above written 1 4,'ttvc-v\-i a _>. j lite-ril �r a% LOT — Neu -Orr -2001 10'02 . DIV WATER RESOURCES • jai ebb 35b7 r.ld1/01 Form No. GWS-25 APPLICANT OFFICE OF THE STATE ENGINEER COLORADO DIVISIONSherman St.. OFWATEado R RESOURCES 3 (303) B66.35s1 THOMAS VERNON 13750 WCR 8 FT LUPTON, CO 80624- (303)857-2093 PERMIT TO CONSTRUCT A WELL 857 WELL PERMIT NUMBER 237447- DIV.1 WD2 DES. BASIN MD APPROVED WELL LOCATION WELD COUNTY NW 1/4 NE 114 Section 20 Township 1 N Range 66 W Sixth P.M. DISTANCES FROM SECTION LIN,U 180 Ft. from North Section Line 2580 Ft. from East Section Line UTM COORDINATES Northing: Fasting: ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT CONDITIONS OF APPROVAL 1) This well shall be used in such a way as to cause no material injury to existing water rights. The issuance of this permit does not assure the applicant that no injury will occur to another vested water right or preclude another owner of a vested water right from seeking relief in a cavil court action.. 2) The construction of this well shall be in compliance with the Water Well Construction Rules 2 CCR 402-2, unless approval of e varianoe has been granted by the State Board of Examiners of Water Wall Construction and Pump Installation Contractors in accordance with Rule 16. 3) Approved pursuant to CRS 37.92-602(3)(b)(il)(A) as the only well on a residential site of 30.00 acre(s) described as part of the NW 1/4 of the NE 1/4 of Sec. 20, Twp. 1 North, Rng. 56 West, 6th P.M., Weld County, more particularly described in attached exhibit A. 4) The use of ground water from this well is limited to ordinary household purposes inside one single family dwelling. The ground water shall not be used for irrigation or other purposes. 5) The total depth of the well shall not exceed 290 feet, which corresponds to the base of the Arapahoe aquifer. Al a minimum, plain casing shall be installed and grouted through ell unconsolidated materials and shall extend a minimum of ten feet into the bedrock formation to prevent production from other zones. 6) The maximum pumping rate of this well shall not exceed 15 GPM. 7) The well constructed under permit no. 237090 must be plugged in accordance with Rule 16 of the Water Well Construction Rules within ninety (90) days of completion of the new well. The enclosed tVoll Abandonment Report form must be submitted to affirm that the old well was plugged. 8) The return flow from the use of this well must be through an individual waste water disposal system of the non -evaporative type where the water is returned to the same stream system in which the well is located. 9) This well shall be constructed not more than 200 feet from the location specified on this permit 10) The Issuance of this permit hereby cancels permit no. 237090. NOTE: To insure a maximum productive life of this well, perforated casing should be set through the entire producing interval of the approved zone or aquifer indicated above. APPROVED 4 z w , State Engineer ‘Recelpt No. 0483713 DATE ISSUED PM 7 6y EXPIFItTION DAT JLV 7 TOTAL P.01 • THIS AGREEMENT, made this/67-2/- _2/-y of October, 1986, between Virginia L. Thomas and Vernon Thomas, he einafter called the first party and Hiram H. Thomas, Virginia Thomas, ,--r-DI) /) !the sec party. THE RIGHT TO USE THE WATER FROM A WELL, (as long as there is water in present well), said well is located on tract of land situated in Weld County and State of Colorado, to wit. hereinafter called The NW 1/4 of the NE 1/4 of Section 20 in Township 1 North of Range Sixty -Six West of the 6th P.M. The well is owned 3/4 by the first party and 1/4 by the second party but it is further understood that each party agrees to pay 50% each for the upkeep and maintenance of the well, repairs and whatever should arise as long as said well is in existence. It is further understood that the first party agrees to pay $15.00 monthly to the second party for the electricity to operate the well. In WITNESS WHEREOF, said parties have hereunto set their hands and seals the day and year first above written �a�Yua _ Lite�,O4 • Form No. .G-125 APPLICANT OFFICE OF THE STATE ENGINEER COLORADO DIVISION OF WATER RESOURCES 818 Centennial Bldg., 1313 Sherman St., Denver, Colorado 80203 (303) 866-3581 VERNON THOMAS 13750 WCR 8 FT LUPTON, CO 80624- (303) 857-2093 PERMIT TO CONSTRUCT A WELL LIC WELL PERMIT NUMBER oZ 3 70 90 - A- DIV. 1 WD 2 DES. BASIN MD APPROVED WELL LOCATION WELD COUNTY NW 1/4 NE 1/4 Section 20 Township 1 N Range 66 W Sixth P.M. DISTANCES FROM SECTION LINES 180 Ft. from North Section Line 2580 Ft. from East Section Line UTM COORDINATES Northing: Fasting: ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT CONDITIONS OF APPROVAL 1) This well shall be used in such a way as to cause no material injury to existing water rights, The issuance of this permit does not assure the applicant that no injury will occur to another vested water right or preclude another owner of a vested water right from seeking relief in a civil court action. 2) The construction of this well shall be in compliance with the Water Well Construction Rules 2 CCR 402-2, unless approval of a variance has been granted by the State Board of Examiners of Water Well Construction and Pump Installation Contractors in accordance with Rule 18. 3) Approved pursuant to CRS 37-92-602(3)(c) for the relocation of an existing well, permit no. O2 37 0€9 The old well must be plugged in accordance with Rule 16 of the Water Well Construction Rules within ninety (90) days of completion of the new well. The enclosed Well Abandonment Report form must be completed and submitted to affirm that the old well was plugged. 4) The use of ground water from this well is limited to ordinary household purposes inside one single family dwelling and fire protection. The ground water shall not be used for Irrigation or other purposes. 5) The total depth of the well shall not exceed 50 feet or the depth to the first confining clay/shale series, whichever comes first. 6) The maximum pumping rate of this well shall not exceed 15 GPM. 7) This well shall be constructed not more than 200 feet from the location specified on this permit. APPROVED JLV Receipt No. 0483373B State Engineer DATE ISSUED OCT 25 2001 By \EXPI TION DAT 25 2003 o • !'`i€..`:..111. S.)4.1(-7!. SEWAGE T) t ;' .r_S !, S V E NO. G-920050 OwNER :1-WMAS, VERNON H" WELD CONTY .... ` 1 itE ...i RMEN r 16TH :AVENUE COURT, .. . t:: "tr CO {:f t.` 353-065 EXT,2225 f'I .f ) R !::: S 4: 13750 Wt.:. .. 31. 659 ?i'•y .. FT LUPTON ou 8061 :.,,•;Y,F I-S•OF ....••. ...)5. ..r,.:: FT LUPTON CO 80621 LEGA1 DESCRIPTION OF SITE SEC 20 TWP RNG 66 SUBDIVISION: 1 0 BLOCK FILING USE TYPE. RESIDENTIAL t',3::'':1...1:_ HOME SERVICES: PERSONS t. 'Y r BATHROOMS 3.00 :OT SIZE 0 ACRES 1;";'111{,f•i(.iM' it L!;`IS E:Mi:'.N {'•"'..!• M ;l.iti?(� Y!:::... I.'' SUPPLY Y I.Ltj-.LL , L+ r�i T i.. t' i APPLICATION METE $115.00 RIEC'r:' BY CINDY `sALAZAR DATE 03/25/92 ` .trNED BY MARILYN (9Fti G.i:N DATE 03/25/92 PERCOLATION RATE:: 3O.,0 MIN PER INCH LIMITING ZONE 8 FE::l:«. SOIL TYPE SUITABLE PERCENT NT GROUND SJ...OF'E Of DIRECTION REQUIRES ENG1:NEE.. DESIGN N NO FROM THE APPLICATION INFORMATION .E L_' PL :I:.D AND T4 -€t_ ON -SITE SOIL PERCOLATION DATA r: THE FOLLOWING MINIMUM INSTALLATION :'Err SPECIFICATIONS Ir i REQUIRED: •`� SI 1_..1.1'"",{:(:'%'I 4' ,.li'`l,:,' r'•�F..., I:t_(�1.1.t.1�F�.>i SEPrIC TANK 1000 GALLONS, ABSORPTION TRENCH 1000 ; OR ABSORPTION BED) 1;300 S(;? F IN ADDITION: THIS '' PERMIT 1:5 SUBJECT TO THE; I-CI@«€..OWIN(. ADD1:,1.•IONA1... TERMS AND CONDITIONS: THIS PERMIT IS GRANTED TEMPORARILY TO ALLOW CONSTRUCTION TO COMMENCE., THIS PERMIT MAY BE REVOKED 'SUSPENDED 'H COUNTY r, \!' T s :., ..: E:: C) OR BY THE .. WELD HEALTH ;IEr DEPARTMENT i'4E�NT FOR i��L'.r-I;';.;�:" SET FORTH ;:N THE WELD COUNTY IND1:VIDi.JA1_, SEWAGE DISPOSAL SYSTEM RECUI...r"-3TIONc .i r`I(:'l►. )IN FAILURE T•(:1 MEET ANY TERM OR CONDITION IMPOSED THEREON ON i'Lr i`!G TEMPORARY OR FINAL APPROVAL. L . HE ISSUANCE OF THIS PERMIT I DOES NOT coN;. T I T U T ; ' ASSUMPTION BY THF DEPARTMENT OR ITS S EMPLOYEES O LIABILITY ' i•_ THE x" «.I_ ; t' R INADEQUACY ( .?.•,«try• { ":L1�: .. i'l.i. €lF.E OR 11•` ,• SEWAGE WAG E. DISPOSAL SYSTEM, S fOI...€_. , _``F•f 03/25/92 ENVIRONMENTAL SPECIALIST DATE: THIS PERMIT Is NOT TRANSFERABLE AND SHA!...!... BECOME-: VOID IF SYSTEM EM CONSTRUCTION HAS NOT COMMENCED WITHIN ONE: YEAR OF ITS S DEPARTMENT IrsSUANC'E.. BEFORE ISSUING FINAL APPROVAL C?VAS_. 01.. THIS PERMIT THE: WELD COUNTY HEALTH, ':_i'f' TME. T RESERVES THE RIGHT TO IMPOSE 1Di:1.. r:IUNrr.:._ TERMS 'CONDITIONS _. :I:E'` •i:, E'E I OUR REGULATION �> ON Fi CONTINUING BA- SIS. L.:F'cPI, .'11�D REQUIRED i_t I MEET � FINAL PERMIT APPROVAL .',, CONTINGENT !. ! I UPON ^t COM— PLETED {� .L (x _ � � 1.. �, ti THE l'. FINAL €', I••1:_. INSPECTION OF a THE r`. SYSTEM BY THE WELD COUNTY HEALTH DEPARTMENT. . :F�'.;F4 T S T. _ SYSTEM J�IIk ! tiL 1._!�'i .. DATE:(11-4-12— SYSTEM .!1 !-� h• •€' tI. I. VE-.Ey!_ .r ...1�4! I�.{--G• }::.r�`.Y1.1'4E'1 F, .µ �y4A.,...��.._�,_n{/`__._.._........_ �>PPR�;t:O'VA!_. ti ;.n, _,r" Jc-10:21 TYPE OF SYSTEM INSTALLED ...'L. -s1 ,...._ !'T ON 1= NT SPECIALIST ' C.__. ., .. .... .... ._.. 7 s:.N .t.:l�,P'`1-.1-: � ('II.,. ...F'!:�C:€.I��:I...1: " 'TLEI:: ISSUANCE OIL THIS PERMIT DOES NOT IMPLY COMP1...f?N:.i::. WITH OTHER .STATE, COUNTY LOCAL REGULATORY 0l.; I UI` ff' �.:1't: t..(.+t.•,.—;!.. ........'iL, REQUIREMENTS, NOR t,i' T. f'�.,.L. THE SF.JO,,; iE.i.: SYSTEM WILL OPERATE I `iCOMPLIANCE i APPLICABLE t•, STATE,r O TO CERTIFY ' , t.1 i WITH I' i !.1 l:: i_ H... _{...: f� .{:i [_. I:. r� COUNTY :1 i ti l', ?...(.!CA«. REUMLATIONS ADOPTED j ER .JrjlhT TO ARTICLE iS.i •r•?•'! ASS CPS 1;...r..A M i, EXCEPT E FOR tir{� THE PURPOSE 0ESTABLISHING tf�I APPROVAL y, r..;.r.. ' FINAL � :... f••I s . •, t.: �� :—: 9.. 1•� ".I i� INSTALLED .� !• FOR j.: .I C. S'..I eN «E OF ;;! ...E.'•..yA... OCCUPANCY PERMIT .. !;A!'r ! TO CIE 1973 25-10-111 1 i 2 :. r.:)R.i It ! N:`)i r. •j::i.!. i.: i'•=fN ! •.• 0 j"• •.. t•iil::..: ti it'1..7", . i.. ' .{A .{;':••4 J J JRADO • Septic Permit - Final Application Number: SP -0800144 App Type: Health\Residential\Repair\Septic Applicant Name: THOMAS T VERNON Owner Name: Parcel #: Legal Desc: Site Address: Weld County Enrronmental Health Services Department 1555 N. 17th Avenue Greeley, CO 80631 Phone: (970) 304-6415 Fax: (970) 304-6411 www.co.weld.co.us Status: Ready to Final Applied: 07/25/2008 Issued: 10/08/2007 Finaled: 01/28/2008 13750 CR 8 FT LUPTON, CO 80621 VERNON THOMAS & VIRGINIA 147120000094-R0102587 PT NW4NE4 20-1-66 LOT B REC EXEMPT RE -903 (.50R) SITUS: 13516 8 CR WELD 80621 SITUS: 13750 8 CR WELD 80621 13516CR8 WELD, CO 80621 ADD Specific Info: 1/2 Bathrooms 3/4 Bathrooms Application Date Associated Building Permit Associated Building Permit Number Basement Plumbing Full Bathrooms Location Description Number of Bedrooms Number of Persons Other Water Supply Utility Parcel Acres Private Water Supply Private Water Supply Permit Reference Number Public Water Supply Public Water Supply Utility Repair Reason Type Septic Permit Expiration Date Waive Fees Waive Fees Comment Year Installed 0 0 07/25/2008 No 1 13516 CR 8. FT LUPTON GO SOUTH UNTIL CR #8 GO EAST PAST RAILROAD TRACKS UNTIL YOU GET TO 13516. 2 2 29.5 Well No Repair for Failure No EHS Pero Test (Site): Engineer Design Required Engineer Evaluation Received Engineer Job Number Engineer Letter Received Ground Slope In 100 Year Flood Plain Limiting Zone Feet Limiting Zone Inches Limiting Zone Qualifier Percolation Rate Qualifier Percolation Rate Value Slope Direction Soil Description Soil Type Suitable Variance Required No Yes 08-1038 No No 8 0 Greater Than Equal To 25 Yes No LOT 13 WIN Minimum Installation: Absorption Bed Absorption Trench Additional Terms and Conditions Bed Option 1 Bed Option 2 Bed Option 3 Chamber Option 1 Chamber Option 2 Chamber Option 3 Septic Tank Size Trench Option 1 Trench Option 2 Trench Option 3 i Septic Permit - Final S Weld County Environmental Health Sen 155b Greer, Phone: (9; Fax: (9701 www.co.wei. 836 643 Y 27 45 36 Biodiffuser Infiltrator Quick4 ARC 36 1000 21 35 28 Actual Installation: Septic Tank: 62D W//)rt gallons`'' Absorption Trench: (07 3 Design Type: tier sgft Absorption Bed : sq ft Chamber Model olio Chambers NOTICE The issuance of this permit does not Imply compliance with other state, county, or local regulatory or building requirements, nor shafted ad to certify that the subject system vial 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 nontransferable and non-refundable. The Weld County Department of Public Health and Evnironment reserves the right to impose additional temps and conditions required to meet our regulations on a continuing basis. Final permit approval was contingent upon the final inspection of the completed system by the Weld County Department of Public Health and Environment. x Env l . n Health Specialist /O./s.d8 ate S 0 / • S individual sea age isposz of anstalled in a itt) posal systems n eld Co Hello