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HomeMy WebLinkAbout20162103.tiffN0V 211969 ASSIGNMENT 30d7 IL. z - FOR VALUE RECEIVED, I hereby sell, transfer and assign to ANDREW HOP, JR. and MURIEL HOP, husband and wife, water taps in the CENTRAL WELD COUNTY WATER DISTRICT, on my described as follows: Situate in Weld County, Colorado, to -wit: The East half (E 1/2) of the Southwest quarter (SW 1/4) and the North half (N 1/2) of the Southeast quarter (SE 1/4) of Section Thirteen (15), Township Five (5) North, Range Sixty-five (65) West of the 6th P.M. It is understood that these taps were purchased for the above described lands and may not be transferred to other lands, without express written consent, in addition to the below consent, of the CENTRAL WELD COUNTY WATER DISTRICT. I further authorize the Secretary of said District to do any and all things necessary to effectuate this transfer on the books and records of said District. IN TESTIMONY WHEREOF I have set my signature this day of , 1969. CONSENT TO ASSIGN?' NT I, Dale D. Olhausen , Manager of the CENTRAL WELD COUNTY WATER DISTRICT, hereby consent to the above Assignment on behalf of said District, Manager ACCEPTED: buyer I Weld County Environmental Health Services Department 1555 N. 17th Avenue Greeley, CO 80631 Phone (970) 304-6415 Fax. (970) 304-6411 Web weldhealth.org Septic Permit - Final Application Number: SP -1400248 Owner Name: HOP ANDREW JAY Site Address: 27295 CR 47.5 WELD. CO 80631 App Type: Health\Residential\New OWTS\Septic BRENDA GREENHAGEN AGPROFESSIONALS 3050 67TH AVE #200 GREELEY, CO 80634 Parcel #: Legal Desc: App Specific Info: 096113000076-M3385286 12412 IMPS ONLY MH PT E2SW4 13 5 65 • Application Status: Ready to Final Applied Date: 09/04/2014 Issued Date: 09/09/2014 Finaled Date : is/`i/ LF Location Description Repair Reason Type Associated Building Permit Associated Building Permit Number Associated Disaster Permit Waive Fees Number of Persons Number of Bedrooms Public Water Supply Public Water Supply Utility Parcel Acres MOBILE HOME New Yes MFG 14-00070 No No 3 2 Yes CWCWD 73.46 Actual Installation: Septic Tank: I i'• 1 -! gallons Design Type -r > Absorption Trench sq ft Absorption Bed sq Chamber Model . .,4 ( k - ' ;. Chambers lei NOTICE The issuance of this permit does not imply compliance with other state. county. or local regulatory or building requirements, nor shall it act to certify that the subject system will operate in compliance with applicable state. county and local regulations adopted persuant to Article 10, Title 25. CRS as amended, except for the purpose of establishing final approval of installed system for issuance of a local occupancy permit persuant to CRS 1973 25-10-111 (2). This permit is non -transferable and non-refundable The Weld County Department of Public Health and Environment reserves the right to impose additional terms and conditions required to meet our regulations on a continuing basis. Final permit approval was contingent upon the final inspection of the completed s em by the Weld County Dgyauffiert ublic Health and Environment x Erfvironmental Health Specialist � Date Report ID. EHS00033v006 Print Date Time. 10/1/2014 8:58:31AM Page 1 of 2 NOV 2 11969 ad IT 2%() ASSIGNMENT 4t— ,13>R) , /5 FOR VALUE RECEIVED, I hereby sell, transfer and assign to ANDREW MOP, JR, and MURIEL MOP, husband and wife, water taps in the CENTRAL WELD COUNTY WATER DISTRICT, on my described as follows: Situate in Weld County, Colorado, to -wit: The East half (ii 1/2) of the Southwest quarter (SW 1/4) and the North half (N 1/2) of the Southeast quarter (SE 1/4) of Section Thirteen (13), Township Five (S) North, Range Sixty-five (65) West of the Gth P.M, It is understood that these taps were purchased for the above described lands and may not be transferred to other lands, without express written consent, in addition to the below consent, of the CENTRAL WELD COUNTY WATER DISTRICT. I further authorize the Secretary of said District to do any and all things necessary to effectuate this transfer on the books and records of said District, IN TESTIMONY WHEREOF I have set my signature this day of 1969, Cam• / Sherman R, N,itmore CONSENT TO ASST CNIIENT Dale D. Olhausen , Manager of the CENTRAL WELD COUNTY WATER DISTRICT, hereby consent to the above Assignment on behalf of said District, i�, Manager ACCEPTED: zuye f Scanning Cover Sheet for Septic Permits Permit # G19810079 Permit Type: Health / EHS History / EHS Conversion History Situs Street Address Situs City, State, Zip 27454 CR 47.5 Sec/Town/Range: 13 -05N -65W Parcel # (12 digits) Owner Full Name: Owner Address: Contact Name: Contact Address: 096113400001-R4250606 A BAR A DAIRY 27454 WCR 47 1/2 • KERSEY,CO 80644 Application Status: Finaled Application Date: 03/11/1996 Owner Phone #: 303 3537112 Contact Phone# Information above has been Verified in Accela by employee noted below X January 16, 2009 Processed by: Date Report ID: EHS00024v003 Page 1 of 1 Print Date -Time: 1/16/2009 1:43:42PM - • , A,PPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM JNo. . WELD COUNTY HEALTH DEPARTMENT 0 .I ` n 'New TotENVIRONMENTAL HEALTH SERVICES ({ 1618 Hospital Road, Greeley, CO 80831 Repair _ PAT 42 / ',wy.,.' BP j� 353-0640 EXT. 270 OWNER t' i"-?-1. _'IA -4 ' j !'n (!'.ADDRESS C 7 r/rV /...4/ r ze r/7 i : .-. PHONE ADDRESS OF PROPOSED SYSTEM LEGAL DESCRIPTION OF SITE: PT '-5 ( ✓y1 S I. T .5 R /C.C. SUBDIVISION LOT ,.BLOCK , FILING USE TYPE: RESIDENTIAL INSTITUTION COMMERCIAL OTHER fro ,r V SERVICES: . PERSONS BATHROOMS /1,749 LOT SIZE 9 19 .+leo.s BEDROOMS BASEMENT PLUMBING WATER SUPPLY / /- !, % TYPE OF SEWAGE DISPOSAL REQUESTED: Dior /! 4 .'q' dal Applicant acknowledges that the completeness of this application is conditional upon further mandatory and additional tests and reports as may be required by the Weld County Health Department to be made and furnished by the applicant or by the Weld County Health Department for purposes of the evaluation of the application; and 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 1973, as amended. The applicant certifies that the proposed system will not be located within 400 feet of a com- munity sewage system. The undersigned hereby certifies that all statements made, information and reports submitted here• with and required to be submitted by the applicant are, or will be, represented to be true and correct to the best -or my knovil- edge and belief, and are designed to be relied on by the Weld County Health Department In evaluating the same for purposes of Issuing the permit applied for herein. I further understand that any falsification or misrepresentation may result In the denial of the application or revocation of any permit granted based upon said application and in legal action for perjury as provided by law. v Application fee �`-� • �� �O/ ----Reed by (#.• '/A ,6 ‘')/h1:7-6:0 Date g -Ic / OwnerlAgent'Slgnature Date • • • • • • • • • • • • • • a FOR DEPT. PERCOLATION RATE 7S!t ,/� -i WATER TABLE DEPTH >&F?' USE ONLY SOIL TYPE a - PERCENT GROUND SLOPE ievir.1 ' REQUIRES ENGINEER DESIGN ( ) YES (.1 No INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT From the application information supplied and the on -site soil percolation data, the following m um installation specifi- cations are required: SEPTIC TANK /Gee GALLONS, ABSORPTION TRENCH 145- . SQ. FT. or ABSORPTION BED l 9.O SQ. FT. In addition, this Permit is subject to the following additional terms and conditions: This Permit is granted temporarily to allow construction to commence. This Permit may be revoked or suspended by the.Weld County Health Department for reasons set forth in the Weld County Individual Sewage Disposal System Regulations, including failure to meet any term or condition imposed thereon during temporary or final approval. The Issuance of this Permit does not constitute assumption by the Department or Its employees of liability for he failure or Indequa;j of sire sewage disposal system. 7/6/4/ Environmental Specialist Date This Permit is not, transferrable and shall become void if system construction has not commenced within one year of its issuance: Before Issuing final approval of this Permit the Weld County Health Department reserves the right to Impose additional terms and conditions required to meet our regulations on a continuing baels. Final Permit approval Is contingent upon the final in- spection of the completed system by the Weld County Health Department. SYSTEM CONTRACTOR _ FINAL INSPECTION n/v SYSTEM ENGINEER APPROVAL X// ` Bari €O ,,,,, E ronmental Specialist Date The Issuance of this Permit does not Imply compliance with other state, county, or local regulatory or building requirements, nor shall It act to certify that the subject systemwill operate In compliance with applicable state, county and local regulations adopted pursuant to Article 10, Title 25, CRS 1973, as amended, except for the purposes of establishing final approval of an installed system for Issuance of a local occupancy permitpursuant to CRS 1973 25.10.111 (2). l Origlnal•Applicant; Copy-WCHD 1 �J WCHD-EHS February, 1981 /‘10 jai 16 �', / Hello