HomeMy WebLinkAbout20063232.tiff MAR-27-2006 02:01K. FAX NO. 3038333285 P. 03
.
• April 17, 1968 '
6.
TAP peg AOPEBMRRr
'MIS 10188K1112, made and entered into chin — 18sh day of now..,her 19_11—
by and between the CENTRAL WILD 00ID7Tt VATRR DISTRICT, berettnlf arclledno Rlherine r
bistriot, and jack Schott' and
• hereinafter called Customer, VPIVBESZTV:
inuotUAS, District has been organized as a legal body and IA boom ea the
. Central Veld County Varer District, and
9MERRAS, catenate are taxpaying electors within said District, or desiringmd,
to join said District. or •
VEEEEA6, Customers or. desirous of wrebaalag
One Vette tap of 5/8
!sakes in diameter tress the said District,
110V, 711EEE70RE, in coaaideretioa of the premises and the terns of this agreement,
it to mutually agreed as follows;
1. Customer
rem p and plant investment foe of g 550.00 .
a ganO sto Dollars:
2. lInine
the Oust it which net economically
islyin theible to *stand the entire dicretion oftDietrict.
Property lime pf Customer
then ell soma paid hereunder shall be returned to Customer and the agreement shall
- be null add void. - '
S. The description of the premises tar which thsoe'teps are being punrbased
is as follows;
— 883/4 Sec. 9, T2e, R67 (ills) Exc.; beg at a pt 266 ft.V of.8R corner,
V 1979 ft, E 1500 ft., E 1274 ft. 8 1440 ft., E 655 ft, 8 60 ft. to bea.(41e)
4, This agreement, when approved by the Board of Directors, shall become a
legal and binding contract upon all parties hereto.
5. Customer further agrees to execute any and all anemone needed by District
et no expense to District, oerpes Customer's property for the purpose Of installing
any pipelines constructed by District. District shell be respocaible for restoring
' surface arcs back to reasonable eondttion-at Dietriot Cost.
6. It is further mutually agreed that this agrsessnt shall extend to end '-be
binding upon the beire, executors, adaintatracnra and:aasigne of the pastime b
7. Customer further agrees to the £ollairing special provisions ; fI
8. Customer further egress to abide by the rates established and she rulM"•.
and regulations of the District.
IV 8111188 WHEREOT, the parties hereto have hereunto and berermdar set their
signatures the day and year first heroinabove written
0Upitrit870VATDst cguflAL WILD tomtit VATet_DI9TRICT
• (Property Drier)
Jack rekatine` t. J fly, sin
� �'izi:2. . ATTEST de* .
Verne is Vpgne Eoketiee Paul Epshlko, Jr., Seer ry
2O06-3232
MAR-06-2006 MON 11 33 AM K. P. KAUFFMAN CO FAX NO. 3038333285 P. 04
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-0500093 Sec/Twit/Rng: 09-02-67 PERMIT
Owner: KAUFFMAN LAND&DEVELOPMENT Applied: 10/12/2005
Applicant: KAUFFMAN LAND&DEVELOPMENT-ROY TETER
Parcel#: 1311-09-4-00-064
Location: 10137 CR 19 FT LUPTON
Legal Desc:
Description: OFFICE
Commercial: Y Residential: N Acres: 4.97
#of Persons: 82 Basement Plumbing: N
#of Bedrooms: 0 Bathrooms-(Full): 2 (3/4): 0 (1/2): 0
Water Public: Y Water Source: CENTRAL WELD COUNTY WATER DISTRI
Water Private: N Cistern: N Well: N Well Permit Number.
Septic Tank: 1000 Tank Material:CONCRETE
Absorption Trench: 270 sq. ft.
Absorption Bed: 500 sq. ft. Year Installed: UNKN
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/ber 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 dui the site was evaluated or inspected
during any phase of construction by this Department to meet regularises.
vironmentai ealth Specialist Date
Fain S_EXIST
WELD COUNTY DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT
1555 NORTH 17TH AVENUE, GREELEY, CO 80631 PHONE: (970) 304-6415 FAX: (970) 304-6411
WEBSITE: WWW.CO.WELD.CO.US
APPLICATION / RECEIPT
Initials: MS
Permit Number: SP-0500368 Receipt Number: HAP-05374
10-12-2005 Amount: $400.00 Payment Method: Check Notation: 910
Owner Name: KAUFFMAN LAND & DEVELOPMENT
Applicant Name: KAUFFMAN LAND & DEVELOPMENT-ROY TETER
Parcel Number: 131109400064
Location: 10137 CR 19 FT LUPTON
Account Code Description Amount
2560-41400-4221-4203 New Septic Permit $0.00
2560-41400-4221-4203 Repair Septic Permit $400.00
2560-41400-4221-4203 Vault Permit $0.00
2560-41400-4221-4203 Variance Request $0.00
4. n
Description: OFFICE f p J u s_ c _52/31...9Commercial: (Y/N) Y Residential: (Y/N) N Acres: 4.97 pa-
11)(i7
Number of Persons: 92 Basement Plumbing: (Y N) N CrfC 9/D
Number of Bedrooms: 0 Bathrooms: Full - 2 3/4: 0 1/2: 0
Water Public: (Y/N) Y Water Supply: CENTRAL WELD CO WATER DISTRI
.ter Private: (Y/N) N Cistern: (Y/N) N Well: (Y/N) N Well Permit Number:
TERMS AND CONDITIONS
A permit fee,as set by separate ordinance of the Board of Weld County Commissioners,shall be required of applicants for new individual sewage
disposal systems(ISDS), payable at time of application. Pemit fees are non-refundable;permit applications are not-transferable. If both a
building permit and an ISDS are issued for the same property and construction is not commenced prior to the expiration date of the building permit,
the ISDS permit shall expire at the same time as the building permit. If an ISDS permit is issued for a property that does not require a building
permit,the ISDS permit shall expire one year after its issuance if construction on the septic system has not commenced. Any change in plans or
specifications after the permit has been issued invalidates the permit unless approval is secured from the Health Officer or his/her designated agent.
Expired permits can be renewed by payment of the permit fee only if:
A.There has been no change in the plans and specifications of the proposed system as set out in the original application or such change is reviewed
and approved by a Division Representative.
B.The surrounding land,its use or zoning has not changed so-as-to cause the original application not to be acceptable under these regulations.
NOTICE
The completeness of this application is conditional upon further mandatory and additional tests and reports as may be required by the Weld County
Department of Public Health and Environment(WCDPHE).The issuance of the permit is subject to such terms and conditions as deemed necessary
to insure compliance with rules and regulations adopted under article 10 title 25,CRS as amended. The applicant certifies that the proposed system
will not be located within 400 feet of a community sewage system.The undersigned certifies that all statements made, information and reports
submitted herewith are,or will be,represented to be true and correct to the best of his/her knowledge and are designed to be relied on by the
WCDPHE for evaluation for purposes of issuing the permit applied for herein. Applicant further understands that falsification or misrepresentation
may result in the denial of the application or revocation of any permit granted,and in legal action of perjury as provided by law.
x �� z /(/D /() /�
Owner/Applicant Date
Form:RT_HAPP
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