HomeMy WebLinkAbout20060623.tiff Auls7'O('RA I UA NCI►1?TTE WATER t'ROJE("1 , IN('. >`� } '�"�IZI
PO BOX 247
FOR'l' LI Il'TON, CO 80621
Certificate Number c_ `7
MEMBERSHIP CERTIFICATE
This is to certify that: )�J(;Zit — V�Qt"�r & A-g2� _is a member of the Aristocrat
Ranchette Water Project, Inc. a corporation without capital stock, organized and existing under the Colorado
Nonprofit Corporation Act, and is entitled to all the benefits and subject to all the rules and regulations of said
corporation as provided in its Articles of Incorporation, By-Laws and Policies.
Member conveys to Aristocrat Ranchette Water Project, Inc. the right, privilege and authority to construct,
operate, maintain, change or remove its water transmission lines, with all pipes, valves, hydrants and other
fixtures and devices, used or useful in the operation of said water transmission lines, through, along, over and
under a course All work shall he done with care, and all damages to the premises caused thereby shall he
repaired at the expense of Aristocrat Randier le Water Project, Inc.
This membership entitles the member hereof to ONE (1)domestic water tap to serve the following real property,
to wit:
Ti ii / Bus:f.: (3
SIIISUtVtSit)N: Aristocratkanchette
otherwise known by street and number as �S 7541(/ /J(24-2/ - Fort I,upton, Colorado 80621
IN WITNESS WHEREOF, Aristocrat Ranchette Water Project, Inc., has caused this Certificate to he signed by
its duly authorized officers and sealed with its corporate seal this (per` day of J ,,.E _,_01065
Prea� t (Luer, J
Secretary (SEAL) J
(Transferable only on approval of the Board of Directors)
1
11k
rn?f uc t (iota., CC�d L' /�4� Certificate # 3
frar :.ira.1io ( I I ) Certificate#
2006-0623
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#: G19949025 Sec/Twn/Rng: ?? PERMIT
Owner: FROST DAVID Applied: 03/08/1994
Applicant: FROST DAVID
Parcel #: 1309-27- - -
Location: 15724 WCR 18 FT LUPTON CO 80621
Legal Desc: ?? ?? ??
Description: . LOAN 027-94
Commercial: ?? Residential: ?? Acres: ??
# of Persons: 3 Basement Plumbing: ??
# of Bedrooms: ?? Bathrooms - (Full): ?? (3/4): ?? (1/2): ??
Water Public: Water Source:
'Tater Private: Cistern: Well: Well Permit Number: ??
Septic Tank: ?? Tank Material: ??
Absorption Trench: ?? sq. ft.
Absorption Bed: ?? sq. ft. Year Installed:
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.
X
Environmental Health Specialist Date
Form:S_EXIST
DEPARTMEN. Jr' PUBLIC HEALTH 84 N 17111 AVENUE
b, GREELEY COLORADO 80631
WEBSITE, N(970)304.cou0
n(itIPPI ADMINISTRATION(970)304-6410
PUBLIC HEALTH EDUCATION&NURSING(970)304-6420
WiiP CS FAX (970)304-6416
ENVIRONMENTAL HEALTH SERVICES FAX(9700)304-6411 0
COLORADO SEPTIC LOAN APPROVAL
CLOSING DATE: 5-31-05 REQUEST NO. : 05-008
FAX FEE: 2.00 DATE RECEIVED: 5-16-05
NEW LOAN FEE PAID: 100.00ms
TO WHOM IT MAY CONCERN: Review and inspection report regarding water and the sewage
disposal system for an existing dwelling:
Owner No. : 303-690-4554 (H)
Mail To: Betty Close
8110 County Road 13, Suite 4 Owner No. : (W)
Firestone, Colorado 80504 Realtor No. : 303-916-9289
Fax To: Betty Close Fax No. : 303-833-3054
Pick Up:
INFORMATION: Address: 15724 County Road 18, Fort Lupton Age of Septic: 1971
Legal: PT: PT: SEC: 27 TWN: 2 N RNG: 66 W
Subdivision: Aristocrat Ranchettes LOT: 1 BLIC: 3 FLG:
Property Owner: Stanek, Lynda Original Owner: Israel, William
Tank Pumped on: 9-29-04 By: A-1 Septic Service, Inc Licensed:Yes XX No
PERMIT ON RECORD: Name: Frost, David Permit #: G19949025 S.O.E. : Yes
Bathrooms: 1 3/4 Bedrooms: 3 Total Acres: 1 Date of Final Inspection: N/A
Water Supply: Aristocrat Well Permit No. :
Tank Capacity: 1000 gallons Leachfield Size: 1200 Square Feet
INSPECTION FINDINGS: Date of Inspection: May 18, 2005
SOIL CONDITIONS: Dry XX Saturated Snow-covered
RESIDENCE: Occupied Vacant XX
SEWAGE DISPOSAL SYSTEM: Satisfactory XX Other
BACTERIOLOGICAL WATER TEST: Acceptable XX Other , y/� `` l (��y-
.r.�c.I. SIGNATURE:'. J %�-VC... � - i
DATE: 7
Environmental Health Specialist
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 in connection with either its
examination of the property or in the report.
This inspection was conducted solely for the purpose of detecting health hazards
observable at the time of inspection, and 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. Water sample reports reflect the
bacteriological quality of the water supply at the time the sample was taken. 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.
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