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HomeMy WebLinkAbout4.0 BOCC Staff Report 11.07.199460JaVelc BOCC 11/7/94 PROJECT INFORMATION AND STAFF COMMENTS REQUEST: APPLICANT: An exemption from the definition of subdivision. Bobby and Donna Burkett LOCATION: A tract of land located in Section 17, T7S, R88W of the 6th PM, located approximately one f (1/2) mile east of State Highway 82 an the CR 113 intersection. Sic SITE DATA: 10.2 acre parcel WATER- Well SEWER: ISDS ACCESS: CR 113 EXISTING/ADJACENT ZONING: A/R/RD I. RELATIONSHIP TO THE COMPREHENSIVE PLAN The site is located in District D - Rural Areas Moderate Environmental Constraints as designated on the Garfield County Comprehensive Plan Management Districts' Map. II. DESCRIPTION OF THE PROPOSAL A. Site Description: The site is located in the lower terrace of the Cattle Creek, in an area of low-density residential and agricultural uses. Improvements on the site include a single-family home located near the south-central portion of the proposed exemption. The parcel slopes gently towards the County Road, with total relief change o the property of approximately 40 feet. A vicinity map is shown on page ' . Based on comments from staff and Board, the • • III. MAJOR ISSUES AND CONCERNS A. Subdivision Regulations. Section 8.52 of the Garfield County Subdivision Regulations state that "No more than a total of four (4) lots, parcels, interests or dwelling units will be created from any parcel, as that parcel was described in the records of the Garfield County clerk and Recorder's Office on January 1, 1973, and is not a part of a recorded subdivision; however, any parcel to be divided by exemption that is split by a public right-of-way (State or Federal highway, County road or railroad) or natural feature, preventing joint use of the proposed tracts, and the division occurs along the public right-of-way or natural feature, such parcels thereby created may, in the discretion of the Board, not be considered to have been created by exemption with regard to the four (4) lot, parcel, interest or dwelling unit limitation otherwise applicable; A deed submitted with the application describes the parent parcel on January 10, 1972 (Book 426, Page 234, Reception #252275). Therefore, the applicant is eligible to request up to four (4) parcels can be created through the exemption process. B. Zoning. Both exemption parcels are consistent with the required two (2) acres minimum lot size for the A/R/RD zone district. C. Legal Access. The parent parcel is accessed directly from County Road 113. As submitted, it appears that the applicant intends on providing access to the exemption parcel with the same driveway. If this is the case, the exemption plat must show an easement to provide for access to both parcels. D. Water and Sewer. The applicant has not indicated any plans for domestic water. A summary report for a well under the name of John P. Wierenga was submitted with the application, but did not indicate the status of future dwelling units on the well. Staff referred the application to the State Engineer's Office. No response has been received to date. Staff would suggest that a favorable response from the State be a condition of approval. Sewer will be provided by ISDS. Soils on the site are predominantly Southace Cobbly Sandy Loam (#98), which is considered to have moderate constraints for ISDS, although the primary constraint is based on slope. Fieldwork indicated that slopes on the site do not appear to be an issue on the site, and no plat notes appear necessary. E. State and Local Health Standards. No State or Local health standards are applicable to the application, with the exception of Colorado Department of Health ISDS setback standards, which should be verified by an engineer. F Drainage. No drainage easements appear to be necessary, but should be verified on the field by the applicant's surveyor. • H. Easements. Any required easements (drainage, access, utilities, etc..) will be required to be shown on the exemption plat. I. School Impact Fees The applicant will be required to pay the $200.00 impact fee prior to the approval of the final plat. J. Natural Hazards. Staff referenced the Lincoln - Devore Laboratories Natural Hazards Mapping for the site. The proposed exemption is located within an area identified as having severe constraints for ISDS. Staff suggests that this constraint is addressed by the proposed Plat Note. K. Floodplain: The property is encumbered by the 100 -year floodplain of Cattle Creek. A review of CWCB 1982 floodplain mapping indicate that the floodplain profile through this section of is quite narrow, a likely will not impact a building envelope on the site. Staff would suggest the following plat note: ( SFS *s-) L. Deed Restrictions.. A portion of the property was subject to a boundary line adjustment/land exchange with David and Julie Beck. The deed restriction prohibits the construction of any residence or dwelling unit except for the purpose of the "grantees or issues". In other words, the dwelling unit must be for either the Burkett's or members of their family. The exemption is being requested to provide housing for the Burkett's son. Staff confirmed with the Beck's Attorney (Dan Kerst) that the deed restriction may be difficult to enforce as written. M. BLM: The Bureau of Land Management has reviewed the project, and indicated that all mineral rights on the southeast portion of the subdivision are reserved for the United States (See Michael Mottice's letter on pages tam ). In addition, the BLM requested fencing standards for the BLM property line. N. Disputed BLM Corner: As discussed at the last hearing, the property includes two (2) BLM 1/16 corner caps. These caps are located approximately 92' from each other, and result in a disputed boundary with an adjacent property owner (Bill Crymble). The County Surveyor (Sam Phelps) conducted the revised survey for the applicant, and will be available at the hearing to address the issues surrounding the different BLM caps. Staff points out that Mr.Crymble has also applied for an exemption, and would suggest that no approval should be given without a favorable recommendation from Mr. Phelp's in terms of potential problems for this property and Mr. Crymble's. O. Adjacent Land Owners: Julia Dows previously submitted a letter of objection at the August hearing (see page ' 6 ). • complete, that all pertinent facts, matters and issues were submitted and that all interested parties were heard at that meeting. 3. That for the above stated and other reasons, the proposed exemption is in the best interest of the health, safety, morals, convenience, order, prosperity and welfare of the citizens of Garfield County. V. RECOMMENDATION Staff recommends APPROVAL of the application, subject to the following conditions: I . That all representations of the applicant, either within the application or stated at the meeting before the Board of County Commissioners, shall be considered conditions of approval. 2. A Final Exemption Plat shall be submitted, indicating the legal description of the property, dimension and area of the proposed lot, access to a public right-of- way, and any proposed easements for setbacks, drainage, irrigation, access or utilities. 3. That the applicant shall have 120 days to present a plat to the Commissioners for signature from the date of' approval of the exemption. 4. That the applicant shall submit $200.00 in School Impact Fees for the creation of the exemption parcel. 5. That the following plat note shall appear on the Final Exemption Plat: "Both parcels are located within the 100 -year floodplain of Cattle Creek. Any encroachment within the regulated floodplain requires a Special Use Permit from Garfield County." A favorable response from the State Engineer's Office must be received prior to the signing of an exemption plat. Control of noxious weeds is the responsibility of the property owner. All construction shall be consistent with USFS Wildfire Prevention Guidelines. The following plat notes shall be included on the Exemption Plat: a. Should any fence construction be considered along the BLM boundary, the height shall not exceed 42", with a 10" kick space between the two top wires. n ithaact narrPl is rec.erverl by the r 1 Or 4I 1ILA 1 ?-00-005 SEE MAP NO. 2393-07 � S EXEMPT UNDARY 2393-074-00-013 Tax Ex. BLM BOUNDARY Tr. 3 X BLM BOUNDA BOUNDARY 9 11 1 4 12 F7 k YYYY 13 14 10 4 4 6 05 -134 -OO -002 18 17 • •- NOR?-/-///4;RNER - SECT/ON /7 BRASS CAP • : /309.03' NW V4 NE %.41 " Goo' 1 31{ 9 AA '' N89'39'3S"E // 7.67 ,5 ° Al N88° l '2/" E 389. 9' 1 I BRASS CAP E PARCEL / - S./97 AC. /V 89°/6'/2"W /3/2. 35' CE/VTER OF THE NE QUARTER , OF SECT/ON /7 ---- ------- 56.00' -- 824.25' 0 8 PARCEL 2 6.603 AC. 0 NE 374.43' 03 (B tth N • SW /4 NE"/4 N O O 56.00' - r 5 OO° 22',3/" W // N499°03'17" W 0.7.: • RCE. '7 SE 4 / • CARBONDALE & RURAL FIRE PROTECTION DISTRICT 1994 1' f4 300 Meadowood Drive October 25, 1994 Dave Michealson Garfield County Planner 109 8th St. Glenwood Springs, CO 81601 Dear Dave, �,,. j ),'r" Carbondale, CO 81623 (303) 963-2491 FAX (303) 963-0569 I would like to offer the following comments regarding Bob Burkett's proposed sub -division exemption for his property located at 1170 County Road 113. As I understand it the proposal calls for making two lots out of one lot and the future construction of a single family house. The District will provide Fire and EMS service to the property with first response coming out of the Westend Fire Station and additional response coming out of the Carbondale Station. Response time to the property is approximately 15 minutes. Water supply for fire protection will be the water carried on the fire trucks, augmented with the District's water shuttle program. All access roads to the improvements should be constructed according to the Garfield County standards for sub -divisions. If you have any questions feel free to contact me at 963-2491. Sincerely, • United States Department of the Interior Vi • BUREAU OF LAND MANAGEMENT Glenwood Springs Resource Area 50629 Highway 6 and 24 P.O. Box 1009 Glenwood Springs, Colorado 81602 September 8, Mr. hark Bean Garfield County Planning Department 109 8th Street - Suite 303 Glenwood Springs, Colorado 81601 SE( 4""t Ca 1994GAFiFNELD CCM Dear Mr. Bean: In response to your request for comments regarding the proposed Burkett Subdivision Exemption, I offer the following statements for your scheduled September 12, 1994, public meeting. Portions of the 10.2 acre tract are adjacent to public lands administered by this office. Current uses on the BLM include wildlife habitat, and dispersed recreation such as camping, mountain biking, off-highway vehicle (OHV) use, hunting, and hiking. 1. Ownership of land adjacent to BLM-administered public land does not grant the adjacent landowner(s) any special rights or privileges for the use of the public lands. 2. The proponents should be aware of the location of property boundaries to ensure no encroachment occurs on public land. Should any fence construction be considered along a BLM boundary, the fence standards should allow for easy passage by big game, i.e. less than 42' in height with a 10' kick space between the top 2 wires. 3. The adjacent public land is not currently being permitted for livestock grazing. 4. I am concerned about the increased use of public land by future residents and what impacts that use may have on public land, particularly with Off Highway Vehicles. The adjacent public land is open to hunting. The proponent should be aware that such recreation uses are allowed on BLM-administered land. • 6. We are not aware of the location of utilities for power, telephone, etc. to the property. If utilities are proposed that would cross public land, the utility company would have to obtain a right-of-way from this office. We appreciate the opportunity to comment on this action. If you have any questions or need additional information, please contact Jim Byers in this office at 945-2341. Sincerely, _A4 atira ('JGt a Michael S. Mottice Area Manager / )j 1=1:.LU Goom. Y `t LA0cA,( 31 &4 ex e -r , V i ccii-i 6-7't,. to y B o �� a...1. -Dv r1 v1c vur1L � "• The- wain+ V r r o f e-✓ 1- y l a 0 v ckfm.4, d aQL � Colo v cicl o T c&vin►�.�-lC�'1_ _cni e - x 447�i c971 Gli1ticL '1'v�u l.l� & l U 5i c9 -v1 . I�'-C� r c irr a `I -TA -2 5 64 -or 1 t� e ro � Q_ r+ � c 06— tit- c ou.-vd% R t�, Car l oe-vtol ?r -to Was v- - --o wl_e_ aL v mai-- I VL rx`u.�od c u i c (9-1&. alL of Go ki C L L V 04 cis coVL+ -- 'To -e.,4a. ka Ck_ sea - 'L C _\v t v3,0 ► l -k ©f— �%.1 s� K+V ajik dL 0 -k-4 0 ore u s ro G04_ - l azvtkoci V`q MAL I vt.q aziA,c9l�- c -f ._�, r--,sem AS L�o�\v r Svcs r ✓'_& 6--� s� t trt' tPd-a, d- 1 d am.. -,,2A___. 44\12_, u dili-Ls--- 1/4e-6 ::, u (-14A--4-,1 V2-12--e-cti-wiu, &-b1 YL.Ci nn 4 si Vl-OrW-aLt2.e_e_C 6 P 0`t �.. 4 _TT:- �oUd- vftc_ctiz_GQv� LJ -a°— Loss AU LC CZ-f;_I', (h '� S KC' e ss V Lctir wt c S CeG rt •}-V\row t ©u C/La-'1A-Cre) `�,1L fes, oa. �r v-‘0\- --o r v a..0-9 ' c.,e9nscde_ r `itu —� 6 �r t cru �l e�.� 0 0 - LI-Aivout 111-Cli i&-0-/U'e-- + j � u`� �Q 1 V)©cc- S\ (icecceil aa v 9-1-94 Dear Mr. Michaelson; • GIARFieLD COUNTY I am writing you this letter in response to a public notice I received regarding a subdivision exemption being applied for by Bobby and Donna Burkett. I have recently moved to 1164 County Rd 113 which is situated 2 properties away from the Burkett property. I am concerned that by granting this exemption that it is way too easy for properties to be divided without knowing the full impact it will have on the neighboring properties. It has been shown with some other properties on Cattle Creek Rd that Garfield County really doesn't care how a property is developed or how that developement will effect neighboring properties. For instance the Go Cart Track and the Pine Stone Company are already compromising nearby residential property values and the rural quality of life on the lower end of Cattle Creek Rd.. By granting the Burkett's an exemption it will set a presidence, if one has not already been set, for others being able to do the same thing. I think this would be a big mistake not only for how the neighboring property owners would be effected but also for Garfield County. With the abundance of growth going on in Garfield County I think it is imperative that we keep a closer watch on how the growth takes place and not make it easier for properties to be developed in a haphazard way. My main concern is how by increasing the population density in this narrow valley will greatly effect the property values of already existing homes and properties. Julie Dows and I bought property on Cattle Creek to be in a rural, low density area, with few neighbors, in hopes of enjoying exactly that type of lifestyle. We have made a significant investment in our property and hate to see our investment put in jeoprody due to shortcut tactics such as subdivision exemptions that are put forth by Garfield County. Not only am I against granting the Burkett's a subdivision exemption but I am against them being able to subdivide their property altogether. Sincerely, Douglas Coffman • • 0617 County Road 113 Carbondale, CO 81623 September 13, 1994 Mr. David Michaelson Garfield County Planning & Zoning 109 8th Street Glenwood Springs, CO 81601 Re: Dear Mr. Michaelson: Subdivision of 1170 County Road 113 Burkett Property As a resident of Cattle Creek having received notice of the proposed subdivision referenced above, I would like to stand in strong support of the Burketts right to do as they wish with their property. I have no objections to their subdivision and see no reason why there should not be another residence on Cattle Creek. Thank you very much. 0,1 SCHENK, KERST & deWINTER, P.C. ATTORNEYS AT LAW SUITE 310, 302 EIGHTH STREET GLENWOOD SPRINGS, COLORADO 81601 TELEPHONE: (303) 945-2447 TELECOPIER: (303) 945-2977 JOHN R. SCHENK DAN KERST WILLIAM J. deWINTER, III August 12, 1994 Mr. David H. Michaelson, Planner Garfield County Planning Department 109 Eight Street Glenwood Springs, CO 81601 jkAVG151994 . , GAii' LLD COj --Y SENT BY FIRST CLASS MAIL AND FACSIMILE TO FAX NO. 945-7785 Re: Burkett Subdivision Exemption Application Dear David: I represent Julie Beck who owns the property which adjoins the Burkett property on the east. I know you have received a copy of the Beck to Burkett deed which contains a covenant regarding use of the subject property. As we have discussed, this covenant is a matter of private enforcement. I also wanted you to be aware of a covenant and agreement contained in the 1979 Agreement between the Becks and the Burketts which provides that no building or other structure shall be placed or constructed upon the westerly 150 feet of the "BLM property". The effect of this covenant would be to prohibit construction within the westerly 150 feet (or the entire 56 foot width of the southerly 653 feet) of the Burkett property which includes the Burketts original 5 acres and the 5.197 acres acquired from the Becks. I enclose a copy of the 1979 Agreement in paragraph 7 of which the referenced covenant appears. Let me know if you have any questions regarding these matters. DK/bck enclosures cc: Ms. Julie Beck Mr. Tim Beck, c/o High Country Engineering • STATE OF COLORADO OFFICE OF THE STATE ENGINEER Division of Water Resources Department of Natural Resources 1313 Sherman Street, Room 818 Denver, Colorado 80203 Phone (303) 866-3581 FAX (303) 866-3589 November 2, 1994 Mr. Dave Michaelson, Planner Garfield County Building and Planning 109 8th Street, Suite 303 Glenwood Springs, CO 81601 RE: Burkett Exemption NE1,4 Section 17, T7S, R88W, 6th P.M. Water Division 5, Water District 38 Dear Dave: Roy Romer Governor James S. Lochhead Executive Director Hal D. Simpson State Engineer Thank you for the referral for the Burkett Exemption located in the Cattle Creek area. The applicant is requesting an exemption to split a 10.02 acre parcel into two parcels of 8.2 and 2.0 acres each. The proposed water service is from two exempt wells. An existing well located on the proposed 8.2 acre parcel may be permitted under file 59954, copy attached. The Colorado River system and its tributaries at this location are over -appropriated. As such, well permits applications in new subdivisions must be evaluated to determine if other water rights would be injured considering the cumulative effect of all proposed wells. It is likely that in many circumstances well permits could not be issued by our office without a water court approved plan for augmentation. However, under current statutes, if the Garfield Board of County Commissioners approves this parcel by exemption as defined in §30-28-101(10)(d) C.R.S., our office must evaluate the well permit application as if the division of land occurred prior to June 1, 1972. Under current laws, §37-92-602(3)(b)(II)(A) C.R.S. and hydrologic conditions, it appears that our office could in this circumstance approve a well permit for ordinary household purposes inside a single-family dwelling provided that the well would be the only well on the individual parcel, return flows would be to the same stream system in which the well is located via a non -evaporative disposal system and that evidence is submitted showing that the County has approved the parcel as an exemption. Absolutely no outside uses, including irrigation and the watering of animals, are allowed under this type of permit. office. Should you have any questions regarding the water supply for this project, please contact this cerely, J - y Sap gton ter R urces Engineer cc: Orlyn Bell, Division Engineer Joe Bergquist, Water Commissioner COLORADO DIVISION OF WATER RESOURC 101 *bine Bldg., 1845 Sherman Street, Denver, Colorad 3 -NT IN BLACK INK. APPLICATION MUST BE COMPLETED BEFORE ACCEPTANCE. p-4) ICATION 'OR: A PERMIT TO USE GROUND WATER X. A PERMIT TO CONSTRUCT A WELL REPLACEMENT FOR NO. y A PERMIT TO INSTALL A PUMP OTHER APPLICANT ,Ji?/ //' 4/, , Street Address 1f nX �[9 City & State ,6LFA/z/i /eft, Telephone No. NAME OF AQUIFER GROUND WATER IS TO BE OBTAINED FROM: r - g N v r,L S PROPOSED TOTAL DEPTH OF WELL '5 ESTIMATED MAXIMUM PUMPING RATE Ft. GPM AVERAGE ANNUAL AMOUNT OF GROUND WAL1R TO BE APPROPRIATED ANTICIPATED GROUT PROGRAM Material 1;-'117E"4,/ 7 Intervals Placement Method PROPOSED CASING: Acre-feet Plain „� in. from , 7 ft. to Ali ft. in. from ft. to ft. Perf.''�� in. from „' ft. to ft. in. from ft. to ft. Driller ree,,. �%i.ZL, No. f; 97. Address r�Zi�r��-gid (ate . IF WELL IS USED FOR IRRIGATION, BACK SIDE OF THIS APPLICATION MUST BE COMPLETED. a 923.x" FOR OFFICE USE ONLY CONDITIONS OF APPROVAL APPLICATION APPROVED: VALID FOR ONE (1) YEAR AFTER DATE ISSUED UNLESS EXTENDED FOR GOOD CAUSE SHOWN TO THE ISSUING AGENCY. Ilr IN/ AMPO GROUND WATER TO BE USED FOR: am. o X DOMESTIC (1) CONM lIAp„;(4) LIVESTOCK (2) INDUSTRIAL (5) MUNICIPAL (8) IRRIGATION (6) OTHER WELL LOCATION 0,412. COUNTY 4- of theAVE- 4 of Section /7 T. 7-5 , R. 577' , %P.M. IN ADDITION TO THE ABOVE, THE WELL MUST BE LOCATED WITH REFERENCE TO GOVERNMENT SURVEY CORNERS, MONUMENTS OR SECTION LINES BY DISTANCE AND BEARING (DOMESTIC WELLS MAY BE LOCATED BY LOT, BLOCK, & SUBDIVISION.) ft. from section lin (North or South) ft. from section lin LOT BLOCK SUBDIVISION (East or West) FILING # Ground Water Basin Water Mgmnt. Dist. Anticipated drilling date /148 t/ Owner of land on which well / is located: 19 %,e Other water rights on this land PERMIT NO. 59954 DATE ISSUED NW 4 1972 STATE BY ST`BE �, tIOR tO RA -0014 OF THE . TYPE OR NT ?71 BLACK INK. RADO DIVISION OF WATER RE RCES 101 Colurit bine`B)dg 1845,Shean- , , �} rm Derlver luolorado 80203 • ;+�l `, f, Pq STATEMENT OF BENEFICIAL USE OF GROUND WATER C-7AMENDMENT OF EXISTING RECORD .5 STATE OF COLORADO COUNTY OF h/9/r1-%f7,42 THE AFFIANT(S) PERMIT NUMBER SS. RECEIVED JUl 0 573 WARS oto. whose address is 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 -_5. k% 1/4 of the N A �-1/4 of Sectior> % , Township 7=5 Range g(5) 14 6 P M at distances of /SDg (E. or W.) and x.31.5 feet from the Z:1-57— section line; the total depth of the well is it)feet; water from this well (East or West) feet from the IYY 4'T ' (North or South) (N. or S.) section line ST was first applied to a beneficial use for the purpose(s) described herein on the / day of M/9/ ,19 7_0 the maximum sustained pumping rate of the well is /07P gallons per minute, the pumping rate claimed hereby is J•; gallons per minute; the average annual amount of water to be diverted is made for from this well is to be used is F acre-feet; for which claim is hereby purpose(s); the legal description of the land on which the water i5 /7, 2 11E 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. Signature(s) Subscribed and sworn to before me on his Jrd day of , 197r My Commission expires. _ (Seal) Notary Pv6Iic ACCEPTED FOR FILING IN THE OFFICE OF THE STATE ENGINEER OF COLORADO ON THIS DAY OF , 19 STATE ENGINEER WHITE COPY FOR DIVISION OF WATER RESOURCES PINK COPY FOR WELL OWNER FOR OFFICE USE ONLY Prior. Date , 19_ Well Use / 1/4, 1/a, 14, Sec T. , R PM Yield Co J Index W D S- 3 d 411M NO. VS -11 STATE OF COLORADO ' • •" OFFICE OF THE STATE ice use only `� 910 111 1 ' /0 i +. cy f�� a`1` '�4 {� 00 l' 1� `��'�� +'/ - � 191 g2 ft, RAVED jug 17 axe t93° ENG•R 8113 Centennial BIdg., 1313 Sherman S6, Denver, Colorado 80203 (303) 866-3581/ 'RIOR TO COMPLETING FORM, SEE INSTRUCTIONS ON REVERSE SIDE CHANGE IN OWNERSHIP/ADDRESS / LOCATION WELL PERMIT, LIVESTOCK TANK OR EROSION CONTROL DAM NEW OWNER `� �Q `. _, 1. . . 1. NAME(S)�.._ f�.., .,L-�t71'lY�. ...✓..c., ..L�..GI••I"k�'_.�— Mailing Address ..�/ ...0..G� p.�ci.yt.. .iJ City, St. Zip Qr.- .0/144 te,-.10 C, .. 8/6.2 Phone (j.Q3) .£. s -1.x.44 THIS CHA IS FOR ONE OF THE FOLLOWING: ❑ ❑ g 9 WELL PERMIT NUMBER c .( 5- LIVESTOCK WATER TANK NUMBER EROSION CONTROL DAM NUMBER WELL LOCATION: COUNTY V r --f''4711 OWNER'S WELL DESIGNATION ,B ^ "(le !'! 7o Cosc.•a )>. �o—� /13, (Address) 5 4 of the AV,EI/4, Sec,..../..7, Twp, 7 ❑ N. or Distances from Section Lines ik-5— 0'8 Ft. from L]'N. or L I S. Cdr6Dtoe / Cay) ,(State) S., Range 8 e ❑ E. a Une, /3 /-5— Ft. from LAW. 10 co E. or o 1 /Awe4 ai42_3 CZiP) P.M. W. Une. Subdivision Lot Block Filing (Unit) LIVESTOCK TANK OR EROSION CONTROL DAM LOCATION: COUNTY 1/44p ❑ N. or ❑ S., Range ❑ E. or ❑ W. P.M. The above listed owner(s) say(s) that he (they) own the structure described herein. The existing record is being amended for the following reason(s): l_T Change in name of owner. 0ange in mailing address. ❑ Correction of location. I (we) have read the statements made herein, know the contents thereof, and state that they are true to my (our) knowledge. • [Pursuant to Section 24-4-104 (13)(a) C.R.S., the making of false statements herein constitutes perjury In the second degree and Is punishable as a class 1 misdemeanor.] Name/Title (Please type• or print) �- Leh 1,--k. e://--- Signature icxet__ ev,chke Date FOR OFFICE USE ONLY ACCEPTED FOR A CHANGE IN OWNERSHIP ONLY liAt Z 1.0.7-7/7,e1A--)of. &-az-/Q9/ State Engineer ay Date Court Case No. Div. Co. .z 3 WD 3 ig Basin MD Use_ <I `ci , ')--c) 1 r !_pA,,, r! -1.}.ti 07:11. .- f-f-dl:glo U-(51:if --tea I :. -.1 ."-°11"-- '2:.; 11--: -- �� 1L I.t C a ' " . . z . A 0 11 H VL -15 ";q4 o � i / ViN