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Home My WebLink About20180748.tiffCERTIFICATE OF CONVEYANCES WELD COUNTY STATE OF COLORADO DEPARTMENT OF PLANNING SERVICES COUNTY OF WELD Heritage Title Company, Inc. 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 Lot C of Recorded Exemption No. 1471 -21 -03 -RE -2251, according to the map recorded November 23, 1999 at Reception Number 2734383, being a part of the Southwest Quarter of Section 21, Township 1 North, Range 66 West of the Sixth Principal Meridian, County of Weld, State of Colorado. CONVEYANCES (If none appear, so state): Reception No. 1592891 I Reception No. 2510314 1 Reception No. 2602010 Book 671 Book 1565 Book Reception No, 2734383 I -Reception No, 4241947 Book Book This certificate is made for the use and benefit of the Department of Planning Services of Weld County, Colorado. This certificate is not to be construed as an Abstract of Title, Opinion of Title or a Guarantee of Title and the liability of Heritage Title Company, Inc. is hereby limited to the fees paid for this Certificate. In Witness Whereof, Heritage Title Company, Inc., has caused this Certificate to be signed by its proper officer this 24th day of July, 2017, at 7:00 am. Order No. H0510923 Heritage Title Company, Inc. By:°t. Authorized Signatory LIMITATION LANGUAGE FOR LIMITATION TO AMOUNT OF FEE PAID FOR SEARCH ALL PARTIES EXPRESSLY AGREE AND ACKNOWLEDGE THAT IT IS EXTREMELY DIFFICULT, IF NOT IMPOSSIBLE, TO DETERMINE THE EXTENT OF LOSS WHICH COULD ARISE FROM ERRORS OR OMISSIONS IN, OR THE COMPANY'S NEGLIGENCE IN PRODUCING, THE REPORT. ALL PARTIES RECOGNIZE THAT THE FEE CHARGED IS NOMINAL IN RELATION TO THE POTENTIAL LIABILITY WHICH COULD ARISE FROM SUCH ERRORS OR OMISSIONS OR NEGLIGENCE. THEREFORE, ALL PARTIES UNDERSTAND THAT THE COMPANY WAS NOT WILLING TO PROCEED IN THE PREPARATION AND ISSUANCE OF THE REQUESTED REPORT BUT FOR ALL PARTIESR AGREEMENT THAT THE COMPANY'S LIABILITY IS STRICTLY LIMITED. ALL PARTIES AGREE. AS PART OF THE CONSIDERATION FOR THE ISSUANCE OF THIS REPORT AND TO THE FULLEST EXTENT PERMITTED BY LAW, TO LIMIT THE LIABILITY OF THE COMPANY, ITS LICENSORS, AGENTS, SUPPLIERS, RESELLERS, SERVICE PROVIDERS, CONTENT PROVIDERS, OR ANY OTHER SUBSCRIBERS OR SUPPLIERS, SUBSIDIARIES, AFFILIATES; EMPLOYEES, AND SUBCONTRACTORS FOR ANY AND ALL CLAIMS; LIABILITIES, CAUSES OF ACTION. LOSSES, COSTS, DAMAGES AND EXPENSES OF ANY NATURE WHATSOEVER, INCLUDING ATTORNEY'S FEES, HOWEVER ALLEGED OR ARISING INCLUDING BUT NOT LIMITED TO THOSE ARISING FROM BREACH OF CONTRACT, NEGLIGENCE, THE COMPANY'S OWN FAULT AND/OR NEGLIGENCE, ERRORS, OMISSIONS, STRICT LIABILITY, BREACH OF WARRANTY, EQUITY, THE COMMON LAW, STATUTE, OR ANY OTHER THEORY OF RECOVERY OR FROM ANY PERSON'S USE, MISUSE, OR INABILITY TO USE THE REPORT, SO THAT THE TOTAL AGGREGATE LIABILITY OF THE COMPANY, ITS EMPLOYEES, AGENTS AND SUBCONTRACTORS SHALL NOT EXCEED THE COMPANY'S TOTAL FEE FOR THIS REPORT. ALL PARTIES AGREE THAT THE FOREGOING LIMITATION ON LIABILITY IS A TERM MATERIAL TO THE PRICE BEING PAID WHICH PRICE IS LOWER THAN WOULD OTHERWISE BE OFFERED WITHOUT SAID TERM. ALL PARTIES RECOGNIZE THAT THE COMPANY WOULD NOT ISSUE THIS REPORT, BUT FOR ALL PARTIES' AGREEMENT, AS PART OF THE CONSIDERATION GIVEN FOR THIS REPORT, TO THE FOREGOING LIMITATION OF LIABILITY AND THAT ANY SUCH LIABILITY IS CONDITIONED AND PREDICATED UPON THE FULL AND TIMELY PAYMENT OF THE COMPANY'S INVOICE FOR THIS REPORT. THIS REPORT IS LIMITED IN SCOPE AND IS NOT AN ABSTRACT OF TITLE, TITLE OPINION, PRELIMINARY TITLE REPORT, TITLE REPORT, COMMITMENT TO ISSUE TITLE INSURANCE, OR A TITLE POLICY, AND SHOULD NOT BE RELIED UPON AS SUCH. IN PROVIDING THIS REPORT, THE COMPANY IS NOT ACTING AS AN ABSTRACTOR OF TITLE. THIS REPORT DOES NOT PROVIDE OR OFFER ANY TITLE INSURANCE, LIABILITY COVERAGE OR ERRORS AND OMISSIONS COVERAGE. THIS REPORT IS NOT TO BE RELIED UPON AS A REPRESENTATION OF THE STATUS OF TITLE TO THE PROPERTY. THE COMPANY MAKES NO REPRESENTATIONS AS TO THE REPORT'S ACCURACY, DISCLAIMS ANY WARRANTIES AS TO THE REPORT, ASSUMES NO DUTIES TO ANY PARTIES, DOES NOT INTEND FOR ANY PARTIES TO RELY ON THE REPORT, AND ASSUMES NO LIABILITY FOR ANY LOSS OCCURRING BY REASON OF RELIANCE ON THIS REPORT OR OTHERWISE. IF ALL PARTIES DO NOT WISH TO LIMIT LIABILITY AS STATED HEREIN AND ANY PARTY DESIRES THAT ADDITIONAL LIABILITY BE ASSUMED BY THE COMPANY, ANY PARTY MAY REQUEST AND PURCHASE A POLICY OF TITLE INSURANCE, A BINDER, OR A COMMITMENT TO ISSUE A POLICY OF TITLE INSURANCE. NO ASSURANCE IS GIVEN AS TO THE INSURABILITY OF THE TITLE OR STATUS OF TITLE. ALL PARTIES EXPRESSLY AGREE AND ACKNOWLEDGE THAT ALL PARTIES HAVE AN INDEPENDENT DUTY TO ENSURE AND/OR RESEARCH THE ACCURACY OF ANY INFORMATION OBTAINED FROM THE COMPANY OR ANY PRODUCTS OR SERVICES PURCHASED. NO THIRD PARTY IS PERMITTED TO USE OR RELY UPON THE INFORMATION SET FORTH IN THIS REPORT, AND NO LIABILITY TO ANY THIRD PARTY IS UNDERTAKEN BY THE COMPANY. ALL PARTIES AGREE THAT, TO THE FULLEST EXTENT PERMITTED BY LAW, IN NO EVENT WILL THE COMPANY, ITS LICENSORS, AGENTS, SUPPLIERS, RESELLERS, SERVICE PROVIDERS, CONTENT PROVIDERS, OR ANY OTHER SUBSCRIBERS OR SUPPLIERS, SUBSIDIARIES, AFFILIATES, EMPLOYEES, AND SUBCONTRACTORS BE LIABLE FOR CONSEQUENTIAL, INCIDENTAL, INDIRECT, PUNITIVE, EXEMPLARY, OR SPECIAL DAMAGES, OR LOSS OF PROFITS, REVENUE, INCOME, SAVINGS; DATA, BUSINESS, OPPORTUNITY, OR GOODWILL, PAIN AND SUFFERING, EMOTIONAL DISTRESS, NON - OPERATION OR INCREASED EXPENSE OF OPERATION, BUSINESS INTERRUPTION OR DELAY, COST OF CAPITAL, OR COST OF REPLACEMENT PRODUCTS OR SERVICES, REGARDLESS OF WHETHER SUCH LIABILITY IS BASED ON BREACH OF CONTRACT; TORT, NEGLIGENCE, THE COMPANY'S OWN FAULT AND/OR NEGLIGENCE, STRICT LIABILITY, BREACH OF WARRANTIES, FAILURE OF ESSENTIAL PURPOSE, OR OTHERWISE AND WHETHER CAUSED BY NEGLIGENCE, ERRORS, OMISSIONS, STRICT LIABILITY, BREACH OF CONTRACT, BREACH OF WARRANTY, THE COMPANY'S OWN FAULT AND/OR NEGLIGENCE OR ANY OTHER CAUSES WHATSOEVER, AND EVEN IF THE COMPANY HAS BEEN ADVISED OF THE LIKELIHOOD OF SUCH DAMAGES OR KNEW OR SHOULD HAVE KNOWN OF THE POSSIBILITY FOR SUCH DAMAGES. THESE LIMITATIONS WILL SURVIVE THE CONTRACT.] tax 6711. Recepttoa _.., _...... _...._..._.._..^ M _. _. . ter. ea Recorded tat ..,.._-a'aetac ,..._.I., JUL 3 1972 Tara DIatED0 Made thin 30th day of June 111 72. Datmenar ADOLPH COORS COMPANY a cevporatlen duly organised and exlating under and by virtue of tim lawa of the Stator of Colorado of the first part, and NEIL A. PUTNA1M Recardeeis SWEEP of tho County of Weld and State of Colorado of tho second part: WITNERSI Tfs, That tlio sold party of the find part. far and In consldarotlon of the aura of One Hundred )ollars and other valuable consideration 1 to the sold party of the flint part in lined paid by the Bald party of the errand part, the receipt whereof Is hera by confenaed and ecknowledttad, bath fronted, bargained, acrid and conaoyad, and by thra: preoenta loth grant, bar. gain, sell, convey and confirm unto the sold part y of the second part, his holm, and analgns for. aver, all of tho following described lot or parcel of land, nituate, lying and bring in the County of Weld and State of Colorndn, to wit: The South Half (S1/2) of Section Twenty-one (21), Township One (1) North, Range Sixty-six (66) Wont of the Sixth (6th) P.M,, EXCEPT all title in Nalooge Lake; together with all water, water rights, ditches, and ditch rights, and including, but not by way of special limitation, eighteen(14) shares of the capital stock of the Burling- ton Ditch and Reservoir Company, eighteen(Y.8) shares of the capital stock of the Wellington Reservoir Company, and eighteen (113) shares of the capital stock of the Brighton Lateral Ditch Company;together with all grantor's interest in and to all oil, gas and minerals now owned or hereafter acquired lying in, under and along said property, TOORTIIEit with all and singular the heredtta:nenta and appurtenances thereunto balancing, or Ira anywise appartalning, and the reversion or revcralana, rumaindeni, rants, lariats and profits thornuf; and ell the agate, right, title, Intarcat, claim and demand whatsoever of the cold party of the stmt port, Dither In law or equity, of. in and to the abora bargained prarnlnro with the hereditament* and appurtenances. TO RAVES AND TO HOLD the cold erosion above bargained and described. with the appurtenances unto the amid part y of the errand part ills Mira and aaalgno forever, And tho 'aid Adolph Coors Company, party of the lint part, for !teelf, and Ito cuecenaora, cloth coeerurnt, grant, bargain, and agree to and with the sold party of the craved Part, his heled and amigos, that at the time of the enacaling and delivery of throe praaents it is wall seised of the promises above convoyed, an of a goal, guru, perfect, absolute and indefeasible cstnto of Inheritance, la Law, in too nimpio, and bath good right, full power and lawful authority to grant, bargain, call and convey the aama In manner nod form efarren:d, and that lhn ammo are free fled clear from all former and other grants, bargalna, onion, Ilona, tears, aav-aamenta and Inetunbranera of whatever hind or nntura sootier; subject to prior mineral reservations, coal reservations, easements,restrictionr_s and rights--of-way of record; also subject to 1972 taxes, and mortgage to The Federal Land Bank of Wichita recorded 9/17/65, under Recep- tion No. 1471879, in Book 550, Weld County records, and also subject 1 to a" of trust dated 527/68, recorded 5/13/60 under Reception No. 6t1e34 Book 594, Veld Cou�l _ty records --which said taxe a,naortgage, 11.0 g�ta> a ! a a � r m 6 sue 'an ^cL t .r ale th`��k2rtyo paoy Ito eocend port his heir¢ and 'c,,steno, against all and emery porous or pparaona lawfully claiming or to claim thu whole or any part thereof, the aoidtpnrty of the first part +shall and will WARRANT AND FOWLKVER DEFEND. IN WITNL,tlfl WIJBAEOP. The said party of the fleet part hash caused Ito corporato name to La hereunto tt y b t -Prnelh;ant, and Ito corporate anal to to hereunto affixed, situated by Ito I) me and Y r X171 Ire watt: - "I":' aee„rare, BY _ ..... PraaLlee t Str.%Te gt erlLt)RAIio, +j I."' aa. ..._...,.....,. County uf.a!4;.f.,�.tit 1}.fills.-I Thin fertraing inatrucrart rrno artnaxlydgad lx-fure me thle 30th day of June 19 72. by W. R. Coors a, Prrsltkat and Ray V. Frost 9aerttry 7" Adolph Coors Company 7 a corporation. My notarial tu.ualaslapr eruiraa .`�4 Wltacse any band and otttebnj Iraq. ',_ • �' 1, Naar" e ', �. i 4 (j J® Ir r l;OMb1JS�i0fi D{PI;?E3 iNj 1,5(44itt Na 1®R w4aRArTY Otitis -Certeeeetre. - anolh,d rnalr.hrse ce., rrteel au -a, Buena, t,n,i,. C,lwa..au / 2510314 B-1565 P -1O51 O9/1O/96 O4:1OP PG 1 OF 1 REC DOC 3/y Weld County CO JA Suki Tsukamoto Clerk & Recorder 6.00 57.60 WARRANTY DEED THIS DEED, Made this S711 between Noi.1 A. Putrlute des it c__ti..:rnhet 14 96 . of the County o r Fo,i idea and State of Co Iora-in grantor, and Clecrge A. Deck and Mari in Saki whose legal address is 2it60C Eaa- 168 t.1-1 Avon.:e, E.righton, Corrado 806.71 it the Country of Weld ;aid .Stairnl try credo ,lir.:nrees_ WITNESS, Thai the granair, ler and in consideration .,f the .;um of FIVE :dui Ep SEVENTY Ix THOUSAND AND NC/100 • - DOLLARS, (6576,060 . C I1 ), the receipt anti sufficiency of which is hereby acknowledged, has granted. :argainud. sold and conveyed. end by these presents does granther- gaia., sell, cat:vey and confirm. unto die grantee;, their heirs and -IL:signs forever. not in tenancy In cutntr un but in inlet tenancy, all the real property together with improvements, if any. .situate. lying and being in the County of Weld and State of Colorado, described at follows: The S::uti_ Half of Cect i-on 21, Township 1 Noi l_I:, Range L6 Welut. of the 6ti Y.M., ctx.ept all title in kaloogn Fake, County of Weld, State o: C::l urado and including 18 paired shares of Burlington and Wellington water stock (Brighton Lateral) /0/ /� 7 alsoknnwnhystreet-.tndnutnberas 14323 We ID ::ounty Road 6, Foe Lunt:On, Colorado 80601 TOGETHER with all mica singular the herein tamants and apdhrtenanec, tharutmlu belonging. or in anywise appertaining, and the reversion and reversion,,. remainder and remainders. rent... issues and profits thereof, and all the estate, right. tile. interest, claim and demand whnOoevcr of the grant.:r, either in low ,:r eslitirv, of. i1t and to the above himgeined premises. with the hered .laments and appurtenances. TO HAVE AND TO 11O1.D .he .;aid premises above bargained and described. with the appurtenances. unto the grantees. their heirs and assigns forever. And the grantor, for himself. his heirs and personal representatives. does covenant grant. bargain nr.d agree to and with the granter,,, their he•.rs end assign:, that [it the time of [hr cusealitig and delivery of these presents, he is well seized of the premise.; alxc.ve conveyed, has zncd. Mme. ner[ect. absolute and indefeasible. estate of inheritance, iii Iuvt-. li fee wimple, and has good right. fall power and lawful -authority to grant. bargain. sell and convey the .carne in [muffler and farm a..i aforesaid, and that the aaui are tree and clear from ail lnriner and otha' grants, hicegaina. ealcs_ ]iris, taxes, us sexsmcuts. encumbrances and rrrtrietions it whatever kind on nature Braver. except for taxes fur the current year, a Ilan hut nut yet due ur pays hle, easetnenls, restrictions, reservations, covenants and richts•uFway of reward, if any, . The grantor shall end will WARRANT AND FOR IIEI'ENI7 the Ii ccto-bargained [>rumises in the duict and irraeeahle lxtsaes- cian of the grantees, their heirs and wolf c. egeiast ali anti cc -err- Parma ,or persons 1awtiil ly claiming the whole or any partthercxtf. The singulie number ;hill include the plural- the plural the iiuguiet. and the use ,:F any ender shall he applicable to all ger.ders. IN WITNESS WHEREOF. the grar;tor but exec',ilti this [toed nn the dine set forth ahcve. Neil A. Putnam, STATE OF colorac₹c COUNTY Oh Adema The foregoing instrument was acknowledged before me :his Neil A. Putr.zim se. clay of itrtptetrher i) 96 , by itratkpu extnres: dun e 22 , 197 Witness my ]rand and ol', icin] ifIRENDAL Affi HLETA; Notary Public Doer_ela T.. At' ;_'-i-slut,:o Int Tenants, r ilz4 (149If$A'i5 'n ty l.t 1.4 m 0 0 K 7 0 0 't7 0 z cot .eel 1.111.1ll IIIIII IIIIi llll 1111111 VIII III VIII 1II I1tl 03/26/1098 02ti1A Weld County CO 1 of 1 R 6.00 A 0.00 JA Suki Tauk.moto QUIT CLAIM DEED THIS DEED, tylnde this 2541. day of March between of the , 19 98, GEORGE A. SACK and MARIE SACK 'County of Weld and Slate of Colorado. grantor, and GEORGE A. SACK and MARIE SACK whose legal address is 1 4323 Weld County Road 6, Fort Lupton, Colorado 80621 of the County nl' Weld - Recorder. end State -of -Colorado, grantees, WLTNESSf I1, That the grantor, lie and in consideration i f the suet of other valuable consideration and TEN and No/100ths (10.00) DOLLARS the receipt and sullieiency of which is hereby acknowledged, has remised, released, sold and QUIT CLAIMED. and by these presents does remise, release, sell and QUIT C.i:AIM-unto the grantees; their -heirs-, successors and assigns -forever, notintenanc-y. in common, but in joint tenancy, all the right, title, interest, claim and demand which the grantor has in and to the real property, together with improvements, if any, situate, lying and being in the County o - Weld and State of Colorado, described as follows: The North One —Half (N1/21 of then ScouthwPat One —Quarter (SW1/4) of Section 21, Township 1 North, Range 66 West of the 6th P.M., County of Weld, State of Colorado, also known by street and number as: 1 4323 Weld County Road 6 Fort Lupton, Colorado 80621 TO 13AVFi AND TO HOLD the same, together with all and singular the appurtenances and privileges thereunto belonging or in anywise (hereunto appertaining, and all the estate, right, title, interest and claim whatsoever, of the grantor, either in law or equity, to the only proper use, benefit and behoof of the grantees, their heirs and assigns forever. The singular number shall include the plural, the plural the singular, and she use of any gender shall ha applicable to all genders. 1N WITNESS WHEREOF, The grantor has executed this deed on the date set birth shove. `�.• a — George'A. Sack STATE OF COLORADO, Marie Sack as. County of ADAMS The foregoing instrument was acknowledged before me this Z 541. day of by George A. Sack and Marie Sack My comntission expires June 6 t r} *Lf in Denver, insert "City and: March , 19 9 9. Witness my hand and official seal, toer. 3 North Main Street Brighton, CO 80601 ,l9 98, No.962. Rev. 12-91. QUIT CLAIM OFCDII, .fa,nrlkn.nta5 aradtord Publishing, 1741 St., Den,,, CO 50202 —. {30]} 292-2500 — I t-91 111111umu�wu tell Mill _0:3 xf,aa X ,4rsN� I SCALE t' [00 SE: 1 1 K _ 0 I War, COUNTY tC�NL. '2 001,21E5 0+0.0 AK' c,U - aa, - 05 MO 2OO:e� NW CORKER t. 21, I 'EN 4.SSW. f€p_ ha.. 1 011 WI/411XLR ii, SEC. 21. T l Y., R.5@nt ..— (Lx 1+ 4 R=bmj I NE5,EEE_ I'IaaliE lap) r _ L II 0010- 1 I. 1.0011 l__. C'O i'2 D D E. EM P I I O\ NC_ 1471 -21 -03 —RE -2251 A PART OI- 1 HE SOUTHWEST 0NE-OTARTER S. CTION 21 , TOWNSI I'P NORTH, RANCE 66 WEST OF TH- SIXTH H PRINC,PAL MERIDIAN, WIELD COUN I`', COI ORADO 02,74 SORNER 511. 7.1. TiN 8540. ;En. F:n am t:Op' 7EN-ER SF 7. 21, I'N 10110+V NY99.1" F ?x t 1•7L+ QC,. 00A+ a II 21 North Lne 101/0 Nee- 21 UT C Ccyntciris 22 19 Acres rrisre or less DO. x 0552bv' Ls 50'00 L E lI 6 L_ S AO GL CO E _ _' 8' E 17a 6 1?. 8F• 1 —1 WELD COJNTY ROAD 6 SE -:3C rEXCEPTED o- E, � of '. +1+[115 L'SNNLM 10++ 11-0- N 6: 4 CORNER 3 7511 ,1, T_ I N_, 0.60.0 1r+ 1," ,+:,,m C'0' 4IC!NTO 1107 — Y• 2500' A. rN1 +FELIF E* THr; 56�1. OW � 01,13I101,13I1R1 1+0 s /PN E PNREE S.�mr NErEUN '11/ A�SiN�` "f wPV4 4N '5 &E74'1 1. ALL '+101+60. CLI .6 5110 f EEy N RdGPFiry .1 + 01+ 5 HE 0000 W5Yt01 iN VHI I 110 C'�R L5ES. M SIZE MAL ON 11N _w.XIG s 3 1,00 70 111E [ L.0 OE 30.01X4 PERM.- ON 0. - SauLL EN 4 NXU wO OCr0N1+L NTr, ,f w 1 X sf. nF N�eaFNT wN .1111 VR if C3FVPPLSE IE CEO IN 1a E21 0 / 1 a +111001+ 100111001N Nax.*O 11x0 F9oX n+[ =0X+01 ".✓. 0+411 d ON N0 031 E OVE RE E0 IA. 9 10x. 0 1030 3340 ?TO#E [ 0s�fN.r+w 4. DOES fm1 ole 11+1 wv5`7UCOr`f Er 1011 £ . 11+10 �., . Ae r.�wX aaoicn1as 9E LOR.C; [ SEC. . N. Kula K:EPI.NCE. Oin .6.1 ta alxM an oProeap iy IO:np, G7s7, ['-40x1[7+5 1I 1x41, '2T ftCOX .. J OA 700 .pry 1I.W E 1 F.l nFo'slrnON 5C`.11INESr ONE-NVa:1tii st_Ikx of NORTH a _ 1[11,1 1+= o 04 f L0SNam1 - eL SAID 1171,1114,51- LONE O'.LLR1Ea 1.11113 x1.1 ENE1151.121G: SOWC C014,1,4.5kMVVf ac'w Al.. 3000 SOLITA LINE Ia ;iS'6NCE ace: +221-K 0+00010110 n 17' IN,.E OF .12.41 'OAM . FL.., - I_ i-G,3 ,XL: 111 SEINE 5C00'0.b r W.,. 111 .5,2.59 5 To", I5p;,r=PESO 4:1€RSr.EcYrN A +,sANCF 2423 NdNE- _. 00FEEL IFIENCE M1,0,01+' n ti91XNf£ c; 1E5, 30 FIT N 114 E2aE 0aW- OF i.M mree0 o NuBjeLl 10 Sow:" Flunk' nfTMe Sewn Ler sda soLtrmea1 0......aim is ..armed e_ te., ..Ne edale nHnr . UE • raXs nN1u, paxrae wdeaa.ww' u • af - >nx armor: my ro m . ed • 01. an w.• r y1 Rk Iry E 000 of 4 Aaoo_..i nn Nc Ocla�� vy�� Weld h �cartoda1�n�it�rf aaar,. `- m `or!e ix 21 Ra Rer 211 F +E. k ININr a-xe tEfla 00mN w ema.i,� 1111g Emeare Eva....1 Ma gate no, Y e.::row,ry M S.nE 00 a N 4cLity +•ki w 3n.. [r ird 0xwvbrvn:eF o 111+.,.5 nwuEce ao�Nrv.� ,tM D o�n,:ao ,5511 other nxr , rg.. cGraNY ...a a LJ. 5x10 ar 4oarcm) =u ryo�f /%�yY6 , )50 of rtiatl..a? ...Oka., R.ILL Warn LouI O�4 E 1,5+101, [EEO1 RECORDED EXE?A,'TI:iN - PAST OF THE SW1/4 SECTt)N 21, TOWNSHIP 1 NORTH, RANG!: iiVEST [DT THE 6TH P.M.. WE_'J CI0U'41-Y, COIORACO ACKa4M ASSOCIATES, INC. a ma0 x Elrex a aP c nor IFuLEO 2:—.N6= if 11230*m 00 II 9 • District Court ❑ Denver Probate Court WELD County, Colorado Court Address: WELD COUNTY DISTRICT COURT 901 9TI1 AVENUE GREELEY, CO 80601 4241947 Pages: 1 of 2 10/03/2016 03:22 PM R Fee:$16.00 Carly Koppel, Clerk and Recorder, Weld County, CO F'Ali 11111 IN THE MATTER OF THE ESTATE OF: MARIE SACK Deceased COURT USE ONLY Case Number: 2016PR30239 Division: Courtroom: DISCLAIMER OF JOINT TENANCY INTEREST I, George A. Sack, am the surviving spouse of the above decedent and the surviving joint tenant of certain property owned by me and the above decedent who died a resident of Weld County, Colorado, on April 25, 2016, as evidenced by the attached death certificate. Being over the age of twenty-one years and desiring to avail myself of the privilege granted to me by §15-11-1201 et. seq. of the Colorado Revised Statutes, and by §2046 and §2518 of the Internal Revenue Code, 1 hereby disclaim and renounce all right to receive the decedent's undivided one-half interest by right of survivorship in and to the following jointly -owned real property, located in Weld County, Colorado: The South Half of Section 21, Township 1 North, Range 66 West of the 6th P.M., except all title in Kalooga Lake, County of Weld, State of Colorado and including 18 paired shares of Burlington and Wellington water stock (Brighton Lateral) I declare that prior to the execution of this disclaimer I have not accepted the disclaimed property nor any benefits therefrom and i have not assigned, conveyed, encumbered, pledged, transferred or acquiesced in the sale or disposition of such property. This disclaimer is voluntary and shall be irrevocable and binding upon my personal representatives, heirs and assigns. After this disclaimer l will continue to own an undivided one-half interest as tenant -in -common in the above -described property and the disclaimed portion of such property shall pass as directed by the decedent's Last Will probated in Weld County, Colorado. STATE OF COLORADO COUNTY OF 0O11)? ) ) ss. George A. Sack Tckie foregoing instrument was acknowledged before me by George A. Sack, this j(171 day of (,) ,Mt¢l , L(0 Witness my hand and official seal. My commis JESSICA GERZE NOTARY PUBLIC lion eeIOF COLORADO NOTARY ID 20074031304 MY C0P MSSION E)U IRES 5/2019 STATE OF COLORADO imp" mevwets) . van ri *Ice al CERTIFICATE OF DEATH DECEDENTS LEGAL NAEY MARIE KATHERINE SACK SOCIAL SECURITY NUMBER -6719 AGE -Last Birthday (Years) Facia), Name /If rot.lrshtut on, give street & nelhtxuI 14323 COLIN IY ROAD6 RESIDENCE- STREET AND NUMBER 14323 COUNTY ROAD 6 RESIDENCE STATE COLORADO STATE FILE NUMBER 105201 6012120 UNDER 1 YEAR I UNDER 1 DAY Months Days IHous Minutes DATE OF BIRTH (Mo(Day/Yr) APRIL 1', 1945 IF DEATH OCCURRED SOMEWHERE OTHER THAN A HOSPITAL DECEDENTS HOME COUNTY WELD CITY, TOWN OR LOCATION Cl- DEATH UNINCORPORATED WELD DECEDENT'S USUAL OCCUPATION (Give kirKi of work Dora during most of working Ian. Do not use retiree) DAIRY FARMER'S WIFE • DECEDEN" OF hdSPANI,. ORIGIN EVER IN US ARMED FORCES NO FATHER'S NAME LAWRENCE VONFELDT INFORMANTS NAME GEORGE A_SAUK NAME OF FUNERAL HOME TABOR -RICE -.FUNERAL HOME METHOD OF DISPOSITION BURAL- CEMETERY IN.#URY AT WORK PLACE OF INJURY MARITAL STATUS AT TIME OF DEATH MARRIED LOCATION OF INJURY (Street 6 Nunbor, Apt. Nre Cy.j Foirym. Ceuoty $1 1e Z!pCodei DESCRIBE HOW INJURY OCCURRED WAS DECEDENT UNDER HOSPICE CARE MANNER OF NATURAI IMMEDIATE CAUSE (Find disease er conrbden resulting in -death) Sequanbaiiy list WPdbons. if any, load+%% to the cause Wed on line 0. ✓=rser the UNDERLYING CAUSE (disease or in}uny that iriEated the events resultintyln death) BIRTHPLACE - Stale or Foreign Ct rtry) COLORADO COUNTY OF DEATH WELD TIP CODE 80621 CITY OR TO'IVN UNINCORPORATED WELD KIND OF BUSINESSRNDUSTRY AGRICULTURE ❑LCEDENTS RAGE • „yya ire INSIDE. CITY UMITS NO DECEDENTS EDUCATION I IIGH SCHOOL GRADUATE OR GED COMPLETED. SPOUSEJPARYNEWP5AM (tls 1ttpiv9 name prior to fifst mernage) GEOR3E A. SAel ' " x. MOTTiOR_S.NAME PR14R 1O. F1t(ST MARRIAGE APF'OELONfA .lentoHO'2 INronstarirb fCicsnEct,4sco SPOUSE ,7°In. y. )I CITY AND SPATE OF FbelERAL-„ BRIGHTON COLORADO DATE OF Ip.1t:RY WAS CORONER NOTIFIED YES TIME OF INJURY - k. 1. .. a 3}. ITC OR PRESUMED TIME OF'D€ATH' - OAT'ONi]UNCFI},UEAD,(III(' DA> TIME PRONOUNCED DEAD It.:2Apg IL - - AP 25,,21111 6 - ` 22:05 MIL y 1 ]r WALSAN AUTOPSY £liFdRlp(�O„ V4ERE A(YFIND;NGS CONSIDERED IN DETERMINING c FDEATH? CAUSE bt -d Enter the Vt�rVaasa, triples. or p - -dlecliy caused the death. b ASCVO PART II Enter other 5p//L(fi Epflt madman; SMnhuero to d98th but not resulting in the underlying cause giver In PART TITLE, NAME. ADDRESS. ZIP CODE AND COUNTY OF PHYSICIAN PR IYANKA CUP IA MD 3593 4TH AVENUE BRIGHTON -CO 80601 TITLE, NAME. ADDRESS, ZIP CODE AND COUNTY OF CORONER DATE FILED 'SY REGISTRAR MAY 02, 2016 MAY 04, 2010 DATE SIGNED APRIL 29,12246 DATE SIGNED Approwmete interval: Onset Io death IMMEDIATE 4241947 Pages: 2 of 2 10/03/2016 03:22 PM R Fee:$15,00 Carly Koppes,IlClerk and Recorder, Weld County, CO �I Rl�ARA DATE ISSUED THIS IS A TRUE CERTIFICATION OF NAME AND FACTS AS RECORDED IN THIS OFFICE. Do not accept unless prepared on sorority paper with high resolution border displsying the Colorado state sal and signature of the Registrar. PENALTY BY LAW, Section 25-2-118, Colorado Revised Statutes, 1982, if a person alters, uses, attempts to use et furnishes to another for deceptive use any vital statistics record NOT VALID IF PHOTOCOPIED. REV 01/16 1111111 :! * 007800801 * Hello