HomeMy WebLinkAbout20083375.tiff • • �i�
CHANGE OF ZONE (COZ) APPLICATION
• FOR PLANNING DEPARTMENT USE DATE RECEIVED:
RECEIPT/AMOUNT# /$ CASE #ASSIGNED:
APPLICATION RECEIVED BY PLANNER ASSIGNED:
Parcel Number / t{ 7 , - 2- 0 - 0 - 00 _ 030
(12 digit number-found on Tax I.D. information,obtainable at the Weld County Assessor's Office, or www.co.weld.co.us).
(Include all lots being included in the application area. If additional space is required, attach an additional sheet)
Legal Description Par+ of The. NW t/r{, o f' , Section 2O , Township I North, Range 4 West
Property Address(If Applicable)
Existing Zone District : AG Proposed Zone District: 1-3 Total Acreage: ' I Proposed #/Lots /
Average Lot Size: AVA Minimum Lot Size: NSA Proposed Subdivision Name: WA
FEE OWNER(S) OF THE PROPERTY (If additional space is required,attach an additional sheet)
Name: Glatt -Zn4U5tria( -Pro pe-r4- e5 LLC
Work Phone# 31261-`141 Home Phone# 3/6sc-0GSS Email Address nuripshere CA-OL.Com
Address: 944 5. 136 Anse LhdalL Q A-OL.COM
City/State/Zip Code Brie'kin%t Co SO(a O
APPLICANT OR AUTHORIZED AGENT (See Below:Authorization must accompany applications signed by Authorized Agent)
• Name:
Work Phone# Home Phone# Email Address
Address:
City/State/Zip Code
UTILITIES: Water: We-u
Sewer: ,&p -ic And teach Redd
Gas: ` ett /7
Electric: (Jai 1--rd (1w-BY-
Phone: aide it
DISTRICTS: School: We-Id CO Re--
Fire: Fort- 1.44.p p tin
Post: Fort- Lu ion
I(We),the undersigned,hereby request hear gsbeforetheWeldCountyPlanningCommissionandtheWeldCounty
Board of County Commissioners concerning the proposed Change of Zone for the following described
unincorporated area of Weld County, Colorado:
I(We)hereby depose and state under penalties of perjury that all statements, proposals,and/or plans submitted with
or contained within the application are true and correct to the best of my(our)knowledge. Signatures of all fee owners
of property must sign this application. If an Authorized Agent signs, a letter of authorization from all fee owners must
be included with the application. If a corporation is the fee owner, notarized evidence must be included indicating the
signato the legal auth ity to sign for the corporation.
Sig r r Authorized Agen Date Sign t : Owner or Authorized Ag t Date
EXHIBIT
2008-3375 1
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CHANGE OF ZONE/REZONING QUESTIONNAIRE:
•1. How is the proposed rezoning is consistent with the policies of the Weld County Code, Chapter 22? If the
proposed rezoning is not consistent with the Comprehensive Plan, explain how the proposed rezoning will
correct what the applicant perceives as faulty zoning, or how the proposed rezoning� _ will fit with what the
applicant perceives as the changing conditions in the area. ev a��rka
2. How will the uses allowed by the proposed rezoning be compatible with the surrounding land uses? Include
a description of existing land uses for all properties adjacent to the subject property. (441U ba.--lo n (s
-Eo our Sa.i-1. and (.ararga 5anct +-&rapt( (nit west of-us,
3. Will the property use a septic system or public sewer facilities? 5epfi G
4 Who will provide adequate water, including q�fire protection, to the property? We(( woj-e a
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For+ turn) P r( yidnc
5. Does the property have soils with moderate or severe limitations for construction? If yes, the applicant shall
submit information which demonstrates that the limitations can be overcome. N
6. Is the road and/or highway facilities providing access to the property(ies)adequate to meet the requirements
of the proposed zone district? If not,the applicant shall supply information demonstrating the willingness and
financial capability to upgrade the road and highway facilities. ye 5
7. Is there a sand, gravel, or other mineral resource on or under the subject property? If so,the applicant shall
provide a mineral resource statement prepared by a certified geologist or other qualified expert. The
statement shall indicate the estimated quantity of resources and the economic feasibility of recovery, now
and in the future, of the resource(s)so that the Planning Commission and Board of County Commissioners
can determine whether a commercial mineral deposit is contained on or under the subject property(ies)as
defined by Colorado Revised Statute. see ¶e rra,con fltja _hment
8. Is the change of zone area located in a Flood Hazard Overlay District? NO
g. Is the change of zone area located in a Geologic Hazard Overlay District? No
10. Is the change of zone area located in the AP (Airport) Overlay District? NO
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Glaze Industrial Properties, LLC
OPERATING AGREEMENT
THIS AGREEMENT is made and entered into this I st day of August, 2005, by and
between Michael W. Glaze and Linda L. Glaze.
ARTICLE 1
Formation
1.01 Formation. The parties do hereby form a Limited Liability Company to do business
as Glaze Industrial Properties, LLC.
1.02 Purpose of the Limited Liability Company. The purpose of this company shall be
to undertake Glaze Industrial Properties, LLC related business and such other lawful business as
• shall be determined by the members. This company is organized for profit and to engage in
trancartions of any or all lawful business within the State of Colorado and in any other state,
territory or possession or other holding in the United States, or in any and all foreign countries,
for which a limited liability company may be organized under the Colorado Limited Liability
Company Act.
1.03 Principal Place of Business. The principal place of business shall be 748 S. 13`x'
Street,Brighton,Colorado 80601,or at such other place or places that all of the members may
designate from time to time.
1.04 Term. The company shall commence upon proper filing of the Articles of
Organization with the Secretary of State and shall continue until such time as the company is
terminated in accordance with the Articles of Organization or this Operating Agreement, but in
no case shall the company continue for a period longer than fifty(50)years.
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ARTICLE 2
Capital Contributions
2.01 Initial and Additional Contributions. The initial capital contribution to this
company prior to its conversion to a limited liability company was$1,000. Capital contributions
to the company may be made at any time at the option of the members.
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2.02 Contributions. Based upon the initial capital contribution, the ownership interests
are as follows:
Michael W. Glaze $500.00
Linda L. Glaze $500.00
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• ARTICLE 3
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Company Profits and Losses
and Distribution of Funds
3.01 Profits and Losses. For accounting and federal and state income tax purposes,the
profits and losses of the company shall be allocated as follows:
Michael W. Glaze 50%
Linda L. Glaze 50%
3.02 Distribution of Funds. The company shall distribute to each of the members in the
same percentages as provided in paragraph 3.01,cash available from the operations of the
company,on a monthly basis after setting aside a sufficient amount of cash for operations of the
company in the reasonably forseeable future. Upon fmal dissolution and liquidation of the
company,the ssets shall be allocated and distributed in accordance with the percentages set
forth in 3.01 above.
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ARTICLE 4
Accounting and Reports
4.01 Books. The books of the company shall be maintained,and kept at the principal
place of business of the company(or at such other place as the members may designate),and said
books shall contain a full and accurate account of the operations of the company.
4.02 Reports. For each accounting year,the books shall be reviewed and financial
statements and tax returns prepared by an accountant or other person acceptable to all the
members. Each member shall be entitled to a copy of the financial statements and tax returns.
Any member shall have the right to a private audit of the books and records of the company,
provided such audit is made at the expense of the member desiring it and is made at reasonable
times and after reasonable notice. Any member shall have the right at his own expense to visit
the principal place of business of the company and examine the books and accounts and discuss
the affairs,finances and accounts of the company at such reasonable times and as often as such
members may desire. The foregoing privilege may be exercised by any duly authorized
representatives of any member.
4.03 Bank Account. The company shall open and thereafter maintain in a federally
insured commercial bank a bank account or accounts in the name of the company in which shall
• be deposited all of the contributions of the members and all company income and from which
shall be made all company distributions. Funds shall be disbursed from such account or accounts
solely for the business of the company.
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ARTICLE 5
Management, Authority,Duties
and Compensation of the Members
5.01 Management of the Company. Management of the company shall be vested in the
members. The members of the company initially shall be to-wit:
Michael W. Glaze
Linda L. Glaze
5.02 Authority. Members shall have the authority and responsibility for the full
management and control of the affairs and operations of the company, subject to the limitations
set forth in this agreement. However,without the prior consent 6i ratification of the specific act
by all members,a member shall have no authority to:
(a) Do any act in contravention of the Articles of Organization or this Operating
Agreement;
• (b) Do any act which would make it impossible to carry on the ordinary business of the
company or which is not within the usual course of business of the company;
(c) Borrow funds on behalf of the company;
(d) Confess a judgment against the company;
(e) Possess company property, or assign his or her rights in specific company property for
other than company purposes;
(0 Transfer,sell or assign his or her interest in the company,except as otherwise
provided in this agreement;
(g)Admit another person as a member or issue an interest in the company,except as
otherwise provided in this agreement;
(h) Except in connection with the winding up of the company following a dissolution, sell
substantially all of the assets of the company at a single sale which takes place at one time or
from time to time in multiple sales;
(i) Except in connection with the acquisition or improvement of assets or the refinancing
of previous obligations,mortgage or subject to the encumbrance of a mortgage, deed of trust,or
other security interest substantially all of the assets of the company it one time or from time to
time;
0) Borrow money from the company;
(k) Deal in stocks,bonds,securities or commodities or in the futures market therefor;
(1)Amend a written Operating Agreement;
(m)Approve a merger or consolidation with another person;
(n)Change the status of the company from one in which management is vested in the
members to one in which management is vested in one or more managers, or vice versa; or
• (o) Determine, modify, compromise or release the amount and character of the
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contributions which a member shall make, or shall promise to make, as consideration for the
issuance of an interest in the company.
5.03 Duties. The members shall diligently perform their duties as contemplated under
this agreement in accordance with good business practices and good faith in the best interest of
the company. A member shall not be liable to any other member,for the performance of any act,
or for the failure to act, so long as such member is not guilty of fraud, gross neglect or bad faith
in such performance or failure.
5.04 Designated Managing Member or Members.
(a) There may be a designated managing member or members of the company who shall
have the responsibility to act on behalf of the company and to carry out the decisions of all the
members by handling the general daily affairs and operations of the company. The managing
member or members shall inform the remaining members of any problems of unusual nature with
the operations, and the members shall determine by vote of the majority in interest the action to
be taken.
(b)The managing member or members shall diligently perform their duties as
contemplated under this operating agreement in accordance with good business practices. The
managing member or members shall not be liable to the other members for the performance of
• any act or the failure to act so long as the managing member or members are not guilty of fraud,
gross neglect or bad faith in such performance or failure.
5.05 Compensation of Managing Member. The managing member or members, if any
have been so designated, shall be entitled to receive a salary as set by the members.
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5.06 Majority in Interest Required. Approval or consent of more than one-half of the
members= aggregate interests in the company shall be required to decide any matter connected
with the business or affairs of the company.
5.07 Matters Requiring a Vote, Approval or Consent. Any action or vote which must
be taken at a meeting of the members, may be taken without a meeting if consent in writing,
setting forth the action so taken is signed by all the persons entitled to act or vote wih respect to
such matter. Such consent shall have the same effect as an act or vote of such persons.
5.08 Execution of Documents. All members so authorized shall execute Articles,
notices or documents permitted or required under the Colorado Limited Liability Act. All
members of the company shall be authorized to execute documents as set forth in this paragraph.
5.09 Tax Elections. The members shall be authorized to make tax elections on behalf of
the company.
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ARTICLE 6
Meetings of Members
6.01 Regular Meetings. Meetings of the members maybe held at such times as may be
reasonable or upon a minimum of 10 days written notice, with notice deemed to have been given
if sent by mail or other means of written communication to the members of record of the
company.
6.02 Special Meetings. Special meetings may be called at any time by any member of
the company. Such meetings shall be called upon a minimum of 10 days written notice and not
more than 60 days written notice.
6.03 Waiver of Meeting. The members may take action without a meeting by executing
a writing signed by all of the persons who would be entitled to vote at a meeting.
6.04 Written Proxy Permitted. Members may execute a written proxy which shall be
valid for three years unless the person executing it specifies therein the length and time for which
• such proxy is to continue in force.
6.05 Quorum. The presence,in person, or by proxy,of persons entitled to vote a
majority of the voting interest of the company shall constitute a quorum for the transaction of
business.
ARTICLE 7
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Disposition of Company Interest by a Member
7.01 Sale or Assignment. No member may sell or assign his or her interest in the
company without first giving written notice to the other members of their intention to sell or
assign their interest and of the consideration that has been offered them for such interest. The
other members shall have thirty(30) days within which to give the members notice of their intent
to purchase such interest in proportion to their interests in the company,or if any do not wish to
purchase such interest, one or more of the remaining members may purchase the interest in such
proportion as they may agree upon., all for the same consideration and on the same terms and
conditions that were set forth in the notice from the member who wishes to sell his interest. If
the remaining members do not consummate the purchase of all or any part of such interest within
a total of ninety(90)days from the date the selling member gave notice of his or her intent of
sell, the member may sell or assign his or her interest to a third party, provided that such sale or
assignment is not for consideration less than that set forth in the notice to the other members. An
assignee of a member shall only be entitled to the profits, losses and distributions to which his or
her assignor was entitled and shall not become a member unless all members consent to a
substitution of such assignee in the place of the assignor. Such substitution shall become
effective upon the execution of an amendment to this Operating Agreement.
7.02 Continuation of the Company. Members may continue the business or affairs of
the company upon an event of withdrawal,judicial determination of incompetency, or
• bankruptcy of a member, including the managing member or members, upon the approval of all
remaining members.
• ARTICLE 8
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Death of a Member
8.01 Purchase of Insurance. The company may purchase insurance on the life of one or
all of the individual members,with the consent of the majority in interest of all members. Any
such insurance will also become subject to the terms and conditions of his agreement without the
necessity of any amendment hereto.
8-02 Death of an Individual Member. In the event of the death of an individual
member the company shall apply for the payment of the proceeds of life insurance,if any, on his
or her life. The company may purchase,at its option and upon agreement of the estate of andior
the trustee or other duly qualified representative of the member may sell, at his or her or their
option,as the case may be, the member's entire interest in the company for a total price equal in
value to the member's interest in said company to be determined by appraisal. Such total
purchase price shall be pro-rated among the remaining members according to their respective
interests in the company. Should the company and duly qualified representative(s)or trustee(s)
of the estate decide not to exercise their respective options to purchase and sell the deceased
member's interest, any remaining original member of the company shall be entitled and
authorized to continue the management of the company without input or interference from
outsiders or family members of the deceased members notwithstanding the continuation of
allocation of profits and losses of the company to the lawful heir's and beneficiaries of the
• deceased member.
8.03 Continuation of the Company. Members may continue the business or affairs of
the company upon an event of withdrawal by death of a member upon the approval of all
remaining members.
ARTICLE 9
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Dissolution and Termination of the Company
9.01 Causes of Dissolution. The company shall be dissolved upon the happening of any
one of the following events:
(a) Agreement of a majority in numbers,not in interest, of the members.
(b)Bankruptcy or insolvency of the company.
(C) Death of or complete disability of the members.
9.02 Procedures Upon Dissolution. Upon the dissolution of the company, a financial
statement shall be prepared by the members or the company's accountants and shall set forth the
assets and liabilities of the company, and a copy of such statement shall be furnished to each of
the members within a reasonable time after such dissolution. Based upon this statement, the
assets shall be liquidated as promptly as possible by the members. The members shall apply the
proceeds of the company in accordance with the provisions of this agreement. A reasonable time
for the orderly liquidation shall be allowed. If any distribution is made in kind,then each
member shall become the owner of the undivided interest in the property so distributed.
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ARTICLE 10
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Miscellaneous
10.01 Notices. Any notices given pursuant to this agreement may be served personally on
the member to be notified or may be mailed, postage prepaid, certified with return receipt
requested,addressed as follows:
Glaze Industrial Properties,LLC
748 S. l3"' Street
Brighton, Colorado 80601
Any member may change the address for notice upon written notice to all other members.
10.02 Waiver of Notice. When,pursuant to the Colorado Limited Liability Company
Act or the provisions set forth is the Articles of Organization or the provisions herein of the
operating Agreement,notice is required to be given to any person, a waiver in writing signed by
that person, whether before or after the time stated in it, is equivalent to the giving of notice.
10.03 Successors and Assigns. All the terms and conditions of this agreement shall be
binding upon the successors and assigns of the members,but in do event shall the terms and
conditions of this agreement inure to the benefit of the successorA and assigns of the theiribers
except as otherwise expressly provided in this agreement.
• 10.04 Counterparts. This agreement may be executed in one or more counterparts,
eachof which shall be deemed an original,and said counterparts shall constitute one and the same
instrument which shall be sufficiently evidenced by one counterpart.
10.05 Captions. Captions to the headings of the articles and sections of this agreement
are solely for the convenience of the parties and are not a part of this agreement and further, they
shall not be used for the interpretation or determination of the validity of this agreement or any
provision hereof.
10.06 Entire Agreement. This agreement constitutes the entire understanding between
the parties with respect to the subject matter.
10.07 State Law. This agreement and its application shall be governed by the laws of the
State of Colorado.
10.08 Person. "Person" includes individuals,partnershi s, domestic or foreign limited
' partnerships,domestic or foreign limited liability companies, doiestic or foreign corporations,
trusts, business trusts,real estate investment trusts, estates, and anther associations or business
entities.
10.09 Amendments, The Operating Agreement may be amended in whole or in part by
approval of all members, in accordance with the Colorado Limited liability Act.
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10.10 Custodian of Documents. The company shall keep its principal place of business
the following:
(a)A current and a past list, setting forth the full name and last known mailing address of
each member or manager, if any, set forth in alphabetical order;
(b) A copy of the Articles of Organization and all articles of amendment thereto,together
with executed copies of any powers of attorney pursuant to which any articles have been
executed;
(c) Copies of the company's federal,state, and local income mx returns and reports, if
any,for the three most recent years or, if such returns and reports were not prepared for any
reason, copies of the information and records provided to, or which should have been provided
to,the members to enable them to prepare their federal, state and local tax returns for'such
period;
(d) Copies of any effective written Operating Agreements, and all amendments thereto,
and copies of any written Operating Agreements no longer in effect;
(e) Copies of any financial statements of the company for the three most recent years;
(f)Unless contained in a written Operating Agreement, a writing setting out;
(I)The amount of cash and a statement of the agreed value of other property or
services contributed by each member and the times at which or events upon the happening of
which any additional contributions agreed to be made by each member are to be made;
(2)Information that would enable a member to determine the relative voting
• rights of the members on a particular matter if such voting rights are other than on a per capita
basis; and
(3)Any events upon the happening of which the company is to be dissolved and
its affairs wound up;
(g) Copies of any written promise by a member to make a contribution to the company;
(h) Copies of any written consents by the members to the admission of any person as a
member to the company;
(i) Copies of any written consents by the members to continue the company upon the
event of withdrawal of any member; and
(j) Copies of any other instruments or documents reflecting matters required to be in
writing pursuant to the Operating Agreement.
10.11 Members' Right to Inspect. Each member may:
(a)Inspect and copy during ordinary business hours,at the reasonable request and at the
expense of such requesting member, any of the company records required to be kept as set out in
paragraph 10.10 above;
(b)From time to time upon reasonable demand, obtain true and full information regarding
the state of the business and financial condition of the company; and
(c) Have an accounting of the affairs of the company whenever circumstances render it
just and reasonable.
10.12 Company. The use of the term "company'herein refers to Glaze Industrial
Properties, LLC.
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10.13 Act, The use of the term"Act"herein refers to the Colorado Limited Liability
Company Act.
10.14 Tax Period and Annual Report. The company shall be taxed as a partnership
under Colorado law. The tax period for this company will end as of the 31n day of December.
An annual report, along with any franchise tax due, shall be filed with the Secretary of State no
later than the 15I of April following the close of the tax period.
10.15 Majority in Interest. A member's interest is based upon his or her percentage of
profits and losses in the company to which he or she is entitled, A majority, for purposes of
voting,approving, or consenting to the affairs of the company,means a majority of all
percentages of interest held by members. Majority in interest does not mean a majority of the
number of members of the company.
10.16 Transfers to Revocable Living Trusts. For the purposes of this agreement, any
member may transfer his or her interest in the company to said member=s revocable living trust.
Upon such transfer, legal title shall be held by said living trust, but such interest shall be subject
to the same events and circumstances as if the transferring member continued to hold title in his
or her own name. Further, said transferring member shall continue to exercise all rights and be
liable for all duties imposed by this agreement notwithstanding said transfer.
IN WITNESS WHEREOF, this Operating Agreement has been executed cii the'date
first above written.
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Linda L. Glaze
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• DEPARTMENT OF PLANNING SERVICES
Planning Division
SOUTHWEST OFFICE
4209 CR 24.5
LONGMONT, CO 80504
WI PHONE: (720) 652-4210, Ext. 8730
O FAX: (720)652-4211
COLORADO jhatch@co.weld.co.us
June 11, 2008
Glaze Industrial Properties LLC
748 South 13th Ave
Brighton CO 80601
Regarding the property located at 2992 County Road 27
To Whom It May Concern:
This letter is to inform you that the Department of Planning Services has determined that Non-
Conforming Use 72:82:45 (NCU) has been vacated. NCU-72:82:45 was assigned to the property
• for a gas station that existed prior to February 28, 1962. Section 23-7-30.C of the Weld County
Code states that if any such non-conforming use of land ceases for any reason for a period of
more than six (6) months any subsequent use of such lot or parcel shall conform to the
regulations specified by Chapter 23 for the zoning district in which such lot or parcel is located.
The Department of Planning Services has noted that the gas station and related structures have
been demolished on the property, therefore the use is not being conducted on site.
If you have any further questions. You can contact me at the above address or call (720) 652-
4210 ext 8730.
Sincerely,
Jacqueline lam-atch
Planner ll
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JUN-26-2008 THU 08:27 AN• FAX N0, • P. 01/01
Report Date:06/26/2008 08:16AM WELD COUNTY TREASURER Page: 1
STATEMENT OF TAXES DUE
• SCHEDULE NO: R6247486
ASSESSED TO:
GLAZE INDUSTRIAL PROPERTIES LLC
748 S 13 AV
BRIGHTON, CO 60601 -,-
LEGAL DESCRIPTION:
15041 PT NW4 20 1 66 BEG 30' E& 30'S OF NW CDR SEC 20 E200'S200' W200'N200'TO BEG sr LIS:2992 27
CR WELD 00000
PARCEL: 147120000030 SITUS ADD: 2992 27 CR WELD
TAX YEAR CHARGE TAX AMOUNT INTEREST FEES PAID TOTAL DUE
2007 TAX 1,845.88 0.00 0.00 1,845.88 0.00
TOTAL TAXES 0.00
GRAND TOTAL DUE GOOD THROUGH 06/26/2008 .. . :, a•°i6G
ORIGINAL TAX BILLING FOR 2007 TAX DISTRICT 2501 -
Authority MITI Levy Amount Values At rill Assessed
WELD COUNTY 16.804* 520.59 RESIDENTIAL 136, Iilni 10,900
SCHOOL DIST RE8 23.784 736.82 COMMERCIAL 69, !I',i1 20,080
CCW WATER 0.4er 15.09 - - -- ••- --------
CCS WATER 0.746' 23.11 TOTAL 206, V 30,980
FORT LUPTON FIRE 8.201 254.07
AIMS JUNIOR COL 6,308 195.42
WELD LIBRARY 3.253 100.78
TAXES FOR 2007 59.583• 1,845.88
•Credit Levy _.. LL
ALL TAX LIEN SALE AMOUNTS ARE SUBJECT TO CHANGE DUE TO ENDORSEMENT OF CURRENT TAXES BY THE L ?:'IHOLDER
OR TO ADVERTISING AND DISTRAINT WARRANT FEES. CHANGES MAY OCCUR AND THE TREASURER'S OFFICE)FILL NEED TO BE
CONTACTED PRIOR TO REMITTANCE AFTER THE FOLLOWING DATES: PERSONAL PROPERTY AND MOBILE HOM :I•AUGUST 1,
REAL PROPERTY-AUGUST 1. TAX LIEN SALE REDEMPTION AMOUNTS MUST RI PAID BY CASH OH CASHI :Its CHECK.
• P.O.Bo
Greeley,CO 80632
(970)3593845 ext.3290
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WELD COUNTY TREASURER it
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Pursuant to the Wild County Subdivision Ordinance,the attached State Jnt(s)
of Taxes Chit, issued by the Weld County Treasurer, are evidence that,as of th' late,
all property taxes,special'assessments and prior,tax liens currently due and pay e
connected with the parcel(s) identified therein have been paid in MI,
11, !
Signed t•�"'"*" .,04 A2�n Date Z ��
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0 WELD COUNTY ROAD ACCESS INFORMATION SHEET
Weld County Department of Public Works
111 H Street, P.O. Box 758, Greeley, Colorado 80632
Phone: (970 )356-4000, Ext. 3750 Fax: (970) 304-6497 ,/ /� O C7
Date: `J O
Road RE # File#: _ Other Case #:
1. Applicant Name ��Y��;�',/a7t_ h �rcl P.O/C, yhCS-h�n Phone Zip —Q'/ /
Address 7i Q J • / _-74
2. Address or Location of Access /30'f 1. fact 9 Lnr/ Lc..p t,O, cc YcX02/
Section 2.0 Township I Range 66 Subdivision Block Lot
Weld County Road #: Side of Road Distance from nearest intersection
3. Is there an existing access(es)to the property? Yes 1.0"--- /No #of Accesses T
4. Proposed Use:
U Permanent U Residential/Agricultural ' Industrial
LI Temporary ❑ Subdivision U Commercial ❑ Other
5. Site Sketch
Legend for Access Description:
AG = Agricultural
----1 li---
RES = Residential (' 27
O&G = Oil&Gas• �,D.R. '►
= Ditch Road %H
a = House
p = Shed
A = Proposed Access
R
A = Existing Access
Ni
7 F
.......................................
OFFICE USE ONLY:
Road ADT
Date Accidents Date
Road ADT Date Accidents Date
Drainage Requirement Culvert Size Length
Special Conditions
U Installation Authorized ❑ Information Insufficient
TRevitle:
CERTIFICATE ed By:
CERFICATE OF CONVEYANCES WELD COUNTY
STATE OF COLORADO DEPARTMENT OF PLANNING SERVICES
. COUNTY OF WELD
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