HomeMy WebLinkAbout20033533.tiff (fit��_ _ DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT
1555 N. 1
Greeley, CO 8063131 Website: www.co.weld.co.us
Administration: (970)304-6410
Fax: (970) 304-6412
Public Health Education &Nursing: (970) 304-6420
VA pc Fax: (970) 304.6416
Environmental Health Services: (970)304-6415
COLORADO Fax: (970)304-6411
July 8, 2003
Corrine Lewis
14504 County Road 3
Longmont, CO 80504
RE: Corrine Lewis No: ISDS-03072
Permit No.: SE-0300068
On July 7, 2003 an evaluation of the existing individual septic disposal system at:
14504 County Road 3, Longmont;
Section 20, Township 03, Range 68,
was conducted by Steve J. Wiatrowski, an Environmental Specialist of this department.
The existing individual septic disposal system is of sufficient size and capacity to adequately
handle the proposed load. This evaluation is based on a final treatment capacity for a 3 bedroom
residence.
Be advised, neither the County of Weld nor any of its agents or employees undertake or assume
any liability to the owner of the above property, to any purchaser of the above property or to any
lending agency making a loan on the above property or in the report.
This inspection was conducted for the purpose of determining compliance with current
regulations and for detecting health hazards observable at the time of inspection. This does not
constitute a warranty that the system is without flaw or that it will continue to function in the
future. Inspections requested during periods of snow cover and high soil saturation may be of
questionable value to potential buyers due to adverse conditions. Evaluations based on
Statements of Existing (S.O.E.) relies on information the property owner provides, under oath,
indicating current status of the system and representing to the best of his/her knowledge the
system is not failing to function properly.
If we can be of any further assistance, please contact our office at (970) 304-6415.
Sincerely,
Stev J. Wi trowski
Environmental Health Specialist awl -552 3
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WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
1555 NORTH 17TH AVENUE
GREELEY, COLORADO 80631
PHONE (970) 304-6415 FAX (970) 304-6411
STATEMENT OF EXISTING SEPTIC PERMIT
Permit #: SE-0300068 Sec/Twn/Rng: 20-03-68 PERMIT
Owner: LEWIS CORRINE A Applied: 06/24/2003
Applicant: LEWIS CORRINE
Parcel #: 1207-20-2-00-094
Location: 14504 WCR 3
Legal Desc:
Description: HOUSE
Commercial: N Residential: Y Acres: 7.6
# of Persons: 1 Basement Plumbing: Y
# of Bedrooms: 3 Bathrooms - (Full): 1 (3/4): 0 (1/2): 0
Water Public: Y Water Source: LONGS PEAK
Water Private: N Cistern: N Well: N Well Permit Number:
Septic Tank: 1050 Tank Material: CONCRETE
Absorption Trench: 0 sq. ft.
Absorption Bed: 900 sq. ft. Year Installed: UNK
NOTICE
The property owner/agent has certified by Notary Seal that the above described septic system is in fact installed as described,and
exists at this time on the parcel identified above by the parcel number and/or legal description,and further states that the system
IS/IS NOT in good working order and to the best of his/her knowledge IS/IS NOT failing to function properly.
The property owner/agent further understands that any falsification or misrepresentation may result in the revocation of any permit
granted based upon this information hereby submitted and in legal action for perjury as provided by law.
The Statement of Existing Record relies on information the property owner or his/her representative provides,under oath, indicating
current status of the system and representing to the best of his/her knowledge that the system IS/IS NOT failing to function properly.
Issuance of the Statement of Existing Permit for any system does not constitute assumption that the site was evaluated or inspected
during any phase of construction by this Department to meet regulations.
7-o
Environmental Health Specialist Date
Form:S_EXIST
WARRANTY DEED
For good consideration,we(1)Corrine Lewis of Longmont,County of Weld.State of Colorado,hereby
bargain,deed and convey to CorrintLewis of Longmont,County of Weld.State of Colorado the
following described land in Weld county,free and clear with WARRANTY COVENANTS;to wit:
Lot B of Recorded Exemption#2133:
Beginning at the W%corner of Section 20 t.3N.,R68 W.,Thence N00'27'10'E30':
Thence N89'33'47"E 418.15';
Thence N00'27'10"E 417.23';
Thence N00'27'10"E 433.19';
Thence S03'27'24"W 381.61';
Thence 534'16'51"E 354.74';
Thence 589'33'47"W 1033.5'to the true point of beginning,except the west 30'for a county road.
This parcel contains 7.65 acres,more or less. Bearings are based on the west line of the S'/z of the
NW%of Section 20 being N00'27'10"E. The W'/corner is an aluminum cap,P.L.S.23500. The
NW corner of the S'A of the NW''his an aluminum cap,P.L.S.28273
Grantor,for itself and its heirs,hereby covenants with Grantee,its heirs,and assigns,that Grantor is
lawfully seized in fee simple of the above-described premises;that it has a good right to convey;that the
premises are free from all encumbrances;that Grantor and its heirs,and all persons acquiring any interest in
the property granted,through or for Grantor,will,on demand of Grantee,or its heirs or assigns,and at the
expense of Grantee,its heirs or assigns,execute and instrument necessary for the further assurance of the
title to the premises that may be reasonably required;and that Grantor and its heirs will forever warrant and
defend all of the property so granted to Grantee,its heirs,against every person lawfully claiming the same
or any part thereof WITNESS the hands and seal of said Grantors this /1 day of /�y, ,'2003.
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ardor
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Grantee
STATE OF COLORADO )
)ss:
COUNTY OF WELD On ( R—O J Jj ,2003 before me,[qq BG r ne 1')•L:'w iS ,personally appeared
,personally known to me(or proved to me on the basis
of satisfactory evidence)to be the person(s)whose name(s)is/are subscribed to the within instrument and
acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies),and that
by his/her/their signature(s)on the instrument the person(s),or the entity upon behalf of which the
person(s)acted,executed the instrument.
WI SS my hand and official seal.
N AR UB �1 /\
My Co ission expires t L�l
(Notary Seal)
Report Date: 12-JUN-2003 02:13 Weld County Assessor
AUTHENTICATION/CERTIFICATION-MANUFACTURED HOME TAX NO: 533
Account NO: M4759486 Parcel Nb: 120720200094
The undersigned certifies that under penalty of perjury, the following information is true and correct to the best of his/her
knowledge and that the manufactured home described will be moved by expiration date of:
Movement: N Title Change: Y Inter-County: New County:
ORIGINAL Owner/Address: ORIGINAL Legal:
LEWIS CORRINE A PT W2NW4 20 3 68 LOT B REC
14504 WCR 3 EXEMPT
RE-2133- IMPS ONLY AME
LONGMONT CO 80504 80-KSDH08A22A23571A 14504
3CR
WELD 00000
NEW Owner/Address: NEW Legal:
TITLE NO SERIAL NO YEAR MAKE/MODEL SIZE
03M849297 KSDDHH08A22A23571A 1980 AGE 14X66
Signatur o +oi Person signing is )( Owner_Agent_Mover
Mover:
Weld County Assessor
I hereby certify that the Assessed Valuation on the above-described Manufactured home is as follows:
Assessed value: 1,180 Tax District: 1345 Mill Levy: Months taxes calculated: 0
Prorated tax due as of certification date is 0.00 through
THIS AUTHENTICATION MUST ACCOMPANY ALL MOVING PERMITS.
THE ORIGINAL MUST BE SUBMITTED WITH TRANSFER OF TITLE.
Certification Date: 06/12/2003
Signature of County Assessor or Deputy
Weld County Treasurer
Due Paid
Certificate/Permit Fee 10.00
2002 Taxes prorated 0.00
Current Year Taxes
Prior Year Taxes
Total Due /O.0U
I hereby certify that all ad valorem taxes due this county applicable to the above described Manufactured
Home have been paid through the current year, including any prorated tax due. J/
Date: 61%R71I
Signature of County Trear r Deputy
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