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HomeMy WebLinkAbout982696.tiff J rtSii i i t. i.-"/.., ' -.."_,'i ' `• '' fl II d _ ..,--' t $ P I I o' r 1 , I Vyg I ft Ey li-' � $ t. ill iI 1 ,8 pal .. Iii I al i 1 i 31$11lligl if,1 3c OF'. � ��� 1 d 1 g „ Pi lit ,), 1,,, I L- ikfflb gI 1t: ''''''' , z a jj! � yjy 4rM J9 IliOni"QV014142P—CrI2MAC.-----M_pit Mslte --.---.—.-- .—-—-—-—-—- — f Tr;;Wt 3 J+asod N ¢ — I N i sal is ! IjjI 111 sI 1(+J eh! .! i Ii N i iI . y AZ 917S I�xaaa N Y • VI I 3 CNI 0_ Pi �- za 00E Ilil I i- 004 i9Yit9ri 4r.tw N V" �' I r i911£9Z S XC.iOA N I I =� s i i W 3,71 ; I II Ili i t 5 I Q 0 € i II III' khMs i N C rs 9n i til iI Jrtl 1.77[7 MiMMi-„ 1L Yta1 M.[fYOYf ) .44909L Q ilia H (.11 I; „it t ir il i? 8 lih t .r.43 i it ti 9' 3 C�is aI 19'9096 in itl,w.Ynaa ti —•—-7Tt ITT-m— l—i?r•—'—- 9m—c iuv9 E''3+AvMvo-isftinii airs ikiibi riV -.2riciT imams!ams!—I- .1: A! IS I iN 114 V I i i'tJ III ash h I 1 Ili J- Y Ij y ai 0,2 li —30-liko--- P %1,$ gi i pin! i, ,. ep Plil 1 i IPA ! 1041 al 541. -- FR � Q lib w SI .1 MN 4ii Mill a Z ligigi 1. i_ $ HIAli I . N id ad - Vt.t oa ett0PAI ililig Iii a io g I ge, t q $ t ri :l Phil TO ; ! "*II fig 8 el nmml 3gt t�1� Y$}l l _ _ psi lifid iddi hl t1 hl c $ _2 r• Etna .42FSil`k \ l 2114 J 4Kett, 0 DEPARTMENT ERVICES RECORDED EXEMPTION COLORADO ADMINISTRATIVE REVIEW Applicant: Harold Neal Case Number:AmRE-1215 Planner: Shani Eastin Legal Description: W2NE4 of Section 26, T2N, R61 W of the 6th P.M.,Weld County, CO. Parcel Identification Number: 1299-26-000016 and 1299-26-000017 Lot C Size: N/A Lot B Size: 78 acres Lot A Size: 2 acres Water Source: well Sewer Source: Septic Meets Criteria Criteria Checklist Yes No X 1. Conformance with the Weld County Comprehensive Plan and any adopted municipal plan. X 2. Compatible with the existing surrounding land uses. X 3. Consistent with the intent of the zone district. X 4. Consistent with efficient and orderly development. X 5. Complies with Recorded Exemption standards in Section 11.8 of the Weld County Subdivision Ordinance. X 6. Provides for adequate protection of the health, safety, and welfare of the inhabitants of the neighborhood and the County. Approved with Conditions The Department of Planning Services has determined through the review,that the standards of Section 11.4.2.1 through 11.4.2.6 of the Weld County Subdivision Ordinance have been met. This Recorded Exemption is approved with the following conditions in accordance with information submitted in the application and the policies of the 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. Prior to recording the plat,the applicant shall: A. The following note shall be placed on the plat: 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. B. All accesses shall be clearly shown on the plat. / '1"I p _°2(p1(o 0 C. Future development may necessitate a larger lot (Lot A) than what is displayed on the plat. In addition,a larger lot would provide additional dilution and attenuation of sewage wastes which may be beneficial to the environment. 3. The applicant shall submit a mylar plat to the Department of Planning Services to be recorded in the office of the Weld County Clerk and Recorder. The plat shall be prepared in accordance with the requirements of Section 11.7 of the Weld County Subdivision Ordinance. The plat shall be submitted within sixty (60)days from the date of approval by the Department of Planning Services. The applicant shall be responsible for paying the recording fees. By ltbA Date January 8, 1998 S ni L. Eastin O rrent Planer • • cilcn - 970-M963 res '‘H% DEPARTMENT OF PLANNING SERVICES 918 10t" STREET ' GREELEY, COLORADO 80631 WEBSITE: www.co.weld.co.us C E-MAIL rcaruso@co.weld.co.us PHONE O (970) 353-6100, XT 3563 FAX (970) 304-6498 COLORADO April 24, 2007 Ron Werner 46674 County Road 20 Wiggins, CO 80654 H1„, , -7-i 7 Subject: Recorded Exemption (AmRE-1215) Dear Mr. Werner: On, January 8, 1998 your application for a Recorded Exemption was administratively approved by the Weld County Department of Planning Services with specific Conditions of Approval. One of the required Conditions of Approval grants applicants sixty (60) days to submit a Mylar Plat. Should you choose not to complete the Recorded Exemption process and provide the required Mylar Plat; the Department of Planning Services will need to be notified in writing of your decision. If you do not formally withdraw your application and/or are unable to meet the Conditions of Approval, your case will be scheduled for a hearing before the Weld County Board of County Commissioners. Planning Staff will be recommending denial or your request at this hearing. If you application is denied by the Board of County Commissioners, the decision could affect future land development applications located on this parcel. Withdrawing applications will not generally affect future applications. Planning Services Staff is aware of the difficulty and associated delays in meeting the Conditions of Approval normally associated with land use cases, and we are willing to work with you in completing your request. Please check one of the following boxes: ❑ I am the applicant of the approved Recorded Exemption and would like to continue with it. Please contact me at ( ) - at your earliest convenience. • 411 ❑ I am the applicant of the approved Recorded Exemption and would like to withdraw it. Please accept my letter attached which stated I would like to withdraw AmRE-1215. ❑ I am the current owner and would like to continue with the Recorded Exemption. Please contact me at ( ) - at your earliest convenience. ❑ I am the current owner and would like to withdraw the Recorded Exemption. Please accept my letter attached which states I would like to withdraw AmRE-1215. If you need any further information, please feel free to contact me at the abote address, telephone number or e-mail address. Sincerely, U.S. Postal ServiceTM m CERTIFIED MA RECEIPT - (Domestic Mail Only;No ranee Coverage Provided) Roger Caruso F r•elivery lnf rmatf•n vlslt•ur we.site etwww.us.s.c ms Planner I m ui Postage $ ) L-5 Certified Fee 10 . 507 Postmark �. 7 Return Receipt Fee Here (Endorsement Required) jg Restricted Delivery Required) Fee ,� (Endorsement Required) mg q(e. 04— H Total Postage&Fees $ n I • Sent To 2 L c '7v 1—i c,To Ip4 rVP-Q (s- -ghee(Apt.No.; O or e Box No. IU5 7 j 'C K I O (� Orly,Stare,ZIP+4 W (nS co O p osS7 PS Form 3800.June 2002 ee Re er -for I tr ti. U.S. Postal Service.. .n CERTIFIED MAa RECEIPT m (Domestic Mail Only;No ranee Coverage Provided) '-R F•r•eliveryiM.rmatl.nvlsit urwe•siteatwww.es•s.q•Irl® m V32 to Postage $ r 7 Certified Fee p Postmark O Return Receipt Fee Here P., (Endorsement Required) 1141 lie it p Restricted Delivery Feejg - (Endorsement Required) a T9 Total Postage&Fees $ 111 Sent To Hi° pp n 1Jar nlAlan( ^• ~ or ciieet Ant.yOBoe,ZtP 11 b J'� (c lb I�� CIE City,State,ZlPa4� . 4 i" /U g p �-j S L) I S_ l • DEPARTMENT OF PLANNING SERVICES NORTH OFFICE 918 10TH Street GREELEY, CO 80631 C. PHONE (970) 353-6100, Ext. 3540 WIID FAX: (970) 304-6498 COLORADO October 10, 2006 Ron Werner 46674 CR 20 y1 Wiggins CO 80654 Re: Conditions of Approval: AmRE-1215 Dear Applicant: On, January 8, 1998 your application for a recorded exemption was administratively approved by the Weld County Department of Planning Services with specific Conditions of Approval. One of the required Conditions of Approval grants applicants sixty(60) days to submit a Mylar Plat. Should you choose not to complete the recorded exemption process and provide the required Mylar Plat, the Department of Planning Services will need to be notified in writing of your decision. If you do not formally withdraw your application and/or are unable to meet the Conditions of Approval, your case will be scheduled for a hearing before the Weld County Board of County Commissioners. Planning Staff will be recommending denial or your request at this hearing. If your application is denied by the Board of County Commissioners, the decision could affect future land development applications located on this parcel. Withdrawing applications will not generally affect future applications. Planning Services Staff is aware of the difficulty and associated delays in meeting the Conditions of Approval normally associated with land use cases, and is willing to work with you in completing your request. Please notify the Department of Planning Services, in writing, within 10 working days of your decision. Planning Services Staff can be contacted at the above address or phone number. Sincerely, The Department of Planning Services DEPARTMENT OF PLANNING SERVICES NORTH OFFICE 918 10TH Street WQIII16e , CO 80631 PHONE: (970) 33 GREELEY 3-611 O, Exxt. 3540 FAX: (970)304-6498 COLORADO May 31, 2006 Ron Werner 46674 CR 20 Wiggins CO 80654 Re: Conditions of Approval: AmRE-1215 Dear Applicant: On, January 8, 1998 your County Department of Pla �Y� tion was administratively approved by the Weld lions of Approval. One of the required Conditit sixty(60) days to submit a Mylar Plat. Should you choose not to complete and provide the required Mylar Plat, the Department of Planning Sery .. writing of your decision. If you do not formally withdraw ,_.,,,ation and/or are unable to meet the Conditions of Approval, your case will be scheduled for a he..i ing before the Weld County Board of County Commissioners. Planning Staff will be recommending denial or your request at this hearing. If your application is denied by the Board of County Commissioners, the decision could affect future land development applications located on this parcel. Withdrawing applications will not generally affect future applications. Planning Services Staff is aware of the difficulty and associated delays in meeting the Conditions of Approval normally associated with land use cases, and is willing to work with you in completing your request. Please notify the Department of Planning Services, in writing, within 10 working days of your decision. Planning Services Staff can be contacted at the above address or phone number. Sincerely, The Department of Planning Services to /M/� , 8,2 p liil Co e 14 8 e IS a t ttl I,ill RI c S f gloNn 00 � — ssv10 isaId aaiaosaad - J — Tr in ca 0 i4 o ! . c 1,"4L� c N- _rn m 0.3. A itii cn C_ C M /w� ^^ vv co a ! 033A13✓3a >.- 1-7. co " 90016X N(lf ow e 00 Si 331330 A313389 3 0� O }uawpedaa 8uiuueld Iquno3 r:cm r a. . 4:i col ( ji DEPARTMENT OF PLANNING SERVICES , NORTH OFFICE 918 10TH Street GREELEY, CO 80631 C. PHONE (970) 353-6100, Ext. 3540 FAX: (970)304-6498 COLORADO May 31, 2006 Ron Werner 46674 CR 20 Wiggins CO 80654 Re: Conditions of Approval: AmRE-1215 Dear Applicant: On, January 8, 1998 your application for a recorded exemption was administratively approved by the Weld County Department of Planning Services with specific Conditions of Approval. One of the required Conditions of Approval grants applicants sixty(60)days to submit a Mylar Plat. Should you choose not to complete the recorded exemption process and provide the required Mylar Plat, the Department of Planning Services will need to be notified in writing of your decision. If you do not formally withdraw your application and/or are unable to meet the Conditions of Approval, your case will be scheduled for a hearing before the Weld County Board of County Commissioners. Planning Staff will be recommending denial or your request at this hearing. If your application is denied by the Board of County Commissioners, the decision could affect future land development applications located on this parcel. Withdrawing applications will not generally affect future applications. Planning Services Staff is aware of the difficulty and associated delays in meeting the Conditions of Approval normally associated with land use cases, and is willing to work with you in completing your request. Please notify the Department of Planning Services, in writing, within 10 working days of your decision. Planning Services Staff can be contacted at the above address or phone number. Sincerely, The Departr--' -" ----'-- ------- /a. 19 a° o000 l7 M h /e 5 Js �l� ci /q'1 I 129 .4o2.DODl9 Sim yds?6 c/u47j(jui • Kit DEPARTMENT OF PLANNING SERVICES 1555 N. 17`h AVENUE GREELEY, COLORADO 80631 IWEBSITE: www.co.weld.co.us C. PHONE (970) 353-6100, EXT. 3540 FAX (970) 304-6498 COLORADO July 25, 2003 Ron Werner 46674 CR 20 Wiggins CO 80654 Re: Conditions of Approval: AmRE-1215 Dear Applicant: On January 8, 1998, your application for an amended recorded exemption was administratively approved by the Weld County Department of Planning Services with specific Conditions of Approval. One of the required Conditions of Approval grants applicants sixty(60)days to submit a Mylar Plat. Should you choose not to complete the amended recorded exemption process and provide the required Mylar Plat, the Department of Planning Services will need to be notified in writing of your decision. If you do not formally withdraw your application and/or are unable to meet the Conditions of Approval, your case will be scheduled for a hearing before the Weld County Board of County Commissioners. Planning Staff will be recommending denial or your request at this hearing. If your application is denied by the Board of County Commissioners, the decision could affect future land development applications located on this parcel. Withdrawing applications will not generally affect future applications. Planning Services Staff is aware of the difficulty and associated delays in meeting the Conditions of Approval normally associated with land use cases, and is willing to work with you in completing your request. Please notify the Department of Planning Services, in writing, within 10 working days of your decision. Planning Services Staff can be contacted at the above address or phone number. Sincerely, The Department of Planning Services S rs DEPARTMENT OF PLANNING SERVICES PHONE (970) 353-6100, EXT.3540 FAX (970) 352-6312 C. WELD COUNTY1400 N. 17TH AVENUE GREELEY, COLORADO 8 631 COLORADO October 25, 1999 Ron Werner 46674 WCR 20 Wiggins, CO 80654 Dear Mr. Werner, On November 25, 1997, you applied for Amended Recorded Exemption 1215. Amended Recorded Exemption 1215 is pending in our office. When we last spoke you were taking the necessary steps to obtain the surveyors plat that was required to finalize this amendment. I spoke to Douglas Hoss of American Land Surveyors on October 22, 1999. He indicated that the plat was finished and sent to you. Submitting this survey to the Weld County Planning Department will finalize Amended Recorded Exemption 1215 and fix the existing illegal land split. We are well aware of the difficulty in meeting conditions associated with land use cases, and are willing to work with all of our clients. Planning Staff will be available to answer any questions and concerns you have. J44/ a"7 (,l Sheri Lockman Planner M/99 re2A . kharrUIL CALLA to- OLC0L a.12., eke, ,1 2JO1)- futaRritotr th-t v EE, 11,e_ hew_ kuiitt ouuti,a c tom. ou / 360 °eta. & Lyt - 6fr tt4tetmt Unt& �a- £L ' t /f/uym 360 --t.- 9-01 ! C CtjefwWt cam. /ley t2i2.4A.ti {fiat duL aperuniztAnyn-tcam. . , .6. rce. & Gam, firr p -geirit butik pcdi .mot : d ha, g 12 C{hJ c kyrww tut ureThil It+ hunt fife-aZ d 2-/Z-e- g / Z2 tc�.,&neA, 9, c , (c)h,o z /Ze ‘ilaiLhoe hew 17/2 wcut &etuia hz ewQ.rc. !.0 w-�.ic.e f. " 4,keyyrt,-itemhxe_del/nted clown ay he-t 1okeLL y " mom cc � z Vcc-!y. Styr anyfid- o a. , r1,e 61/0-061/0-0 /hit ,�. wvziY�,ru� -Utz 1`� • • cteisie , DEPARTMENT OF PLANNING SERVICES PHONE (970) 353-6100, EXT.3540 FAX (970) 352-6312 C. WELD COUNTYGREECOLORADO DEM INISTRATIVE OFFICES 47THVENUE COLORADO January 18, 1999 Harold and Beverly Neal 46508 WCR 18 Wiggins, CO 80654 Dear Mr and Mrs Neal, On November 25, 1997, you applied for amended recorded exemption 1215. Amended Recorded Exemption 1215 was conditionally approved by planning staff on January 8, 1998. As a criteria of this approval you were given sixty (60) days to meet the conditions and record the mylar. To date, we have not been made aware of any attempts to meet these conditions. If you are having difficulty in satisfying these conditions, or should you wish not to proceed with this amended recorded exemption, then the Department of Planning Services will need to be notified in writing of your decision. We are well aware of the difficulty in meeting conditions associated with land use cases ,and are willing to work with all of our clients. I have included a copy of the staff recommendation for your review, and will be available to answer any questions and concerns you have. If I do not hear from you within 30 days this case will become inactive. (�UOte Sheri Lockman Planner Enc. • DEPARTMENT OF PLANNING SERVICES rat ct re4ecNi Weld County Administrative Offices 1400 N. 17th Avenue Greeley, 80631 35 Phone(970) 353-610-610 0,, Ext. 3540 Fax(970) 352-6312 C. COLORADO November 26, 1997 Harold and Beverly Neal 46508 WCR 18 Wiggins, CO 80654 Subject: AmRE-1215 -W2NE4 of Section 26,T2N, R61W of the 6th P.M.,Weld County, Colorado. Dear Mr. and Mrs. Neal: Your recorded exemption application is being processed. If it is determined that the application meets the approval criteria of the Weld County Subdivision Ordinance, you will be notified that the recorded exemption is approved. If the staff determines that the application does not meet the approval criteria,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. If you have any questions concerning this matter, please call me. Sincerely, Sharii L. Eastin Current Planner SLE/wi C) OS / r ° . .L. 7, /9'97 �1^ f 05)}ch /O !r✓ Gjah1 FY) t)co� c�2ri-, 2e Z,eaa,e. cob ` CC y > L to f ld L e, a_ ifila 71ziAb. c - A° J 91 a. 6k,Q Lem 18-124,c. clat_ L , ci_ be pGiT b`- ,// /9-9'7 . 7izi o1 �-94 1-i.„ r1 ..„-) d W 0. s co vQ42 /L A/v. Ctiw -e o -t'o O sy_e,, -z-,'o h x L/a /S w 4,4 eiA 6.—e�a. 1 /.e e,21--(2-_ CfJ✓v2-e--1 1 / (3 0`-4 r Gam, cN e1 y e l -2 tee- cie-dp-e,A C /a /5 4yez.-Q Tic; I 7/ /orris-e_ / le-rK me r A-ss-I2/Y , cd/ /L<-ss/< c__ a r PP- AX1920 1/-e-- (a( L ,,,,,,o,--,/,,„„tz, y 7//,_ J4 — _e C /J_/ 5 (. n of a/1 v-e)d Weld County Planning Dc,l. NOV 1 419°7 i.,//f-,V-7-z-- ,mss I// "7/ 9-7 , WELD COUNTY Qr RTMENT OF PLANNING SERVICES/BeIG INSPECTION "" CITIZEN INQUIRY FORM 14 N. 17TH AVENUE, GREELEY, CO 80631 PHONE: (970) 353-6100 EXT. 3540 FAX: (970) 352-6312 ❑ TELEPHONE pi OFFICE FIRST INQUIRY? U YES VNO DATE: / ) - J g cl- rl NAME: / _,A9-'^' (_,(__Q-g_A__/-t_LA_J PHONE: ADDRESS: TYPE OF INQUIRY: 7 / LI MHZP ❑ SKETCH PLAN ❑ ZPMH ❑ PRELIMINARY PLAN ❑ RE ❑ FINAL PLAT / r, • : f " ` - AMENDED RE Li RESUBDIVISION ❑ SE ❑ FHDP ❑ AMENDED SE ❑ GHDP l '' ' -7,61 J " ❑ SITE PLAN REVIEW ❑ USR ❑ REZONING ❑ AMENDED USR ❑ PUD SKETCH PLAN ❑ USR MINING ❑ PUD DISTRICT ❑ USR MAJOR FACILITY ❑ PUD FINAL PLAT ❑ USR DISPOSAL SITE sy, PERSONNEL .6)21-thani Eastin ❑ Gloria Dunn ❑ Todd Hodges ❑Julie Chester ❑ Scott Ballstadt ❑ Kerri Keithley ❑ Ed Stoner ❑ Roger Vigil ❑ David Sprague ❑ Johnny Roberts ❑ Jeff Reif ❑George Carroll ❑ Dennis Renley ❑ Monica Daniels-Mika ❑ ITEMS DISCUSSED: S p fi- -J ,__( _,1 if ,D-""' l" ' c_ed_ _cieJ , -11-- c ary-Lo_ngLi ` Q6. la-L .ma---- '1/ ' _-11-Li kt-h-9-t,a0O h, w •-±---P ki3i LAC,n-L-c) ' �t ltri--, t Ey-c1.r-- --/1.t-4'-C' t A_AJ-(A - /C--(-) dc) 3_16)1' kt_i_C 1'ttt UG _; ,t.aLiaiD % , A,(_ JO-) k1-t-t i.OL.1-raft, GDYc; ,i(-91-• Tf o ‘-itJn J`J 1/4ax) ,a./ `d oa /C - ✓ztad rtH ia2 -Trz-c,) (1g t? f Time Spent / l Staff Memberslnitials Z/ citizen , i-de ' jay/ h 1153 it 02202819 U1/16 90 15 : 7.0 . 00 1/002 ‘..- -ea=- o�893 F 1554 Y ANN FEUERSTEIN ERK & r:CORDER WELD CO, CO ,IIIMM=ME AMIN - " RECORDED EXEMPTION NO. 1299-26 - I - RE 1215 . SOULS _______-- 2161.16' _ _ _ 3087.91 435.6' NW COR. County Rd. 18 S NE COR. SEC. 26 SEC. 26 /T2N, R6IW 435.6 T2N, R6IW • LOT IAI 2 ACRES ,;U/4', to a) CC LOT I I BI 318 A RES • . 8 I (NOMI AU _ _ F _ _ 4 W I/4 COR. I EI/4 COR. SEC. 26 SEC. 26 T2N, R6IW T2N; R6IW • N , I NOTES: 1) Section corners found were only observed as tops • • r of .bars. Frozen conditions prevented further examination. Lailil a 0 4�, 8�, 16Q0• 2) South, west, and east lines of Section 26 were not measured, as not being needed to establish Lot A. SCALE, r=800' 3) Nominal acre value of Lot B was used due to O Sec. Cor 115 Bar Found information given in note s2. • Sec. I/4 Cor. 4) All corners of Lot A are 90" angles. • Cor. 414 Bar W/ Cap Set LOT AL J Count/ Rd. 16 ' Lot A = 2.0 acres Lot B = 318.0 acres I Total = 320.0 acres M 2 6 if J PURPORTED COPY 1"=2000' PAGE I OF 2 • FTic. ' Jay/ ,, 1253 a U22U2bi9 ul/1 )6 15 : 0 1.0 . 00 1/002 F 1554 Y ANN FEUERSTEIN ERIK & RECORDER WELD CO, CO RECORDED EXEMPTION N0. I299-26 - I - RE 1215 i ArrEras 2161 1 _ _ 3487.91 _ 4 NW COR. County Rd IS I : 0 ; NE COR. SEC. 26 - SEC. 26 T2N, R6IW • 4s T2N, R6IW • p/4' Ln m m • v -o . cc T S U p� 8 `` P' \ — •— W 1/4 COR. ( EI/4 COR. SEC. 26 LOT b SEC. 26 T2N, R61W r &4.,, T2N, R6IW H4 . I I NOTES: 1) Section corners found were only observed as tops a 1 of bars. Frozen conditions prevented further examination. 1 _a o 400 800 ��' 2) South, west, and east lines of Section 26 were not measured, as not being needed to establish Lot A. SCALE, 15=8001 3) Nominal acre value of Lot B was used due to O Sec. Cor. #5 Bar Found information given in note r2. • Sec. V4 Car. 4) All corners of Lot A are 90' angles, • Cor. $1 4 Bar W/ Cap Set LOT A J Count " Rd. 18 L Lot A = 2.0 acres Lot B = 318.0 acres Total = 320.0 acres 0 M ::: :_181✓t:Icncii_: :: :::::::::::::::: 26 i' U PURPORTED COPY I"=2000' PAGE I OF 2 APPLICATION FL.OVf�'SHEET CASE#AmRE-1215 APPLICANT: Harold Neal REQUEST: Amended Recorded Exemption LEGAL: W2NE4 of Section 26,T2N, R61W of the 6th P.M., Weld County, Colorado P.M.-Weld County, CO LOCATION: South of and adjacent to WCR 18;Approximately 1/4 mile west of WCR 95 PARCEL NUMBER: 702 91 _24. .2 actG /q / /29902- a000/7 Date By Application Received Nov. 25, 1997 Shani L. Eastin Application Completed Nov. 25, 1997 Shani L. Eastin Referrals listed Nov.25, 1997 Shani L. Eastin File assembled I I acq—1 j Letter to applicant mailed 11P(o Q 7 W� Vicinity map prepared Referrals mailed I I -i7 LOC Chaindexed I (.- Co-C17 W.1) Field check by DPS staff Administrative Review decision: Cl �? �' -/1 `,•111-1 History card completed Date By COMMISSIONER HEARING DATE Surrounding property owners notified Air photo and maps prepared /7/fir-7 CC action: CC resolution received History card completed Recorded on maps and filed 7 02--07 Overlay Districts Zoning Airport Yes No Geologic Yes No 'z Flood Hazard Yes No 17" • I I ": a n 2; File F Ios Sheet { ,�c,i:: tt g:>.,4i,� *I I 17 C • /aZhl t /A 71, ',42 T/C d, G GGyYL JUE. di i i t't 1& M,-fit . , L�` � d.e-c cet , 6()3 .45 -/s3 ) (3 �� &-d LL e0 ikk,O7. 1k r 11_ 7.1�. 'a � Oz /""z n 1- /l a').41 .42.kkill1, I, a 40.14,i,d4 il A(,), _lice,:n Liej AL 11K)L f,!).2224-Li, . E I I I I I j EPARTMENT OF PLANNING SERVICES Weld County Admill,rative Offices, 1400 N. 17th Avenue, GreeWColorado 80631 Phone (970) 353-6100, Ext. 3540 -Fax# (970) 352-6312 APPLICATION FOR RECORDED EXEMPTION Application Fee IYbr--- Receipt Number O I `5 Ce 4' Case Number /V/ L I I Recording Fee Receipt Number Zoning District Application Checked By Planner Assigned to Case /,k_i TO BE COMPLETED BY APPLICANT: (Print or type only except for required signatures). I (we), the undersigned hereby request that the following described property be designated a recorded exemption by the Weld County Board of County Commissioners. Legal Description: I Ni F R f a! y� Total Acreage: 0 Zoning Akot, Parcel Number: (12 digit number- found on Tax I.D. Information or obtained at the Assessor's Office). Has this property been divided from or had divide4from it any other property since August 30, 1972? Yes V No Is this parcel of land under consideration the total pontiguous land owned by the applicant? Yes V No Does the parcel of land under consideration lie in any of the following Overlay Districts? Flood Hazard: Yes_ No X ; Airport: Yes No $ ; Geological Hazard: Yes_ No)C Mt-OWNERS OF P OPERTY Name: -A1( Home Phone# yp Z7/51Gork Phone#' r�o // Address: lb stc cu C• Pd. /5' City/State/Zip Code 6v-cl € YCU Coll/ Applicant or Authorized Agent: Row WbPryCR Phone 97D' `1$3'71)1 Address: `&6 111 IBC R 2.o City/State/Zip Code (k ;Qc;nS Co , se) 651 Name: Home Phone# Work Phone# 920- c13- 73a$ Address: City/State/Zip Code Larger Parcel Smaller Parcel Smaller Parcel Applicable only for 3,lot Recorded Exemption Water Source Wen WE �I Type of Sewer Septic. S (OA_ Proposed Use 49/ices kles,c e Hes'clx,,,ccc Acreage 7 8 i a t Existing Dwellings Yes or No 7Es YrES Existing Dwellings Address (if applicable): Larger Parcel ",/(05O$ L'. C. Rd Iz Smaller Parcel n5-76 tock / $ Smaller Parcel (applicable only for 3-lot Recorded Exemption) I hereby state that all statements, proposals,or plans submitted with this application are true and correct to the best of m VgiU ltl)Uf1tV Planning Dept. �A��� Rev: 1-27-97 ign ture: Owner or Author ed Agent NOV 2 5 1997 REC IVED 5 /� /r /. f1 See PeRm ; Ly✓c /vdcc( P. 11/0 3 R i qct lion) .`) C 11 �, C _ ( sec -5 ' c Peg IT1t Q ,aic/red ) �xjs /I o? •/-onz -• .3t PaPeel /) /es,'cte,.0ce (2 /lcnes) P4 Age 1 /3. /les ,e!co/cc llaaµq>;oun,a f L,,I,esf«.K ( 179s ) f. ... 1 / Yews fo�,4eR S /fc.ti/ ,ft ?AOvr� /Oj�CI<�S /,v, lcl,n� S-fie$ aw / • %:,N /loos,`. I- Shop /- l7tlan& CM? ) Nue,,c4ous oufvv /-cd ev pan) ( /1)0 Cov)s ) I- iA 4 o,.i ,'^7 Eck S✓ C/vurnkROus P'ys ) ! ' to geld tickle( J(ec oil/cial (11€44/0i, 1y244a'/, 6"/ ot /� CS � r�n,^.;�. e ; /0a S1 /Ic$iYlo✓ce afi1/4w el /'A/ M y/Q0vr1.ed IA Ale I i,I✓a 51'Oc e 4 M/)Rouero,enit S -1 A oce:tecl n,o 1.4-414( AC/ /I p✓ Sovttieas / Coon,/ c, rc(' U- C , />d, `1. FD4CtQET o.C — each f=p1 '/ .26- R `cL. rJl,� „� Any,( �e5-,rt/rr�ces Ir/ 'l Yv6 �• (o E '% rvv .Co' 113/4 ? : all 5'f 12vc /vI1t c/o s-,ee1 sef,4tc/c /"1v,2C 1,A,) 5-h /Pr.? F,co,•-• , 6. or)3 eR Uti'6iai� ( 4Sk',044.40 y '. Nv /O: Piloposct( Jytec+s a // lac?v,'Rmoils to /°/aws /l. /2RL 4 r16 n // l , n io.,t c/ • ,z ,i/' 13 11 f/I (a /Rrnely 6 is tr'r+5 &Am awl urern 9404,44 f • • oe1\ tS ur `` Ww v c6 Z 2 V1 �S d of 4 3 4 `'_ vet cc `bW CIL O -9 a 'Se tJ cl Z `,3 c� ' Z au r7 'f adoS • '( i\ 1.1 • • JJJ J 1 1 t \ v\ o Q ?till' - U 2 -72/77.0-c/ L O---n-lt`l vt-? • (ii 1)(1._‘,10---97 Z-{i - 1 a REFERRAL LIST • NAME: Harold Neal CASE NUMBER: AmRE-1215 REFERRALS SENT: November 26, 1997 REFERRALS TO BE RECEIVED BY: December 18, 1997 COUNTY TOWNS and CITIES Attorney _Ault X Health Department _Brighton Extension Service _Berthoud Emergency Management Office _Dacono Sheriff's Office _Eaton X Public Works _Erie Housing Authority _Evans Airport Authority _Firestone Building Inspection Fort Lupton Frederick TS ATE Garden City Division of Water Resources Gilcrest Geological Survey _Greeley Department of Health _Grover Department of Transportation Hudson Historical Society Johnstown Water Conservation Board Keenesburg Oil and Gas Conservation Commission _Kersey La Salle FIRE DISTRICTS _Lochbuie Ault F-1 _Longmont Berthoud F-2 _Mead Briggsdale F-24 Milliken Brighton F-3 _New Raymer _Eaton F-4 _Northglenn Fort Lupton F-5 _Nunn _Galeton F-6 _Pierce Hudson F-7 _Platteville Johnstown F-8 _Severance La Salle F-9 _Thornton _Mountain View F-10 _Windsor Milliken F-11 _Nunn F-12 COUNTIES Pawnee F-22 _Adams _Platteville F-13 _Boulder Platte Valley F-14 Larimer Poudre Valley F-15 _Raymer F-2 FEDERAL GOVERNMENT AGENCIES X Southeast Weld F-16 _US Army Corps of Engineers _Windsor/Severance F-17 _USDA-APHIS Veterinary Service _Wiggins F-18 _Federal Aviation Administration Western Hills F-20 _Federal Communication Commission OTHER SOIL CONSERVATION DISTRICTS Central Colo.Water Conservancy Dist. _Brighton Panhandle Eastern Pipe Line Co. _Fort Collins Tri-Area Planning Commission _Greeley X Longmont West Adams COMMISSION/BOARD MEMBER RECEIVED DEC 0 1 1997 0 'Ne1d CnUntN Flans g W eld County Referral 1 CpE� p &1g97 November 26, 1997 COLORADO r� The Weld County Department of Planning Services has received the following item for review: Applicant Harold Neal Case Number AmRE-1215 Please Reply By December 18, 1997 Planner Shani L. Eastin Project Amended Recorded Exemption Legal W2NE4 of Section 26,T2N, R61W of the 6th P.M., Weld County, Colorado. Location South of and adjacent to Weld County Road 18; approximately 1/4 mile west of Weld County Road 95 Parcel Number 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 Current Planner associated with the request. U We have reviewed the request and find that it does/does not comply with our Comprehensive Plan U We have reviewed the request and find no conflicts with our interests. O• See attached letter. Comments: 1/o Aec rss SNrrr 47Tp cWrn Signature Agency eta( Date OWeld County Planning Dept. O1400 N.17th Ave.Greeley,CO.80631 4(970)353-6100 ext.3540 O(970)352-6312 tax • 4' •44 MEMORAN! UM TO: Shani Eastin, Current Planner DATE: December 3, 1997 III D C 6,FROM: Don Carroll, Project Administrator at COLORADO SUBJECT: AmRE-1215; Harold Neal The Weld County Public Works Department has reviewed this proposal; the following requirements are recommended to be a part of any approval: COMMENTS: I spoke with Ron Werner, the applicant's representative. He has verified that the two-acre split will be at 46576 WCR 18. This will be identified as Parcel A. REQUIREMENTS: Lot A, the two-acre parcel has an existing house and structures in place. The applicant should utilize the existing residential access, no additional accesses will be granted. For Lot B, the 78-acre parcel, the applicant should utilize the residential/agricultural accesses to this parcel. No additional accesses will be granted. cc: Commissioner Harbert AmRE-1215 Planning Dept. VV61C1 county plan10 DEC 0 41997 • • Road File# IS RE: A M - 2E 1215 Other Case No. APPENDIX B WELD COUNTY ROAD ACCESS INFORMATION SHEET Weld County Public Works Department Date: _ / a — 2- - q7 933 North 11th Avenue,P.O. Box 758, Greeley,CO 80632 Phone: (970)356-4000, Ext. 3750 Fax: (970)352-2868 1. Applicant Name VIA Ro L D N EA I.—. Phone 453 - &a r 4- Address 4c.5 o p, kA.) c re- l 8 City it c tit°i State Ca Zip gO„.54- 2. Address or location of access Section G Township . - Range Co / Subdivision Block Lot Weld County Road # /8 Side of Road ea 44, Distance from nearest intersection .mot/ e t * Fir=m. (1C: 3. Is there an existing access to the property? Yes X No # of accesses 3 4. Proposed Use: id Permanent A Residential/Agricultural ❑ Industrial ❑ Temporary ❑ Subdivision ❑ Commercial ❑ Other *********************************************************************************************************** 5. Site Sketch j c Legend for Access Description: 4 AGR = Agricultural RES = Residential -dca O&G= Oil&Gas v.Ca. 8 D.R. = Ditch Road lido = House = Shed or Outbuilding m 4. 9 e v r a *********************************************************************************************************** OFFICE USE ONLY: Road 18 ADT I Date Accidents Date Road as ADT Date Accidents Date Drainage Requirement Culvert Size Length Special Conditions *********************************************************************************************************** ❑ Installation authorized ❑ Information Insufficient Reviewed By: Title: m:wpfiles\engineer\access i 14114 " N AI) 2 C t".•O1. �.` v its � 'y u, 2 I •1 r s=I \ , -aill 2.1t° V1 0 i z,,) 1,� n a / t4 r?N , c_"Ovsi"- C . p 1- t �/l a p , 1 • • flf \\I\ MEMORANDUM TO: Shani L. Eastin, W.C. Planning DATE: December 15, 1997 C FROM: Sheble McConnellogue, W.C.. Health Dept. CASE NO.: AMRE-1215 NAME: Neal, Harold COLORADO Environmental Protection Services has reviewed this proposal; the following conditions are recommended to be part of any approval: 1) A Weld County Septic Permit is required for the proposed home septic system and shall be installed according to the Weld County Individual Sewage Disposal Regulations. The proposed acreage for Lot A currently does not meet current Weld County Health Department policy. We would encourage the applicant to increase the acreage for Lot A to two and one half acres(2.5). However, in the event the applicant cannot or chooses not to increase the lot size, please place the following note on the plat. Note: Future development may necessitate a larger lot(Lot A)than what is displayed on the plat. In addition, a larger lot would provide additional dilution and attenuation of sewage wastes which may be beneficial to the environment. SM/vh3184 Weld County Planning Dept. JAN 0 9 1998 RECEIVED EIVED — D L, ,,,,_ o i.2 -s-�7 T It Weld County Planning Dept. Weld County Referral JAN 0 5 1998 VIID' November 26, 1997 COLORADO RECEIVED The Weld County Department of Planning Services has received the following item for review: Applicant Harold Neal Case Number AmRE-1215 r P/ease Reply By December 18, 1997 Planner Shani L. Eastin Project Amended Recorded Exemption Legal W2NE4 of Section 26,T2N, R61W of the 6th P.M.,Weld County, Colorado. Location South of and adjacent to Weld County Road 18; approximately 1/4 mile west of Weld County Road 95 Parcel Number 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 Current Planner associated with the request. U We have reviewed the request and find that it does/does not comply with our Comprehensive Plan Q, We have reviewed the request and find no conflicts with our interests. 0--See attached letter. Comments: Signature 4,4--; /..or 5'/277 / Agency i 5.c k2 get, T. C, b. Date +Weld County Planning Dept. +1400 N. 17th Ave.Greeley,CO.80631 +(970)353-6100 ext.3540 +(970)352-6312 fax • • SOUTHEAST WELD NATURAL RESOURCES 57 W. BROMLEY LANE SOIL CONSERVATION CONSERVATION BRIGHTON, CO 80601 DISTRICT SERVICE (303 ) 659-7004 *************************************************:rte********* December 29 , 1997 Weld County Planning Department 1400 N. 17th Avenue Greeley, CO 80631 We have reviewed the application for an Amended Recorded Exemption, Case # AmRE-1215 , for Harold Neal, and have the following concerns : SOIL LIMITATIONS **************** All of the soils located here have severe limitations for the development of septic systems because of poor filter materials . SOIL EROSION ************ The Vona loamy sands and sandy loams are considered highly erodible soils . For this reason, any construction activities need to be limited to impact as few acres as possible . If soil erosion is observed during construction, silt fences can be constructed to prevent the soil from blowing. Thank you for giving us the opportunity to comment on this matter. If you have any questions or need comments on another application, please contact us at the above address . Sincerely, _ John Hagen, President Board of Supervisors • i -- CERTIFICATE OF CONVEYANCES WELD COUNTY STATE OF COLORADO DEPARTMENT OF PLANNING SERVICES COUNTY OF WELD The Security Title Guaranty TITLE INSURANCE or ABSTRACT COMPANY 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: The North Half of Section 26, Township 2 North, Range 61 West of the 6th P.M. , County of Weld, State of Colorado • CONVEYANCES (if none appear, so state): Reception No. 1497959 ,Book 576 Reception No. • ,Book Reception No. ,Book Reception No. ,Book Reception No. ,Book Reception No. ,Book Reception No. Book Reception No. ,Book 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 Security Title Guaranty COMPANY, is hereby limited to the fee paid for this Certificate. In Witness Whereof, Security Title Guaranty COMPANY, has caused this certificate to be signed by its proper officer this 18th day of November , 19 97 , at 8:00 a.m.. i9 LCrxtrF§i°Wt11I ya 00 10th St.,#302 Greeley, CO 80631 Company /� By: !�U Id/L_. Authorized S1ignature 6 57G K r is -1�,,..,_e_._.DEC 12 1966_ • c.• DIED r a - DOW All 1® IT Tffi PRIIRa Rehabilitation , that Colorado Rural Rehabitation :- Corporation, a Colorado corporation, of 1.575 Shaman Street, Denver, Colorado, far and in consideration a sal the s of $10.00 d other good aMairr vb1s consideration, to it in Mad Raid, the receipt of which ;x•' ^ a-se al • is hereby .elorevledcd sells, hereby sel a cavay Barad s to Hard L. leaf sad w Beverly L. Taal Meld County, Colorado, as joint tent. with fall _ p rights of survivorship, the followingde;cribd real property situated .r: p Beverlyin Meld County, Colorado to.wit: Townshi e:', ?'� r. `��l p 2, North, Pange 61 West: ^' denim 25: llir (Parcel 1) ma • s...26: 24, except om-bnlf of ell all., w ot her ar 2; 0•0110010: D41'}, D)f, (Parcel 3) Section 15: Illt4 iC ,(Parcel 3) Together with two turbine pumps an two electric rotors used in 'a correction with the irrigation wells located on Parcel/3. A Together with all appurtenances sod grantor •arrants the title Xe to tea same amalnst all end ever/ person or persons leldblly claleIng or to Claim the whale or any part thereof by, through or liMe the grantor, subject to the following: . I I i' 1966 Tarn due sal payable la 3.967. 1 Nights of way or oche easements or rights a greeted or reserved • : . by instruments of record or asnow misting ca said ,raise.. .. Age and all rights, reservations, m limitations, m usadon is in oditlo , s Cs,- exceptions ctained structs of regal atlas In A ray relate to or burden the ..sane described premises. ". IS- Possessory rights, if say, of third Partin. CIES icon, Colorado Mural lehulitatica Corporation has I e ab c Etq ),te cm corporate acme to be hereunto eub d ecrib by its President i p:. k s berporate seal to be hereunto affixed, attested by its Secretary, 1 ?'. . /14y,of /amber, 1966. - e,.' .4(...7:a I, COwnDQ lgnttl. TSATLITAII C aTna � :. A �j�/ I '1st r c • Rte Lt f' nit_ /+rts j�. .' Y ' 16.2E Ao/ . 'I�y�• — •i3,fi •t�.Sin�~i t BTATS OP COLORADO i`••.,....... to. .2+ ss. b° lI, CITE AND CCU'S= CP DISYIII ) ^+... 61: The fat-oscine instrument w acknowledged before ens this 21st day of November, 1966, by iliac Miller as President sod I. I. Paul as secretary of Colorado Rental Rehabilitation Corporation, a corporation. Nitsess ay head And official s r 1 lc Donal..im expiresg— /17- /974 1.75-a. ()ILL" < 1 \ 1 i �R"e 576 • • Ir 66 se,„.,—�..e__P DEC 121966 lac u,.+. - Spew.,s«vd. DIED —I I • c KNOW ALL NEN EC T884S PRESENTS, that Colorado Rural Rehabilitation w J Corporation, a Colorado corporation, of 1575 Shemin Street, Dearer, Colorado, for and in consideration of the sue of $10.00 and other geed and valuable consideration, to It in head paid, the receipt of which ... - v i. acknowledged,hereby hereby sells and corny, to Harold L. Neal. and r RI ,y Beverly L. Neal of Weld County, Colorado, as joint tenants with fall RI c rights of survivorship, the following described real property situated 4: - o in Weld County, Colorado to-wit: •. ,v Township 2, North, Range 61 Wert: tee w • `" Section.-. �2`: N11k (Parcel 1) :I, ..• 'V _Section 26: Si, except one-half of all oil, gas and other d • _ o — minerals (Parcel 2) of Section ib: Nig+, Sates&, Yap$ (Parcel 3) ,,r - Section 15: Ns1N1$ (Parcel 3) bed Together with tvo turbine plops and two electric motors and in usand • connection with the irrigation wells located on Parcel #3. 4a: Together with all appurtcvanees and grantor warrants the title to the same against all and every person or persons lawfully claiming Y; or to claim the whole or any part thereof by, through or under the " grantor, subject to the following: ./ 1966 Taxes due red e' payable in 1967. s, + Rights of wey or other easements or rights as granted or reserved se by instruments of record or as now existing on said prises. S Any and all rights, ed reservations, limitations, conditions, and • exceptions contain in instrucsnts of record which in any sr' • way relate to or burden the above described praises. , • Possessory rights, if any, of third parties. � rd ' . — IN IC:TIP&9S WP, Colorado Rural Rehabilitation Corporation has jrr• l4,its.,.,corporate name to be hereunto subscribed by its President M _ `T',p'If, y• �._. seal to be hereunto affixed, attested by its Secretary, e.. .,, ,. .. .... tr,d4 of November, 1966. ve _ p o; -7(_ '..s ' COLORADO RURAL a EABILInAZIOR CW�ORATICR .I LL"�n'I 'I, S0'.,11I gn�;'NS ii : 1...1 ;ir - STATE OP COLQMDO ) - b P 1 0 41/44 . ) es. `./'•.. •��{ cfTY AND COUNT! 07 DENVER ) �Sh.... 3 1:%;: The foregoing instrvent as acknowledged before we this 21st day of November, 1966, by Elton Miller as President and S. E. Paul as Secretary of Colorado Rural Rehabilitation Corporation, • corporation. • Witness Ry hand and official s_ V i � my Coaiseioa Expires (7-- / — / 17/47 L.. O - e CO SION OF WATER U-5-71' 101 Colu Bldg, 845 Sherman Street,Denver,Colordo RESOURCES RECEIVED ?PE CR PRINT IN BLACK INK. APPLICATION MUST BE COMPLETE BEFORE ACCEPTANCE, JUt. 1 2. 22 ?PLICATTON FOR: GROUND WATER TO BE USED FOR: 'WATER 7E:'1!cf x A PERMIT TO USE GROUND WATER x DOMESTIC (1) COIli1 §t"iAL .(4) x A PERMIT TO CONSTRUCT A WELL e� x LIVESTOCK (2) INDUSTRIAL (5) r--- 1l REPLACE=NT FOR NO. �Xis '° "1e^( MUNICIPAL (8) IRRIGATION (6) _ A PERMIT TO INSTALL A PUMP OTHER _ OTH R WELL LOCATION: PPLIOANT Harold 1. Neal COUNTY Weld treet Address Star Rt. # 1 NW 4 of the NE oof Section 26 ity & State Wiggins, Colo. 80654 T. 2 N , R. 61 W , 6th P.M IN ADDITION TO THE ABOVE, THE WELL MUST BE elephone No. 483—L420 LOCATED WITH RE'ERENCE TO GOV:ihN2- 'T SURVEY ‘ME OF AQUIFER GROUND 'MATER IS TO BE OBTAINED CORNERS, moNtrivaTiTs CR SECTION LINES BY D?,STnNC: AND BEARING (DOMESTIC WELLS MAY BE LOCATED BY ROM: Alluvial LOT, BLOCK, & SUBDIVISION.) ROPOSED TOTAL DEPTH OF WELL 14.0 Ft. 162 ft. from North section lit (North or South) 3TIMATED MAXIMUM PUMPING RATE 15 GPM 2470 ft. from East section lii (East cr West) 'rERAGE ANNUAL AMOUNT OF GROUND WATER TO BE LOT BLOCK FILING rr °PROPRIAT-i' 1 Acre-feet SUBDIVISION TTICIPATED GROUT PROGRAM Ground Water Basin k:O.�d - r7; ; 0‘t aterial Cement Water Mcant. Dist. 1Vcrl,,9,n tc“,4- /j;;c=c. ntervals 0-10 Anticipated drilling date July 19 72 Lacement Method Sn` l1 tube Owner of land cn which well is located: ROPOSED CASING: Same Lain 5 in. from 0 ft. to 80 ft. Other water rights on this land in. from ft. to ---- "t, erf. 5 in. from gp to —COT None in, from — — ft. to ft. rifler Canfield Dri1L^_G Co. No. 7ftstvi 77� / / Signature o: ALpf_cant 'dress Box 519, Ft. Morgan, Colo. 80701 IF WELL TS USE- FOP, l _'I CU, B C. SITE CF _ !S APPLICATION MUST BE CONTLETrn, -2-7?. .P.7%.< FOR O FIC_ LSE ONLY CNDITICUS OF APPROVAL APPLICATION APPROVED: VALI_- FOR 0"_ (1 ) __'mot AFTER DATE ISSUED UNLESS EXTENDED FOR GOOD CAUSE SHOWN TO THE ISSUING AGEDCY, PERMIT NO. 62478 JUL 1 8 1972 DATE ISSUTT STATE: _BY1 n WRJ.25.72 COLD 0 DIVISION OF WATER RESOUNS THIS FORM MUST BE ,ern--!;11.0 SUBMITTED PRIOR TO Columbine Bldg., 1845 Sherman St. THE EXPIRATION OF THE PERMIT. TYPE OR Denver, Colorado 80203 PRINT IN BLACK INK. fi...- % STATEMENT OF BENEFICIAL USE OF GROUND WATER AMENDMENT OF EXISTING RECORD WMER CiECY E STATE COLO. PERMIT NUMBER 62173 STATE OF COLORADO 1 SS. COUNTY OF .ra7.d J THE AFFIANT(S) Harold L. Neal whose address is Star at. 1, 'air-rims, Colo. 80651, being duly sworn upon oath, deposes and says that he (they) is (are) the owner(s) of the well described hereon; the well is located in the - 1/4 of the 1/4 of Section 26 2 , Township , (N. or S.) Range — 6th P.M. at distances of 162 feet from the = ,. section line (E. or W.) (North or South) and feet from the - %t section line; the total depth of the well is 1L,1 feet; water from this well (East or West) GG was first applied to a beneficial use for the purpose(s) described herein on the ,Y.7- L/ day of 'r c.‘ (Y. , 19 / / the maximum sustained pumping rate of the well is 15 gallons per minute, the pumping rate claimed hereby is gallons per minute; the average annual amount of water to be diverted is 1 acre-feet; for which claim is hereby made for Domestic `_ Livestock purpose(s); the legal description of the land on which the water from this well is to be used is NW-I:7-Sec.2t.._m;_r;_ 61:1-eleld Co. which totals acres and which is illustrated on the map on the reverse side of this form; that this well was completed in compliance with the permit approved therefor; this statement of beneficial use of ground water is filed in compliance with law; he (they) has (have) read the statements made hereon; knows the content thereof; and that the same are true of his (their) knowledge. ��//// / //J Signature(s) I iti 2CT�//� :7 ' "' g j FOR OFFICE USE ONLY Subscribed and sworn to before me on this ," 7 day of f Prior. Date , 19 My Commission expires: / 2,;:iViJ7l i) / ,A;17.5 well use (Seal) i (67/12 � � i//g� a a, I A, sec. —Notary blic ACCEPTED FOR FILING IN THE OFFICE OF THE STATE ENGINEER OF T. P.M.R. COLORADO ON THIS DAY OF 19 • Yield W.D. Co. "ATE ENGINEER Index WHITE COPY FOR DIVISION OF WATER RESOURCES PINK COPY FOR WELL OWNER THE LOCATION OF THE WELL MUST BE SHOWN AND THE AREA ON WHICH THE WATER IS USED • MUST BE SHADED OR CROSS-HATCHED ON THE DIAGRAM BELOW. This diagram represents nine (9) sections. Use the CENTER SQUARE (one section) to indicate the location of the well, if possible. +--1 Mile • I r r r - + - + - + - + - + - + - I I I I + - I - + - - + - + - + - + - + - NORTH SECTION LINE I I - ' F I X w r4 NORTH - + — + �a +z ± — + N o 0 Hi H C9 I I C l I 41 W co rn - + -- + co- + -s- + - r- f f i I SOUTH SECTION LINE - + — + — + — + — + — + - I I I I I I - + — + — + — + — + — + - I I I 1 I I THE SCALE OF THE DIAGRAM IS TWO INCHES EQUALS ONE-MILE Meter Serial No. ❑ Flow Meter ❑ Electric Meter ❑ Fuel Meter Owner of land on which water is being used WATER EQUIVALENTS TABLE (Rounded Figures) An acre-foot covers 1 acre of land 1 foot deep. 1 cubic foot per second (cfs) . . . 449 gallons per minute (gpm). 1 acre-foot . . . 43,560 cubic feet . . . 325,900 gallons. 1,000 gpm pumped continuously for one day produces 4.42 acre-feet. 1OO gpm pumped continuously for one year produces 16O acre-feet. (5) THE LOCATION OF THE PR OSED WELL and the area on (6) THE L MUST BE LOCATED'BELOW which the water will be used must be indicated on the diagram below. by (stance�s 1from section lines. Uce the CENTER SECTION (1 section, 640 acres) for the well location. ,{1. 1 +per\ r..,o I a`0( ft.•from Nb �� line �- — —}- — -�— — -{— — + — _1_ — --_ — ± — T + lj l,f i �r Inott n'or scut1 rt If 1 MILE,5280 FEET / � 0O ft.from 'EAST S . line (east or west) T + ± - 'l' LOT BLOCK FILING S I I NORTH SECTION LINE _ + _ SUBDIVISION (7) TRACT ON WHICH 1 `WELL WILL BENN II NORTH+ ( LOCATED Owner: kc r Id L, IVec / -t' z- — T — T — T — —a + ± No. of acres �"� . Will this be J N HI ip m I the only well on this tract? Al 0 + H { — + (8) PROPOSED CASING PROGRAM 0 I z 0 r I Plain Casing l-L -� — — T — — _m + T in.from ft. to / 0 a ft. I I in.from ft. to ft. } — + _ I I _ _ 4 Perforated casing SOUTH SECTION LINE I �f in. from / 0 0 ft. to l Y`tJ' ft. -I- + -I -}- + t -r + + in.from ft. to ft. I I I (9) FOR REPLACEMENT WELLS givedistance and direction from old well and plans for plugging r i The scale of the diagram is 2 inches= 1 mile \ Each small square represents 40 acres. \\ - WATER EQUIVALENTS TABLE (Rounded Figures) An acre-foot covers I acre of land 1 foot deep 1 cubic foot per second (cfs) .. .449 gallons per minute (gpm) A family of 5 will require approximately 1 acre-foot of water per year. 1 acre-foot . . .43,560 cubic feet . . . 325,900 gallons. 1,000 gpm pumped continuously for one day produces 4.42 acre-feet. (10) LAND ON WHICH GROUND WATER WILL BE USED: Owner(s): N No. of acres: N. Legal description: (11) DETAILED DESCRIPTION of the use of ground water: Household use and domestic wells must indicate type of disposal system to be used. f n ,t =r.1— / ( 1 I \/e'-< 7—,n, C IC FQY) G r LFACN FfEt-L-) (12) OTHER WATER RIGHTS used on this land, including wells. Give Registration and Water Court Case Numbers. Type or right Used for (purpose) Description of land on which used 0 ) , SAr-E (13) THE APPLICANT(S) STATE(S) THAT THE INFORMATION SET FORTH HEREON IS TRUE TO T E BEST OF HIS KNO LEDGE. SIGNATURE OF APPLICANTIS) Use additional sheets of paper if more space is required. Y/ n WRJ.5-Rev. 76 COLOADO DIVISION OF WATER RESOUR (Ov 818 Cente_nQial Bldg., 1313 Sherman St., Denver,Colorado 80203 CO? PERMIT APPLICATION FORM bApe li � i ere VVV VVVV be a where ECENED ( ) A PERMIT TO USE GROUND WATER applicable. Type or ( ) A PERMIT TO CONSTRUCT A WELL print in BLACK SEP 2 2 TWA: ( I A PERMIT TO INSTALL A PUMP - __-_- -- INK.No overstrikes w�Ow� - -- or erasures unless WATEA �� ( ) REPLACEMENT FOR NO. - .__. initialed. SIAN. WEE� I ( OTHER - EMC WATER COURT CASE NO. (1) �/APPLICANT - mailing address FOR OFFICE USE ONLY:lI DO NOT WRITE IN THIS COLUMN ,]NAME ( arcdd Le.,R07 Neal Receipt No.30SS /_ STREET 4LeS0CJ tI' Ift (Cltn Rd. I n 2 Basin o� Dist. + CITY IAN V)Cayl n5 Co �'nbW l ty tel z;pl CONDITIONS OF APPROVAL TFI EPunNE Mn _3Q3_ 3.2 i-QR. _ ILL .._ This well shall be used in such a way as to cause no material injury to existing water rights. The (2) LOCATION OF PROPOSED WELL issuance of the permit does not assure the applicant that no injury will occur to another vested water right or preclude another owner of a vested water County LO P, I d right from seeking relief in a civil court action. N W 7. of the N 1/.,Section a- 6 / Twp. LJ , Rng. 6 ( v. 6 P.M. ,:, ,14 4'- CE HCEri c AP ivIHF:77r eficpcicr - :.,E .. iN.SI IE.WI ..-. -. _ _,.... (3) WATER USE AND WELL DATA Ai ! 1 _ 91 THc AVETAUEIA -_:,y MIS -;ELL SHALL Proposed maximum pumping rate (gpm) 15 O p YY\ ACRE-FEET. . Average annual amount of ground water ( 7 c AREA SHALL 'T ACRE F n.. ND E;'J. to be appropriated (acre-feet): 1 WATER FROM TUFT WELL NA( EE USED, FiA THE Wd EE7G i;F L - .. . Number of acres to be irrigated: I ?,/,1rG --' PAST6RE. Proposed total depth (feet): 3 C G17 1 S THIS +1F'-! .H"ST FE OUNSTRUCTED T::' ;ITHDRAN HA 1 t eR_ 0. UR -TS TR E "--- uc :EPTH UF THIS it :T 1 THE PF r fl - - -=- Aquifer ground water is to be obtained from: 1 1_`;;y _^,�;"Ij gd - - -- 11 Ti .Iry4Cl „,C E JIM 7HE E u, —; ME ;;TTY , Owner's well dexigna*ion Hn :_. - jIL [-. -;, r -, GROUND WATER TO BE USED FOR: ( I HOUSEHOLD USE ONLY - no irrigation (0) (fl DOMESTIC (1) ( ) INDUSTRIAL (5) -1>4) LIVESTOCK (2) ( ) IRRIGATION (61 I I COMMERCIAL (4) ( ) MUNICIPAL (8) ( ) OTHER (9) APPLICATION APPROVED DETAIL THE USE ON BACK IN (11) 155610 PERMIT NUMBER (4) DRILLER OCTQQ DATE ISSUED 0CT 1 �6 1989 Name / ) C EXPIRATION DATE UC 1 1 `/ 1990 Street City S E IN (State) (Zip) BY it q ' Telephone No. Lic. No. Q I.D. CJ — — COUNTY (0 2— . (5) THE LOCATION OF THE PROPOSED WELL and the area on 6))) THE It MUST BE LOCATED.BELOW which the water will be used must be indicated on the diagram below. T{,bly.s i}ta¢cel f9Qn :cjion lines. Use the CENTER SECTION 11 section, 640 acres) for the well location. 1/24:0• /f 7 r t f r f 14,44), i r� )y r cit 0'r° f .,ft,irorP /T'0r2'rti II sec(line — rt — -� — � — -)- — -� — -)- — -}- — -�- ,., (norm or soµt')� 11 i -4--1 MILE,5280 FEET —;;l /c, o o ft.from ' - AST sec. line + + ± ± + 4 (east or west) f - LOT BLOCK FILING * + _ T NORTH SECTION LINE _ + — H- I I I (7) TRACT ON WHICH WELL WILL BEl�� LOCATED Owner: kQ rO Id L., I V eCL I NORTH 1 + t� r z_ - - — — — —m + ± No.of acres l 0 Will this be -I .4 Z N 0 m the only well on this tract? t1 T , -1 I U I 3 - + (8) PROPOSED CASING PROGRAM 2 w� — r Plain Casing _rn -I- r in. from+ ) ft. to () 0 ft. ' in. from ft. to ft. + — + _ I I ! _ _4_ _ 1 Perforated casing SOUTH SECTION LINE _in, from / 0 ft. to 7Lcr ft. t - -e 1 in. from ft. to ft. ! (9) FOR REPLACEMENT WELLS givedistance and direction from old well and plans for plugging i _ s _ _ _ ! — y — , it: The scale of the diagram is 2 inches = 1 mile N Each small square represents 40 acres. WATER EQUIVALENTS TABLE (Rounded Figures) An acre-foot covers 1 acre of land 1 foot deers 1 cubic foot per second (cfs) .. .449 gallons per minute lgpml A family of 5 will require approximately 1 acre-foot of water per year. 1 acre-foot . . .43,560 cubic feet . . .325,900 gallons. 1 000 gpm Dumped continuously for one day produces 4.42 acre-feet. (10) LAND ON WHICH GROUND WATER WILL BE USED: Owner(s): � No of acres: N Legal description: (11) DETAILED DESCRIPTION of the use of ground water: Household use and domestic wells must indicate type of disposal system to be used. tl NI Fi N-/ /, 1 i ,ter EL 7-OA f 1 r �/ I j9 i7 (- ti LEACN P/4)-1.) (12) OTHER WATER RIGHTS used on this land, including wells. Give Registration and Water Court Case Numbers. Type or right Used for(purpose) Description of land on which used (13) THE APPLICANT(S) STATE(S) THAT THE INFORMATION SET FORTH HEREON IS TRUE TO T E BEST OF HIS KNO LEDGE. IL/ 77- J SIGNATURE OF APPLICANT(SI Use additional sheets of paper if more space is required. • Y[O J ' l� WRJ-1-Rev. 76 COLD Q,QIVISION OF WATER RESOUR• 1 C ntgr�n' I }aa6__ 1313 Sherman St., Denver,Colorado 80203 �]y7]1P S jL PERMIT APPLICATION FORM F ip i k +Ihust� be complete where D ( ) A PERMIT TO USE GROUND WATER applicable. Type or , ( ) A PERMIT TO CONSTRUCT A WELL __ print in BLACK �SC(4S2 tie: ( ) A PERMIT TO INSTALL A PUMP - I N K.No overstrikes ....7777 CCCC O� - - -- -� or erasures unless ( ) REPLACEMENT FOR NO. - _ __ _. initialed. MMIER RES811RCIS I I OTHER gym r SIGMA In WATER COURT CASE NO. - (1) APPLICANT - mailing address 1� FOR OFFICE USE ONLY: DO NOT WRITE IN THIS COLUMN Ha rr,a rr, 1_d L-Q.R0 7 I \I ed Receipt No. 9 05425 _. -. STREET 4Le5O$ tP. Ia CUL1117 ga. I ? Basin o_ Dist. 7 CITY_ HA) LU f elQ l�g COIZI fO65Y CONDITIONS OF APPROVAL TFI CPH�IAIF NIQ_ _ :BO 3L—y1` X _ In cC I _.__ This wPII shall he 'mad in such a wax, as to cause no material injury to existing water rights. The (2) LOCATION OF PROPOSED WELL issuance of the permit does not assure the applicant that no injury will occur to another vested water right or preclude another owner of a vested water County LO P, \, I d right from seeking relief in a civil court action. N.'"4 Z of the N %,Section r)— 6 1) ISSUED PURSUANT T6 ?--S'0-'OS CRS. Twp. a- N , Rng. I c P.M. 21 WATCR FROM THIS ..ELLS MAY FE USED FOP DOMESTIC; PURPOSES ':•:E IN.S) (ENO iIHGLE ; AM_ WE_L:NG. (3) WATER USE AND WELL DATA -' HE +A:I;UM ^F St: SATE ;t THIS WELL HAL'i_ Ai THC AVERAGE `NIAI )�('P 1 " '°•"It! r _ ___ '_i_ _ Proposed maximum pumping rate (gpm) )5 C p YY\ ACRE-FEET. Average annual amount of ground water THE IRRIGATED AR EA SHALL LiT D' I ACRE r l CE !. to be appropriated (acre-feet): ( Si WATER FROM THIS WELL lAt 3E USED FOR THE WATERING OF Y:YEIR - . Number of acres to be irrigated: / RANGR AND PASTURE. Proposed total depth (feet): � 1`1 " T iS WELL 'MI` FE :r:9 I' ED T-I .W WATr y -. P P F ._..WA 1CSEEs .T.. TP SU THE ,EP- H -. -' r - .. log 4,F OF Eilr EirTEH ,S ,i- �, I E I - Aquifer ground water is to be obtained from: FS E I,.i HTF E 118` NOT 1111011!FL LC )J EM 'HE _..1 PE Owner's s well re on I HF!'rrIA -.I) :H__ ws . .l L L E _'_.- GROUND WATER TO BE USED FOR: ( I HOUSEHOLD USE ONLY - no irrigation (0) 04 DOMESTIC 11) ( I INDUSTRIAL (5) >41 LIVESTOCK (21 ( ) IRRIGATION (6) ( 1 COMMERCIAL (4) ( ) MUNICIPAL (81 I 1 OTHER (9) APPLICATION APPROVED DETAIL THE USE ON BACK IN (11) 1556_1.0 PERMIT NUMBER (4) DRILLER DATE ISSUED tO�C+T 16 1989 Name l_ U I EXPIRATION DATE - ( 15 1990 Street / City IS € cilt\I E4"'"" (State) (Zip) P ' v q� BY (/ A. ri_419-1-61-4 Telephone No. Lic. No. Q I.D. U - / - 0 I COUNTY l`0 • DORADO DIVISION OF WATER RESCES THIS FORM MUST BE SUBMITTED 1313 Sherman Street - Room 818 WITHIN 60 DAYS OF COMPLETION Denver, Colorado 80203 OF THE WORK DESCRIBED HERE- ON.TYPE OR PRINT IN BLACK WELL COMPLETION AND PUMP INSTALLATION REPORT INK. PERMIT NUMBER 156610 WELL OWNER Harold LeRoy Neal NW ''h of the N-F Y.of Sec. 26 ADDRESS 46508 WCR 18 , Wiggins , CO 80654. T. 2 N , R. 61 W 6 DATE COMPLETED December 28 , 19 89 HOLE DIAMETER WELL LOG 12 in. from 0 to 15O ft. Water From p To Type and Color of Material Loc. — in. from to ft. 0 1 top in. from to ft. 1 6 sand DRILLING METHOD 6 34 clay, fine sand CASING RECORD: Plain Casing 34 60 clay 60 67 z clay, sand, fine sand Size 6 5/� kind Steel from +1 to 20 672 81 gravel , sand Size 5 & kind Plasticfrom 6 to 9O 81 862 coarse gravel , cemented strips 862 88 sand Size & kind from to 88 91 sand, some coal 89Z ' 91 94 sand Perforated Casing 94 96 gravel 96 97 rock, 7" Sizes & kind _Plastic from 9O to 15O 97 101 sand 101 102 hard rock, 14" Size & kind from to 102 114 sand 114 1142 rock, fairly hard Size & kind from to 11421172 sand 1172134 sand, drills easy GROUTING RECORD 134 1372 sand, short strips of rock 1372150 sand Material Neat Cement Intervals 6 ' to 20 ' Placement Method spill tube GRAVEL PACK: Size Buckshot Interval 20 ' to 150 ' TEST DATA Date Tested December 28 79 Static Water Level Prior to Test 892 Type of Test Pump Bailed Length of Test 2 hours Sustained Yield (Metered) 15 gpm TOTAL DEPTH 150 ' Use additional pages necessary to complete log. Final Pumping Water Level 195 ' PUMP INSTALLATION REPO / .... Pump Make -/ rr . , Type ® - j Powered by HP • ..n `Pump Serial No. s w Aa WATER • Motor Serial No. w w TABLE W —W .t, ' J I-J Date Installea ¢ U, w Pump Intake Depth a Remarks - <: Z z ,.- a r.` Z 0 n ca -- a i i . • x - r+ WELL TEST DATA WITH PERMANENT PUMP a — I'. �t o Date Tested .J r = '' CONE OF F a °, '?' DEPRESSION Static Water Level Prior to Test c Length of Test Hours _ Sustained yield (Metered) GPM rr ,t,...1 Pumping Water Level Remarks ti v .c, CONTRACTORS STATEMENT The undersigned, being duly sworn upon oath, deposes and says that he is the contractor of the well or pump installation described hereon; that he has read the statement made hereon; knows the content thereof, and that the same is true of h' wn know dge. -Signature / License No. 765 State of Colorado, County of 727 .may,_ SS Subscribed and sworn to betore me tit. day 0 /�JJ r- , 199- .. // 7 My Commission expires: ( , 19 9,c-,. Notary Public /�rLIV�-1 2 . FORM TO BE MADE OUT IN QUADRUPLICATE: WHITE FORM must be an original copy on both sides and signed. WHITE AND GREEN copies must be filed with the State Engineer.PINK COPY is for the Owner and YELLOW COPY is for the Driller. • ._( I IN, HSF'i l;')(I:: INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT NO. G-900 ('11:::€...I) COUNTY HEALTH H DEPARTMENT NEW PERMIT ENVIRONMENTAL t. A L.. T H SERVICES 1517 16TH ;..., U,.. COURT, t.r ':::.E.»C:. , , CO 80631 353-0635 E XT .::'":'"'."; OWNER Ni:::AL, (:5'1..ENN ADDRESS ESS 35.\...5 4 CR 81 PH (303) 849 ROGGEN CO 80652 ADDRESS OF PROPOSED SYSTEM 46576 WCR 18 W.I.Gt.Il`::r CO }: 0654 LEGAL 1 '_..,t•....,....:. . ,....�t.:,ti.I. : ]:f:l 1••' '':i€'�' SITE : �!I:::.<A EEC ;:'�::: E�(r:l I"' ;? F;I`]t; fr-i • SUBDIVISION : LOT ,:1 BLOCK K 0 h:I:I...I1N(. ') USE TYPE : RI:::S:I:Dl=NTIAL.. -MOD(JL..AR !-HHI::••••WIL SERVICES: - PERSONS 6 BATHROOMS :?i..4:!>::! LOT SIZE(L:: 2.00 ACRES 'iI::. BEDROOMS BASEMENT PLUMBING YES WATER SUPPLY r'WEI._€... nF'I:'I._t ATION FEE '.!o150,00 ,.,•I::'C D BY ( t.,s': t::. r , D.,.r••1N N E:. SIGNED ;• GLENN L, N...-L DATE 03/20/90 DATE'i::. 03/2 0/90 . {: 0 PERCOLATION RATE 7,3 i'i]:N PER ]:N C i'i LIMITING ZONE <:3 FEET SOIL SUITABLE PERCENT GROUND SLOPE 2Z DIRECTION W—E REQUIRES— ENGINEER DESIGN GN N+:1 FROM 'T'I..II:� APPLICATION(;11 I It.tP'! INFORMATION tiD (:i S' %t. .t. ,� • SUPPLIED AND THE€"I i::. ON-SITE:€:'T'€::: SOIL i... PERCOLATION i i--t.. THE FOLLOWING MINIMUM INSTALLATIONSPECIFICATIONS ARE REQUIRED - SEPTIC: I ,.,N!: 1500. GALLONS, i'1`'( (• ''� ON �E ..;..t,t',_ ..I FT . c . ..:.:., ABSORPTION� � :!: TRENCH:s..! ;:. .�:.t:�. OR ABSORPTION BED 1185 S( . I.;...r,. IN ADDITION, THIS PERMIT IS SUBJECT TO THE FOLLOWINGAl D:I:TIONAI_ TERM, AN:() CONDI f:I:0NS • ........C.AsP, o..7. ..._9. ....Y _._ ...n :1X!.+ -Ckes..l 1.'.<S._._r »..gip...........-......_.._. THIS €''L:.RM:l:T .,.,.; GRANTED TEMPORARILY TO ALLOW CONSTRUCTION TO COMMENCE. THIS PER ' MAY Et!: REVOKED OR SUSPENDED 1) BY THE WELD COUNTY HEALTH DEPARTMENT FOR REASONS 0i'!S FORTH IN THIN WELD COUNTY INDIVIDUAL SEWAGE r:: D:OSPOSAL SYSTEM REGULATIONS ]:f,!(::I...!.1D]: FAILURE TO MEET ANY TERM i`i OR CONDITION IMPOSED THEREON DURING TEMPORARY OR r-]:Nr^i APPROVAL. -- THE ISSUANCE iNCE OF THIS PERMIT DOES JulCONSTITUTE ASSUMPTION BY THE DEPARTMENT OR ITS! EMPLOYEES I...OYI:_I:::;' (7r` LIABILITY FOR 1111:: FAILURE OR INADEQUACY OF 1€"IL SEWAGE DUI-VEAL SYSTEM.EM. -Irel-<,`ih-c-[i ) 1,-/g-9/ l7- I...YNN Rr.:l£sI+]:(:1 {)•+]f0::≥/9 ENVIRONMENTAL SPECIALIST DATE THIS PERMIT I0 OOT TRANSFERABLE AND ;:if—IA,...I:.. TjEOOME VOID IF SYSTEM i:;(:•ir....T st.J(:''I .. . N i'. NOT COMMENCED('f;;.N ....,. WITHIN I ». ,y' A ` F' ... ISSUANCE.!'`{t.,E:.., BEFORE .*S'(.1 (, .,t . .,: .I_.t!t..1::.:.: ,.0:. T I t I i.. ONE!is:: YEAR r-�I!�ti (.l, ITS��'" .,.:'.;I;;i ISSUING i'•I f FINAL,, •t 1... APPROVAL THIS PERMIT THE WELD (::;:1(.1"T'Y' HEALTH 1)1..!'c R•(-. ,•. T. RESERVES THE RIGHT ID IMPOSE •;:!.; TI(:lNAI... TERM '' AND CONDITIONS REQUIRED TO MLFT (:1tJ; REGULATIONS ON A OONTINUING t:, ,..S, FINAL :'€::. ..sI't APPROVAL I..:1 CONTINGENT '.I '(:'r..'. THE FINAL.. Itit. f'I:::CTI(•. Or THt::. COM L. I ,.. .. ,: SYSTE:i BY T,-IL.. WELD ..,... ..I'` 'i ..,_.A L.. I h'I ..1 i:..Pf:}. . M t...i • SYSiLf1 .i.N,':Oi.OO.OER _______:_ri ... .. FINAL TNzi::-.... —Tor DAT'T. Ji..,/..e..7-.." ,y.s-r,„„.„ „:„.„:„:„.4,:::„,„: SYSTEM INSTALLED, r.eetc.k Ii'-P •LriClO•i�tl: !•1•'Cl._ .:;s�'I:::f::IAl»:I:ST TYPE:. (:.l ' .. � .a .... t .... i ;tl...i... 1: .... ..»...._....._..... .. THE ISSUANCE OF THIS PERMIT DOES NOT IMPLY COMPLIANCE WITH OTFIE:R EIATE, COUNTY OR . LOCAL I...t:i(:.'l-tE... REGULATORY•l'f Y OR BUILDING REQUIREMENTS, NOR SHALL IT ACT TO CERTIFY THAT T'(••€i= S OT.oJ C;T 'r'S I l:::M '' I:i._I... (:l Pi::Ri iT`: :I:i4 i::(:lMI'!._:I:i',t'•(OI: WITH APPLICABLE S•r'0,'I i:: : COUNTY AN ....,.i,.ril... Mr.:.,Y..,l.... ....: ..-; ;'.:PCP TED PERSft'INT .1..;::' ARTICLE 10, TITLE 25, (.;RS 4V .Oi, AS AMEND 1::. . EXCEPT !..:.t". � '•::. I' . ,. . ,::L':. •..�I'� 'r iii 0,...:i .... I''•!l:r.I. .1.'.,.,.. �i r--I''i",t.� t I��!._ .. , r•'•1 i i .I.E`•:... r s i... ... SYSTEM :I IS S' "• tNOr of:A..m.LT r 1 CRS 1973 ii/Prc x (OL1 t ,. C ic7 �C aBr STATEMENT OF EXISTING SEPTIC SYSTEM (PLEASE FILL OUT IN INK) OWNER OF RECORD: /47 IMO/J ge2}/ �j/ / Phone: 94-(o,/4/ MAILING ADDRESS: 5/(y a8 h . 'Rid. /B W/q4idi CO rCio6iV Cffty State Zip SITE ADDRESS: 1(4408 %J. C. R,, /8 W4410; CO gd(o, t/ _ CSri Stated Zip LEGAL DESCRIPTION: PT PT N.r.'l�, Section Ql/1/ Township 2/V Range /SRO SUBDIVISION LOT BLOCK FILING NUMBER OF PEOPLE: 2 Bedrooms: IZ Bathrooms: Water Supply LJJ El ( RESIDENTIAL OR COMMERCIAL: RE. aid E1J hi R, Lot Size: Acres SYSTEM •SIZE: Tank is Constructed of CEry(EN-1-- R;j6g, and has 1QOC9 gals capacity material) FIELD: Bed or Trench 36 0 sq. ft. Date System Installed: in You are required to draw a diagram of the system on the reverse side of this form and indicate position, length, width, and distance from the dwelling. The undersigned property owner hereby certifies that the above described septic system is in fact installed, as described, and exists at this time on the parcel of ground identified by the above legal description and further states chat the system is in good working order and to the best of his/her knowledge is not failing to function properly. I further understand that any falsification or misrepresentation may result in revocation of any permit granted based upon this information hereby submitted and in legal action for perjury as provided by law. f� Date Owner y� Subscribed and sworn to before me this 917/ day of �yL , 19 �74) by /qC7, n / .4 '<a1 Witness my hand and official seal. My commission expires 7,/ /(T <2/ �Date Notary Public STATEMENT OF EXISTING REVIEWED BY — — Environmental Protection Specialist Date No a-4AI c4,� \o,, n \ J re El u T Y O -4- J ‘,/-1 Hello