HomeMy WebLinkAbout20141719.tiff WATER TAP ASSIGNMENT
FOR VALUE RECEIVED,l/we hereby sell,transfer and assign to 7 ' (,I"1''
, one 5/8" water tap in the CENTRAL WELD COUNTY WATER
DISTRICT, on my/our property described as follows situate in Weld County, Colorado, to wit: (Legal
Description)
:Se( (CUP( ke '
IT IS UNDERSTOOD that these taps were purchased for the above described land and may not be
transferred to other land, without express, written consent, in addition to the below consent, of the
CENTRAL WELD COUNTY WATER DISTRICT. Uwe 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. l/we
hereby state that all water rates and charges and other monies owed to the District have been paid and if not,
shall be held out at the closing of the sale of my/our premises.
IN TESTIMONY WHEREOF, I/we have set my/our signature this , > day of
, ) 4,{l1C-t__ , 201/ .
** SELLER:
** SELLER:
l/WE FURTHER AGREE to pay any and all charges hereinafter levied by said District for said taps and to
abide by all regulations adopted by said District. The District has the right to review the annual allotment and
compare it to actual usage to determine if additional raw water will be purchased and transferred to the
District by Tap Holder.
ACCEPTED: '
**BUYER: Todd Bean
Dba Plumb Ridge, LLC.
**BUYER:
CONSENT TO ASSIGNMENT
I, John W. Zadel, General Manager of the CENTRAL WELD COUNTY WATER DISTRICT, Hereby
consent to the above assignment on behalf of said District.
BY:
John W.Zadel, General Manager
DATE:
f atet1 SEPTIC PERMIT INFORMATION FORM
IIIIk
COLORADO To obtain an I.S.D.S.permit,one must file an"application for Individual Sewage Disposal System"
at the Weld County Environmental Health Services office and pay the application fee. A"repair"fee
shall be charged for the expansion,replacement,or repair of an existing system. The following
information must be provided on the septic information form.
COMMERCIAL PERMIT RESIDENTIAL PERMIT
NEW or REPAIR $850.00 NEW or REPAIR $750.00
VAULT PERMIT MINOR REPAIR PERMIT
NEW or REPAIR$250.00 $100.00
PARCEL NO.: (IL P i ,, `) ( C' ' ( r) (12 DIGIT NUMBER)
LEGAL DESCRIPTION: SECTION TOWNSHIP ; 7. RANGE ( "1 ACRES C/ '; ty/
SUBDIVISION ',1 /_) LOT I ,' BLOCK /VIP FILING RE rj;; c-/
THIS INFORMATION CAN BE OBTAINED FROM THE ASSESSOR'S OFFICE AT (970) 353-3845 EXT 3650
SITE ADDRESS IPTh
DIRECTIONS TO SITE I-• '�`� r _ c , \,\ n on
0
Li 00th .
PROPERTY OWNER:1)1 (1nn I ? 'irIaP L-L('
MAILING ADDRESS: ' oaf CITY [ ST 1!; ZIP ,0(r' I;7 HOME PHONE: ( ) r,J I !{ WORK PHONE( ) (\J/ (`' FAX( )
EMAIL ADDRESS:- L1-)pr,tn(CPUr'(vCin CC (n
APPLICANT NAME: _ x ,o;'y. ! , '�)1 ) i ! . t'I'
MAILING ADDRESS: I' I t' ,( ): ',( ���-j 7 CITY ci r ti P I r. ) ST ( i ' ZIP ( (
HOME PHONE: ( ) A]: C. WORK PHONE(l) 'Y .CL`-r FAX( ) All h
EMAIL ADDRESS: i C7,nr'ic-f o,r A Q P✓-mar{i nry i.uX+-P r. !'.car.-,
DESCRIPTION OF BJIL�DING(EX:HOUSE,MOBILE HOME, MODULAR, SHOP,OFFICE) I 1 C,
IF OBTAINING A REPAIR PERMIT,WHAT IS BEING REPAIRED?
NUMBER OF PERSONS 1C, - IN FLOOD PLAIN AREA? YES/NO
NUMBER OF BEDROOMS /C ;,I PERCOLATION HOLES MUST BE MARKED FOR
INSPECTION OR A$50.00 FEE WILL BE CHARGED
BASEMENT PLUMBING YES/LNO
CENSUS TRACT
BATHROOMS: FULL sh 'A _
PUBLIC WATER SUPPLY IYES-YNO NAME i \P.)h 1,^ ' :'
PRIVATE WATER SUPPLY YES/lNO WELL/CISTERN PERMIT#
Weld County Environmental Health Services Department
1555 N. 17th Avenue
aI8ol t'. Greeley, CO 80631
Phone: (970)304-6415
• Fax: (970)304-6411
I Web:www co weldhealth org
Septic Permit Application
Application Number: SP-1400029
App Type: Health\Commercial\New\Septic
JIM GODDARD
EXPEDITION WATER SOLUTIONS
PO BOX 336597
GREELEY, CO 80633
Owner Name: PLUMB RIDGE LLC
Parcel#: 096336300026-R6779018
Legal Desc: PT W2 36-5-64 LOT A REC EXEMPT RE 5024
Site Address: TBD
App Specific Info:
1/2 Bathrooms 2
3/4 Bathrooms 0
Basement Plumbing No
Full Bathrooms 0
Location Description TBD
Number of Bedrooms 0
Number of Persons 10
Parcel Acres 43
Public Water Supply Yes
Public Water Supply Utility CWCWD
TERMS AND CONDITIONS
A permit fee,as set by separate ordiance of the Board of Weld County Commissioners,shall be required of applicants for new individual
sewage disposal systems(ISDS),payable at time of application Permit fees are non-refundable;permit applications are
non-transferable If both a building permit and an ISDS are issued for the same property and construction is not commenced prior to the
expiration date of the building permit,the ISDS permit shall expire at the same time as the building permit If an ISDS permit is issued for a
property that does not require a building permit,the ISDS permit shall expire one year after its issuance if construction on the septic system
has not commenced Any change in plans or specifications after the permit has been issued invalidates the permit unless approval is
secured from the Health Officer or his/her designated agent.Expired permits can be renewed by payment of the permit fee only if:
A There has been no change in the plans and specifications of the proposed system as set out in the original application or such
change is reviewed and approved by a Division Representative
B The surrounding land,its use or zoning has not changed so-as-to cause the original application not to be acceptable under these
regulations
NOTICE
The completeness of this application is conditional upon further mandatory and additional tests and reports as may be required by the Weld
County Department of Public Health and Environment(WCDPHE) The issuance of the permit is subject to such terms and conditions as
deemed necessary to insure compliance with rules and regulations adopted under article 10 title 25,CRS as amended.The applicant certfies
that the proposed system will not be located within 400 feet of a community sewage system The undersigned certifies that all statements
made,information and reports submitted herewith are,or will be,represented to be true and correct to the best of his/her knowledge and are
designed to be relied on by the WCDPHE for evaluation for purposes of issuing the permit applied for herein Applicant further understands
that falsification or misrepresentation may result in the denial of the application or revocation of any permit granted,and in legal action or
perjury as provided by law
X 'J v. j1,2' <
. /,fir " 7'
iJ,Oyrner/Applicanj-( Date
Report ID: EHS00056v003 Page 1 of 1
Print Date Time: 2/10/2014 11:30:34AM
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