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E a' C O m w p CC 0 w " I- L_ 5 a� c a= CC D 2 CC Z CC v p- -0 4- N CU D cn Q W Lij Q O w r a) -O (Cr_ (1) to D Z Z CCU - L (0 0 Y CC CERTIFICATION RE: NOTIFICATION OF MINERAL INTEREST OWNERS AND LESSEES The undersigned Applicant certifies compliance with the provisions of C.R.S. § 24-65.5- 103(1). and in support thereof, states and certifies as follows: 1. That Applicant has provided notice. (a copy of which is attached hereto as Exhibit "A"). containing the time and place of the initial public hearing on its application for Case Number USR 13-57. the nature of the initial public hearing, the legal description by section. township and range of the property which is the subject of the initial public hearing, and the name of the applicant: 2. That said notice was provided thirty (30) days prior to the scheduled public hearing. that it was provided by certified mail. return receipt requested. or by a nationally recognized overnight courier: 3. That said Exhibit A includes the list of the names and addresses of the surface owners. mineral estate owners and lessees of mineral interests to whom the notice was sent, including those persons who have requested receipt of such notices, pursuant to C.R.S. § 24-65.5-103(3). APPLICANT: Tc1/57.2e,t4ivt.._ c'l itec�t� STATE OF I� COUNTY OF ' ` - Subscribed and sworn to before me this ,'"day of 1,; r �,t �_ . 2013, by Notar wPublic Note: This Certification must he received by the Weld County Department of Planning Services prior to or at the initial public hearing. If the Certification is not received by that time. the hearing will be rescheduled to a later date. and Applicant must re-notify all owners of mineral interests. JAMES M BJORLAND NOTARY PUBLIC STATE OF COLORADO NOTARY ID 20134033352 MY COMMISSION EXPIRES MAY 28,2017 Weld County Colorado Page I of I /C l ti r r ^ r l se.irrh Home About Departments Services Contact Us Properly In10/mation Mineral Ownership Listing By Legal Desc. for Township:05 Range.67 Section,32 ,.n f;a-x,.,5•ervP/i - cordsfar ins repuest 6a F http: '�+��w.co.weld.co.us'appsassessocownershiptindex.ctm I2•27 201 AFFIDAVIT OF INTEREST OWNERS SURFACE ESTATE • Property Legal Description: tort 1 the SaS“--)y o{' `ject,'on 32, TSJJ , Rro7ew o } +he 6/4 P- m b_ -id (0,* , C Parcel Number DA .5 '7 - 3 a - D - o o - 0 a 67 (12 digit number-found on Tax I.D. information, obtainable at the Weld County Assessor's Office,or vwv co.weld.co.us) (Include all lots being included in the application area If additional space is required,attach an additional sheet) THE UNDERSIGNED, being first duly sworn, states that to the best of his or her knowledge the attached list is a true and accurate list of the names, addresses, and the corresponding Parcel Identification Number assigned by the Weld County Assessor of the owners' of property (the surface estate) within five hundred (500) feet of the property being considered. This list was compiled from the records of the Weld County Assessor, or a person qualified to do the task, and shall be current as of a date no more than thirty days prior to the date the application is submitted to the Department of Planning Services. Signatures of all fee owners of property must sign this application. If an Authorized Agent signs, a letter of authorization from all fee owners must be included with the application. If a corporation is the fee owner, notarized evidence must be included indicating the signatory has the legal authority to sign for the corporation. I (We) hereby depose and state under the penalties of perjury that all statements, proposals and/or plans submitted with or contained within the application are true and correct to the best of my (our) knowledge. Signature Date Signature Date Signature Date -5- WELD COUNTY COLORADO LAND RECORDS AFFIDAVIT OF INTERESTED LAND OWNERS SURFACE ESTATE THE UNDERSIGNED, States that to the best of his or her knowledge the attached list is a true and accurate list of the names, addresses, and the corresponding Parcel Identification Number assigned by the Weld County Assessor of the owners of the property(the surface estate)within 500 feet of the property being considered. This list was compiled utilizing the records of the Weld County Assessor available on the Weld County Internet Mapping site, http://www.co.weld.co.us, and has not been modified from the original. The list compiled for the records of the Weld County Assessor was assembled within thirty days of the applications submission date. ,./�(L,f�,r1 ''),C Signature /y i" 3 Date Property Owners Within 500 ft. of Parcel# 095732000026 Account Parcel Owner Mailing Address R0422301 095732000026 GREATHOUSE SHAWN A 24155 CR 15 1/2 JOHNSTOWN CO 80534-9556 R0422401 095732000027 GREATHOUSE SHAWN A 24047 CR 15 1/2 JOHNSTOWN CO 80534 R0422401 095732000027 GREATHOUSE STACEY L R6777819 105905200071 NELSON PAUL DAIRY FARM 9000 COUNTY RD 52 LLC MILLIKEN CO 80543 R1023102 095732000017 RIEDER FARMS LP 7525 COUNTY ROAD 50 JOHNSTOWN CO 80534 R4539586 105906000033 SANDBERG KAY F R8572400 105906000035 SANDBERG KAY F R4539586 105906000033 SANDBERG LAUREN P O BOX 396 JOHNSTOWN CO 80534 R8572400 105906000035 SANDBERG LAUREN P O BOX 396 JOHNSTOWN CO 80534 R4702307 095731100007 SAUER JOHN SR LLC 6681 CR 50 JOHNSTOWN CO 80534 Hello