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HomeMy WebLinkAbout1.0 ApplicationGARFIELD COUNTY Building & Planning Department 108 8th Street, Suite 401 Glenwood Springs, Colorado 81601 Telephone: 970.945.8212 Facsimile: 970.384.3470 www.garfield-county.com Special Use Permit GENERAL INFORMATION ➢ Street Address / General Location of Property: (34- -4:0Y10A,- Lcyt a I3+ (c(,, Lt iJr -i cYacotk Co pill35- ,")y-) ➢ Legal Description: L i /di of \dl/,1..qW ttq- I S -Q c- -1 ) 2c, bla }p1� P - k iAco Q5 - c -- PM - ➢ Existing Use & Size of Property in acres: fi_cu r -e s 1 _ / 2 A -GV ➢ Description of Special Use Requested: -ttak,R' - 4- f , irhp 1 am, r,vpr GI it ICI A Inas a , VyxYL Q .),(-, Pry c (sac, -.,n 1 nr So waTe, LA LOL'V1 iortuloc - on ➢ Ze District: our Ian AS S , (rn J > Name of Property Owner: n� t it r -E , ba,ecQap,,-- nG ➢ Address: I,��}- Co, "r7 r a ,- La VA 23,E 'Xxc Telephone: q70 " cc?D > City: 13Cie`1(t C t-1( -C State: U ip Code:21(C �5 FAX: a ,o�,�r- ,'1 z (9 / r4 . Co .41 ➢ Name of Owner's Representative, if any (Attorney, Planner, etc): ➢ Address: Telephone: ➢ City: State: Zip Code: FAX: STAFF USE ONLY ➢ Doc. No.: Date Submitted: TC Date: )> Planner: Hearing Date: MA4- ZSR,)3 I. APPLICATION SUBMITTAL REQUIREMENTS As a minimum, specifically respond to all the following items below and attach any additional information to be submitted with this application: 1. Please submit, in narrative form, the nature and character of the Special Use requested. Submit plans and supporting information (i.e. letters from responsible agencies). Include specifications for the proposed use including, but not limited to, the hours of operation, the number and type of vehicles accessing the site on a daily, weekly and/or monthly basis, and the size and location of any existing and/or proposed structures that will be used in conjunction with the proposed use, and provisions for electric power service and any other proposed utility improvements. Be specific. 2. If you will be using water or will be treating wastewater in conjunction with the proposed use, please detail the amount of water that would be used and the type of wastewater treatment. If you will be utilizing well water, please attach a copy of the appropriate well permit and any other legal water supply information, including a water allotment contract or an approved water augmentation plan to demonstrate that you have legal and adequate water for the proposed use. 3. Submit a site plan /map drawn to scale that portrays the boundaries of the subject property, all existing and proposed structures on the property, and the County or State roadways within one (1) mile of your property. If you are proposing a new or expanded access onto a County or State roadway, submit a driveway or highway access permit. 4. Submit a vicinity map showing slope / topography of your property, for which a U.S.G.S. 1:24,000 scale quadrangle m ap will suffice. 5. Submit a copy of the appropriate portion of a Garfield County Assessor's Map showing the subject property and all public and private landowners adjacent to your property (which should be delineated). In addition, submit a list of all property owners, private and public, and their addresses adjacent to or within 200 ft. of the site. This information can be obtained from the County Assessor's Office. You will also need the names (if applicable) of all mineral interest owners of the subject property, identified in the County Clerk and Recorder's records in accordance with §24-65.5-101, et seq. (That information may be found in your title policy under Exceptions to Title). 6. Submit a copy of the deed and a legal description of the subject property. 7. If you are acting as an agent for the property owner, you must attach an acknowledgement from the property owner that you may act in his/her behalf. 8. Submit a statement that specifically responds to each of the following criteria from Section 5.03 of the Zoning Regulations: (1) Utilities adequate to provide water and sanitation service based on accepted engineering standards and approved by the Board of County Commissioners shall either be in place or shal I be constructed in conjunction with the pr oposed use. (2) Street improvements adequate to accommodate traffic volume generated by the proposed use and to provide safe, convenient access to the use shall either be in place or shall be constructed in conjunction with the proposed use; (3) Design of the proposed use is organized to minimize impact on and from adjacent uses of land through installation of screen fences or landscape materials on the periphery of the lot and by location of intensively utilized areas, access points, lighting and signs in such a manner as to protect established neighborhood character; 9. Depending on the type of Special Use Permit requested, you may need to respond to additional review standards in the Garfield County Zoning Resolution Section 5.00 [Supplementary Regulations]. This may include uses such industrial uses [section 5.03.07 & 5.03.08], Accessory Dwelling Units [section 5.03.21], Utility line/Utility Substations, etc. Specific sections of the Zoning Resolution which can be located on the Garfield County web site at http://www.ciarfield-countv.com/building and planning/index.htm, or information can be obtained from this office 10. A $400.00 Base Fee: Applicant shall sign the "Agreement for Payment" form and provide the fee with the application. 11. Submit 2 copies of this completed application form and all the required submittal materials to the Building and Planning Department. Staff will request additional copies once the Special Use Permit application has been deemed technically complete. II. PROCEDURAL REQUIREMENTS (The following steps outline how the Special Use Permit Application review process works in Garfield County.) 1. Submit this completed application form, base fee, and all supplemental information to the Garfield County Planning Department. It will be received and given to a Staff Planner who will review the application for technical completeness. 2. Once the application is deemed technically complete, the Staff Planner will send you a letter indicating the application is complete. In addition, Staff will also send you a "Public Notice Form(s)" indicating the time and date of your hearing before the Board of County Commissioners. Prior to the public hearing, Staff will provide you with a Staff Memorandum regarding your requested Special Use. (If Staff determines you application to be deficient, a letter will be sent to you indicating that additional information is needed to deem your application complete.) 3. It is solely the Applicant's responsibility to ensure proper noticing occurs regarding the requested Special Use and the public hearing. If proper notice has not occurred, the public hearing will not occur. Notice requirements are as follows: a. Notice by publication, including the name of the applicant, description of the subject lot, a description of the proposed special use and nature of the hearing, and the date, time and place for the hearing shall be given once in a newspaper of general circulation in that portion of the County in which the subject property is located at least thirty (30) but not more than sixty (60) days prior to the date of such hearing, and proof of publication shall be presented at hearing by the applicant. b. Notice by mail, containing information as described in the paragraph above, shall be mailed to all owners of record as shown in the County Assessor's Office of lots within two hundred feet (200') of the subject lot and to all owners of mineral interest in the subject property at least thirty (30) but not more than sixty (60) days prior to such hearing time by certified return receipt mail, and receipts shall be presented at the hearing by the applicant. c. The site shall be posted such that the notice is clearly and conspicuously visible from a public right-of-way, with notice signs provided by the Planning Department. The posting must take place at least thirty (30) but not more than sixty (60) days prior to the hearing date and is the sole responsibility of the applicant to post the notice, and ensure that it remains posted until and during the date of the hearing. 4. The Applicant is required to appear before the Board of County Commissioners at the time and date of the public hearing at which time the Board will consider the request. In addition, the Applicant shall provide proof, at the hearing, that proper notice was provided. 5. Once the Board makes a decision regarding the Special Use request, Staff will provide the Applicant with a signed resolution memorializing the action taken by the Board. Following the Board's approval, this office will issue the Special Use Permit to the applicant. If the Board's approval includes specific conditions of approval to be met, this office will not issue the Official Special Use Permit certificate until the applicant has satisfied all conditions of approval. The Special Use Permit approval is not finalized until this office has issued the Official Special Use Permit certificate signed by the Chairman of the Board of County Commissioners. I have read th statements above and have provided the required attached information which is cor ct and accurate to the best of my knowledge. (Signature of Property Owner) Last Revised: 07/2007 GARFIELD COUNTY BUILDING AND PLANNING DEPARTMENT FEE SCHEDULE Garfield County, pursuant to Board of County Commissioners ("Board") Resolution No. 98-09, has established a fee structure ("Base Fee") for the processing of each type of subdivision and land use applications. The Base Fee is an estimate of the average number of hours of staff time devoted to an application, multiplied by an hourly rate for the personnel involved. The Board recognized that the subdivision and land use application processing time will vary and that an applicant should pay for the total cost of the review which may require additional billing. Hourly rates based on the hourly salary, and fringe benefits costs of the respective positions combined with an hourly overhead cost for the office will be used to establish the actual cost of County staff time devoted to the review of a particular project. Actual staff time spent will be charged against the Base Fee. After the Base Fee has been expended, the applicant will be billed based on actual staff hours accrued. Any billing shall be paid in full prior to final consideration of any land use permit, zoning amendment or subdivision plan. If an applicant has previously failed to pay application fees as required, no new or additional applications will be accepted for processing until the outstanding fees are paid. Checks, including the appropriate Base Fee set forth below, must be submitted with each land use application, and made payable to the Garfield County Treasurer. Applications will not be accepted without the required application fee. Base Fees are non-refundable in full, unless a written request for withdraw from the applicant is submitted prior the initial review of the application materials. Applications must include an Agreement for Payment Form ("Agreement") set forth below. The Agreement establishes the applicant as being responsible for payment of all costs associated with processing the application. The Agreement must be signed by the party responsible for payment and submitted with the application in order for it to be accepted. The complete fee schedule for subdivision and land use applications is attached. GARFIED COUNTY BUILDING AND PLANNING DEPARTMENT BASE FEES The following Base Fees shall be received by the County at the time of submittal of any procedural application to which such fees relate. Such Base Fees shall be in addition to and exclusive of any cost for publication or cost of consulting service determined necessary by the Board for the consideration of any application or additional County staff time or expense not covered by the Base Fee, which have not otherwise been paid by the applicant to the County prior to final action upon the application tendered to the County. TYPE OF PROCEDURE BASE FEE Vacating Public Roads & Rights -of -Way $400 Sketch Plan $325 Preliminary Plan $675 + application agency review fees and outside consultant review fees, as authorized pursuant to the Regulations, such as the Colorado Geologic Survey Final Plat $200 Amended Plat $100 Exemption from the Definition of Subdivision (SB -35) $300 Land Use Permits (Special Use/Conditional Use Permits) • Administrative/no public hearing $250 • Board Public Hearing only $400 • Planning Commission and Board review & hearing $525 Zoning Amendments • Zone District map amendment $450 • Zone District text amendment $300 • Zone District map & text amendment $500 • PUD Zone District & Text Amendment $500 • PUD Zone District Text Amendment $500 Board of Adjustment • Variance $250 • Interpretation $250 Planning Staff Hourly Rate • Planning Director • Senior Planner • Planning Technician • Secretary $50.50 $40.50 $33.75 $30 County Surveyor Review Fee (includes review of Amended Determined by Surveyor$ Plats, Final Plats, Exemption Plats) Mylar Recording Fee $11 — ls` page $10 each additional page Page 2 The following guidelines shall be used for the administration of the fee structure set forth above: 1. All applications shall be submitted with a signed Agreement for Payment form set forth below. 2. County staff shall keep accurate record of actual time required for the processing of each land use application, zoning amendment, or subdivision application. Any additional billing will occur commensurate with the additional costs incurred by the County as a result of having to take more time that that covered by the base fee. 3. Any billings shall be paid prior to final consideration of any land use permit, zoning amendment, or subdivision plan. All additional costs shall be paid to the execution of the written resolution confirming action on the application. 4. Final Plats, Amended or Corrected Plats, Exemption Plats or Permits will not be recorded or issued until all fees have been paid. 5. In the event that the Board determines that special expertise is needed toassist them in the review of a land use permit, zoning amendment, or subdivision application, such costs will be borne by the applicant and paid prior to the fmal consideration of the application. All additional costs shall be paid prior to the execution of the written resolution confirming action on the application. 6. If an application involves multiple reviews, the Applicant shall be charged the highest Base Fee listed above. 7. Types of "Procedures" not listed in the above chart will be charged at an hourly rate based on the pertinent planning staff rate listed above. 8. The Planning Director shall establish appropriate guidelines for the collection of Additional Billings as required. 9. This fee structure shall be revised annually as part of the County budget hearing process. Page 3 GARFIELD COUNTY BUILDING AND PLANNING DEPARTMENT AGREEMENT FOR PAYMENT FORM (Shall be submitted with application) MA (GARFIELD COUNTY hereinafter COUNTY) and 1r � 66‘viiley- (hereinafter APPLICANT) agree as follows: nn 1. APPLICANT has submitted to COUNTY an application for A 1) Li (hereinafter, THE PROJECT). 2. APPLICANT understands and agrees that Garfield County Resolution No. 98-09, as amended, establishes a fee schedule for each type of subdivision or land use review applications, and the guidelines for the administration of the fee structure. 3. APPLICANT and COUNTY agree that because of the size, nature or scope of the proposed project, it is not possible at this time to ascertain the full extent of the costs involved in processing the application. APPLICANT agrees to make payment of the Base Fee, established for the PROJECT, and to thereafter permit additional costs to be billed to APPLICANT. APPLICANT agrees to make additional payments upon notification by the COUNTY when they are necessary as costs are incurred. 4. The Base Fee shall be in addition to and exclusive of any cost for publication or cost of consulting service determined necessary by the Board of County Commissioners for the consideration of an application or additional COUNTY staff time or expense not covered by the Base Fee. If actual recorded costs exceed the initial Base Fee, APPLICANT shall pay additional billings to COUNTY to reimburse the COUNTY for the processing of the PROJECT mentioned above. APPLICANT acknowledges that all billing shall be paid prior to the final consideration by the COUNTY of any land use permit, zoning amendment, or subdivision plan. APPLICANT / Signature 72-7/7 Date: ( A46,4, 6u.icir,Lr- Print Name M ing Address• ra(h 10/2004 Page 4 1. We are submitting this Special Use Permit to be considered for an ADU. My brother Daniel Gardner and I share 20 acres in which Daniel already has a home on. His home is less than 1500 square feet so we are wanting make his home be the ADU and we would like our home be the main house and be approximately 2600 square feet. Daniel's house has been on this 20 acres since 1996, building permit #5843 for your reference. When measured length by width, his home measures 52.4 X 27, for a total of 1414.8 in square feet. There is an abandoned house on the property that has not been occupied for nearly 7 years. The house was Albert and Mona Gardner's who have both been gone for quite some time. However, we use it for storage at the present time and would like to continue to do so, it is not at all in a livable state. I have been told we need to remove all sinks and toilets so we are in the process of doing so. It will be done ASAP. There is an existing driveway off of County Road 303 that goes to the back part of the 20 acres, that is the driveway we plan to use. We personally own two vehicles, one full size truck and one mid size truck. The full size truck will leave one to two times a day for work, and the other maybe once a day. On a weekly basis there would be approximately two additional vehicles entering our driveway from the county road and on a monthly basis around five additional, all more than likely to be cars. As far as hours of operation, it would be like any other home in the area I am sure. We are in the process of getting electricity out to where we plan to place a modular. The electrical company will be placing approximately 3-4 power poles. We are going to put in a septic system, propane tank and drill a well. We plan on having an attached garage (24x24) and maybe in the future a small shop. To my knowledge that is all of the additional structures and such that we plan to add to the property. 2. We are in the process of getting a well permit, we have already applied for one, however the status is pending on approval from West Divide Creek. We are within the boundaries we are assured to buy water rights from the river, the meeting is December 10, 2007. Once the board makes their decision, the well permit will be approved from there on. I will keep you posted on that as I hear more. I have attached some documents showing we have applied for both. In doing research on the existing well on our property it was drilled in 1953 and late registered in 1971 by Albert Gardner, I was told by the Division of Water Resources that it was registered to have two houses on it originally and that they would honor that if need be. They recommended that we buy water rights if we are within the boundaries though and we feel the same. Either way we will have access to the existing well or have our own drilled. N) 5. Attached is the Assessor's Map showing all properties next to us. Daniel and I own 100% of the mineral rights for this 20 acres. Encana has them leased at this time, but as far as ownership it's just the two of us. Here is a list of all landowners within 200 feet of our property line - 178 Steven and Pam Leuallen 0318 County Road 303 Parachute, CO 81635 158 Barbara Lou and Donald Max Allred 0421 County Road 303 Parachute, CO 81635 129 Watson Ranches LTD PO Box 586 Meeker, CO 81641 177 William Dominguez 304 County Road 303 Parachute, CO 81635 005 Dave Wasserman 1100 Whitefield Northbrook, IL 60062 009 William and Arianna Lightfoot 123 Rosewood Way Parachute, CO 81635 010 Dave Wasserman 017 Monument Ridge LLC 1586 County Road 300 Parachute, CO 81635 021 L" C ) &1rY ✓tar ?JIFo, -race , Co 8 1. As mentioned above, we plan to have a well drilled and purchase water rights from the river, we are installing a septic system. We don't plan to put the septic in until the house is set. If we need to do that different, please let us know. 2. We have a driveway already in place, it has been used for years to get to back part of the 20 acres and then some. It's in great condition so we plan to use that driveway. 3. We do plan on having a fence, one has not been decided upon yet, we are thinking either a split rail or privacy fence. We are planning on planting several trees and doing quite a bit of landscaping, there is not much there right now. As far as lighting and signs there will not me any. We won't have anything that will be horrible to look at for the neighbors, we would keep our land and home looking nice for sure. VIII Ila"`,+ P01 MM lik&RICM diene J 11111 Reception#: 719210 03/1912007 03:07:23 PM 8:1903 P:0767 Jean Alberico 1 of 1 Rec Fee:66.00 Doc Fee:0.00 GARFIELD COUNTY CO STATE OF COLORADO )ss. COUNTY OF GARFIELD Stephen L. Carter being first duly sworn upon his oath deposes and says: 1. During her lifetime, I was acquainted with Mona Genevieve Gardner, who died on March 4, 2001. A certified copy of her Death Certificate is filed at the same time as this Affidavit. 2. I know of my own knowledge that this Mona Genevieve Gardner is one and the same person as the Mona G. Gardner who, together with Mark E. Gardner and Daniel R. Gardner, owned in joint tenancy the following described real property situate in the County of Garfield and State of Colorado to wit: The E'/2NW'/4NW'/4, Section 20 Township 7 South, Range 95 West of the 6ih P.M. together with all appurtenant ditch and ditch rights water and water rights, all as more fully described in a certain Quitclaim Deed dated April 3, 1995 and recorded April 5, 1995, Book 936, Page 234, Document 476304, Garfield County Records 3. I have no record interest in the property described above, and I file this Affidavit for the purpose of establishing the title of the surviving joint tenants in and to the property herein described. Dated this 16"' day of March, 2007. Subscribed and sworn to before this 16`" day of March, 2007 by Stephen L. Carter. WITNESS MY HAND AND OFFICIAL SEAL My commission expires: VA/07 "4/ Notary Public DEC -13-2007 04:39 PM HOLLY GARDNER Form No. GWS -26 APPLJNT 9702852453 OFFICEOF THE STATE ENGINEER COLORAPOISONOFWATER RESOURCES ESOURCES 818 Centennial edg, 1313 DIVISION Dnr, Colorado (303) 865-3581 MARK & HOLLY GARDNER 3312 COUNTY ROAD 306 PARACHUTE, CO 81635- (970) 285-2453 PER i. • CON ` " U L ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT 1) This well shall be used In such a way as to cause no material injury to existing water rights. The issuance of this permit does not ensure that no Injury will occur to another vested water right or preclude another owner of a vested water right from seeking relief in a civil court action. 2) The construction of this well shall be in compliance with the Water Well Construction Rules 2 CCR 402-2, unless approval of a variance has been granted by the State Board of Examiners of Water Weil Construction and Pump Installation Contractors in accordance with Rule 18. 3) Approved pursuant to CRS 31-90-137(2) for the construction of a well, appropriating ground water tributary to the Colorado River, on the condition that the well shall be operated only when the West Divide Water Conservancy District's substitute water supply plan, approved by the Stale Engineer, Is In effect, and when a water allotment contract between the well owner and hestentt Divide aWatWOWCD cont Conservancyer District for the release of replacement water from Rued Reservoir Is in effect, or under an approved plan for au 9 #071210MHG(a). 4) Approved as a well on a tract of land of 20 acres described as that portion of the E 1/2 of the NW 1/4 of the NW 114, Sec. 20, Twp. 7 South, Rng. 95 West, th P.M., Garfield County, more particularly described on the attached exhibit A. ses 5) The use of ground water from this well feimited to et (0.14 ofre an protection, homenary gardesand lawnehold s and theide one waeringl) single of fiiften (5)yhe did domestic Irrigation of not more than 6,000 square animals. All use of this well will be curtailed unless the water allotment contract or a plan for augmentation is in effect. This well is known as Gardner Well. 8) The pumping rate of this well shell not exceed 16 GPM. 7) The average annual amount of ground water to be appropriated shall not exceed 0.887 acre-foot (289,029 gallons). 8) The owner shall mark the well in a conspicuous place with wee permit number(s), name of the aquifer, and court case number(s) as appropriate. The owner shall take necessary means and precautions to preserve these markings. 9) This well shall be constructed not more than 200 feet from the location specified on this permit. 10) A totalizing flow meter must be installed on this well and maintained In good working order, Permanent records of all diversions must be maintained by the well owner (recorded, at least annually) and submitted to the Division Engineer upon request, NOTE: Permit no_ 47521 is also located on this parcel. NOTE: Parcel Identification Number (PIN): 23-2407-202.00-048 /2"/12."..--":2/pe 7 NOTE: Assessor Tax Schedule Number: 8270252 P.02 LIC WELL PERMIT NUMBER DIV. 5 WD45 DES. BASIN MD APPROVE=D WEL LOCAT'1ON GARFIELD COUNTY NW 1/4 NW 1/4 Section 20 Township 7 5 Range 95 W Sixth P.M. DIS 1260 Ft. from North 890 Ft. from West C f Eluting: -r 111 Section Line Section Line DINS S :.rs .r'.13N Northing: APPROVED DMW State -Eng neer By 1/4Receip.t No. 9502952 DATE ISSUED 12-12-2007 EXPIRATION DATE 12-12-2008 , DEC -13-2007 04:39 PM Holly Gardner 3312 County Road 308 Parachute, CO 81635 Phone Number (970) 285-2453 Fax Number Same as above Web Address Email - gardnerfamily2©msn.com HOLLY GARDNER FAX TI 4NSMrTTAL 'FORM 9702852453 To: 'Oh C� P Name: Phone: Fax: t_F, 1.4,510 From: -t-11 vu Date Sent: `zi. Number of Pages: Message: \ j -- op.A_OL, onef:)v_ ry\_,12- , U)D1A. b (A -A E. rAca_ C Lt -(ono, v-r_s Q� rCQVLQ� ��t P.01 UULURADU DIVISION OF WATER RESOURCES DEPARTMENT OF NATURAL RESOURCES 1313 SHERMAN ST., RM 818, DENVER, CO 80203 phone — info: (303) 866-3587 main: (303) 866-3581 fax: (303) 866-3589 htlp://www.water.state.co.us RESIDENTIAL Note: Also use this form to apply for livestock watering Water Well Permit Application Review instructions on reverse side prior to completing form. The form must be completed in black or blue ink or typed. 1. Applicant Information Name of applicant (-k and -ALL ting addres E.,6 b0 Office Use Only r 7 to r r.. �r. WATER Rt.�r,:,; c STATE Gi�ic GLS Foran GWS -44 (06/2006) rcer )k r ttd--) llJ{ . i 5 00 - Zde Telephone # E-mail (optional) Cj (a?OD Z.-45 Z.1-4 c:53 2. Type Of Application (check applicable boxes) j Construct new well ❑ eplace existing well ❑ Change source (aquifer) ❑ Other: 3. Refer To (if applicable) ❑ Use existing well ❑ Change or increase use ❑ Reapplication (expired permit) 6. Use Of Well (check applicable boxes) See instructions to determine use(s) for which you may qualify ❑ A. Ordinary household use in one single-family dwelling (no outside use) p B. Ordinary household use in 1 to 3 single-family dwellings: Number of dwellings: 1 Er Home garden/lawn irrigation, not to exceed one acre: area irrigated l tC() g sq. ft. ❑ acre -Domestic animal watering — (non-commercial) E 1 C. Livestock watering (on farm/ranch/range/pasture) 7. Well Data (proposed) Maximum pumping rate l gpm Annual amount to be withdrawn Well permit # Water Court case # Total epth 1 feet Aquifer 1 acre-feet Designated Basin Determination # Well name or # 8. Water Supplier 4. Location Of Proposed Well County Is this parcel within boundaries of a water service area? OYES j 140 If yes, provide name of supplier: � a 1-e_1&( 1/AN 1/4 of the fj 1/4 Section j ❑ Township Not� Range_ RE I EWl 1 Principal Meridian 2 Distance from section Ines (section lines are typically not property lines) I I Q C)_ Ft. from BO ❑ S I / jCE) Ft. from ❑ Ei W For replacement wells only— distance arid direction from old well to new wet feet direction 9. Type Of Sewage System • Septic tank / absorption leach field O Central system: District name: , O Vault: Location sewage to be hauled to: ❑ Other (attach copy of engineering design and report) Well location address (Include City, State, Zip) ❑ Check if well address is same as In Item 1. rac,hu(i C, t CO 81 to 2-y---; Optional: GPS well location Information In UTM format. GPS unit settings are as follows: Formal must be UTM ❑ Zone 12or0Zone 13 Units must be Meters Datum must be NAD83 Northing: Unit must be set to true north Was GPS unit checked for above? 0 YES Remember to set Datum to NAD83 Easting: 5. Parcel On Which Well Will Be Located (PLEASE ATTACH A CURRENT DEED FOR THE SUBJECT PARCEL) A. You must check and complete one of the following: El Subdivision: Name Lot Block Filing/Unit O County exemption (attach copy of county approval & survey): Name/# Lot # O Parcel less than 35 acres, not in a subdivision, attach a deed with metes and bounds description recorded prior to June 1, 1972, and a current deed O Mining claim (attach a copy of the deed or survey): Name/# O Square 40 acre parcel as described in Item 4 O Parcel of 35 or more acres (attach a metes and bounds description or survey) Other (attach metes & bounds description or survey and supporting documents) 10. Proposed Well Driller License #(optional): L; C9..✓-eJ. 11. Signature Of Applicant(s) Or Authorized Agent . The making of false statements herein constitutes perjury In the second degree, which is punishable as a class 1 misdemeanor pursuant to C.R.S. 24-4-104 (13)(a). I have read the statements herein, know the contents thereof and state that they are true to my knowledge. Sign here (Must be original signature) Date Print name & title /4?: Office Use Only USGS map name �a010-- DWR map no. Surface elev. B. # of acres in parcel , C. Are you the owner of this parcel? 45 YES 0 NO (if no — see instructions) D. Wtu this be the only well on this p�a�r]cel? OYES 91 NO (if no — list other wells) E. Slate Parcel IOU (optional): 7 - CCOLIze WE WR CWCB TOPO MYLAR SB5 I Receipt area only DIV WD BA MD APPLICATION TO LEASE WATER FROM WEST DIVIDE WATER CONSERVANCY DISTRICT 109 West Fourth Street, P. O. Box 1478, Rifle, Colorado 81650 vateratwdwcd.org Fax: (970) 625-2796 Telephone: (970) 625-5461 1. APPLICANT INFORMATION Name: NY\Q r% * o \\ Q rte`- Mailing address: 3 3 1 C R, 3 010 �Grc�cry �e 0 'lb ,S Telephone: cl -t O a% 5_ a-4 53 Authorized agent 2. COURT CASE #s: Decree Case No. Augmentation Plan Case No. 3. USE OF WATER lit RESIDENTIAL (check applicable boxes) No. of main residences: / No. ADU's ['Subdivision: No. constructed units: No. vacant lots Jj-lone garden/lawn irrigation of cc, 00 0 sq. ft Method of irrigation: ❑ flood V1 sprinkler ❑ drip ❑ other 2INon-commercial animal watering of / 5 animals Pi Fire Protection ❑ Evaporation: Maximum water surface to be exposed: Description of any use, other than evaporation, and method of diversion, rate of diversion, and annual amount of diversion of any water withdrawn from the pond: S ell Sharing Agreement for multiple owner wells must he submitted If greater than two owners. application must he made under a homeowners association. O COMMERCIAL (check applicable boxes) Number of units: Total sq. ft. of commercial units: Description of use: ❑INDUSTRIAL Description of use: Evaporation: Maximum water surface to be exposed: Description of any use, other than evaporation, and method of diversion, rate of diversion, and annual amount of diversion of any water withdrawn from the pond: 0 MUNICIPAL Description of use: El DIRECT PUMPING Tributary: Location: 4. SOURCE OF WATER Structure: Z) e \\ Structure Name: G (3, rd.' e r UJ e\\ Source: ❑Surface ❑Storage VIGround water Current Permit # (attach copy) 5. LOCATION OF STRUCTURE .‘/..k)(.01/(1 fV 1 J 1/14 County Quarter/quarter Quarter �� 15 Section Township Distance of well from section lines: Range P. M. Elevation: 4 ,, on c Well location address: i b d C D (Attach additional pages for multiple structures) 6. LAND ON WHICH WATER WILL BE USED (Legal description may be provided as an attachment.) See neA Number of acres in tract: cP Inclusion into the District. at .Applicant's e pense. mnar be required 7. TYPE OF SEWAGE SYSTEM IX Septic tank/absorption leach field Central system —Other District name: 8. VOLUME OF LEASED WATER NEEDED IN ACRE FEET: % (minimum of 1 acre foot except augmentation from Alsbury Reservoir where a lesser amount is allowed) Provide engineering data to .support volume of water requested Commercial, municipal. and Industrial users must provide diversion and consumptive data 00 a monthly basis. A totalizing flow ureter with remote readout is required to be installed and usage reported 10 West Divide. .Applicant expressly acknowledges it has had the opportunity to review the District's forms ff iter Allotment Contract and agrees this application is made pursuant and subject to the terms and conditions contained therein. Applicant Signature Applicant Signature Application Date: // - 0 7 ISSUED AS AREA B CONTRACT YES i/ NO The printed portions of this form, except differentiated additions or deletions, have been approved and adopted by the West Divide Water Conservancy District. Form # WDWCD 050901 APP 4RJ-25-70 Index No._7i4 IDWD C etiere C�t✓�LC/ Yield Checked By STATE OF COLORADO ) SS STATE OF COLORADO DIVISION OF: WATER RESOURCES OFFICE OF THE STATE ENGINEER MAP AND STATEMENT FOR WATER WELL FILING CLAIMANT (s)- Albert Gardner PERMIT NUMBER 47521 .41:e, being duly sworn upon oath deposes and says that he (they) is (are) the owner (s) of the well descrjbed hereon; the total number of acres of land irrigated from this well is '• wodk.was commenced on this well by actual construction op the w ✓, , day ofr-' O Com• 19e3 • the sustained yield from said well is 11 gpm, for which claim is hereby made fork, domestic purpose (s); the average annual amount to be diverted is none acre-feet; this map and statement is filed in compliance with law; he (they) has (have) read the statements made hereon; knows the content thereof; and that the same ire true of his (their) own knowledge. — .04V/tilfrte17," Signature (s) r% a4/--. Subscribe • and sworn to before me on this of f � . 19 7/ My Com mission e (Seal) WELL DATA day Nota Pu•Iic v Garfield p11t213/4 0�,� iv sA U � � �lrri+� 8e[a 9Z SZgL County WELL LOCATION NW 1/. of XVI '/., sec 20 T. '1 S R ✓ 95W Atli P M INDICATE WELL LOCATION ON DIAGRAM w w NORTH m j — -1 m SOUTH WELL SHALL BE LOCATED WITH REFERENCE TO GOVERNMENT SURVEY CORNERS OR MONUMENTS, OR SECTION LINES BY DISTANCE AND BEARING. 40 ft from North section line. (North or South) 910 ft. from West section line. (East or West) Ground Water Basin Water Management District Date Completed c/ Approx. October 10, 2953 Domestic wells may be Ned i spir following: LOT , BLOCK SUBDIVISION FILING # / G� ACCEPTED FOR FILING IN THE OFFICE OF THE STATE ENGINEER OF COLORADO ON THIS, ! DAY Static Water Level - 20' Total Depth of WeI I e/ 112t STATE EN NEER FORM TO`,BE MADE OUT IN QUADRUPLICATE: WHITE FORM must be an o tginal copy on both sides and signed. WHITE AND GREEN copies must be filed with the State Engineer within 30 days after the well is completed or within 7 days after expiration date of the permit, whichever is sooner; PINK COPY is for the Owner and YELLOW COPY is for the Driller. WELL LOG WELL DATA Front, . •,., t $' , Type & Color of Material Water Loc. 0 : 132 Iava< Boulders 132 132 Graved _ n 1 Use additional paper if necessary to complete log. State of Colorado, County of Garfield ) ss Subscribed and sworn to before me this 14th My Commission expires that.24 19 75 T1LoMe de Notary Public Type Drillbit Cable Tool HOLE DIAMETER: 7 in. from 0 ft. to 132 ft. in. from ft to ft. in. from ft to ft. CASING RECORD Plain Casing Size.j, kind Std. from 0 ft to 132 ft. Size_, kind from ft. to ft. Size.__, kind from ft. to ft. Per grated Casing 1/8x4 Size_, kind—Tarrhfrom 712 ft to 132, ft. Size—, kind from ft to ft. Size_, kind from ft to ft. GROUTING RECORD Materia I Intervals Placement Method GRAVEL PACK RECORD Size Interval TEST DATA Date Tested AApxeg 10-10-53 Tiype of Pump -* er Length' of Test 3 bre. Sustained Yield (Metered) Drawdown 0 20 g,iaL WELL DRILLERS STATEMENT The undersigned, being duly sworn, deposes and says: he is the driller of the well hereon described; he has read the statement made hereon; knows the codtent thereof, and the same is true of his own knowled G License No 78 day of -� 1 i .411/4 �1y ,19 71 WELL LOG o Fror}L Pr, , Thr .. ; , `. • ,. Type & Color of Material Water Loc. 0 M: 132 , Lava, Boulders 112 132. Gravel k i Z 1 Use additional paper if necessary to complete log. State of Colorado, County of Garfield 1 ss . Subscribed and sworn to before me this l th My Commission expires slinky 24 WELL DATA Type Drill4g Cah1 Taal HOLE DIAMETER: 7 in. from 0 ft. to 132 ft. in from ft to ft. in. from ft to ft. CASING RECORD Plain Casing Size., kind Std. from_ft to 132 ft. Size_, kind from ft to ft. kind�._from ft to ft Perlf9rated Casing 1/S x 4 Size_., kind r hfrom .172„ ft. to .2.32, ft Size—kind from ft to ft. Size, kind from ft to ft GROUTING RECORD Material Intervals Placement Method GRAVEL PACK RECORD Size Interval TEST DATA Date Tested ppr.z 31-10-53 Type of Pump ' Length of Test 3 ErA. Sustained Yield (Metered) Drawdown 0 20 gpir WELL DRILLERS STATEMENT The undersigned, being duly sworn, deposes and says: he is the drPller of the well hereon described; he has read the statement made hereon; knows the codtent thereof. and the same is true of his own knowled License No 7$ ,1975 day of T1. 6; Notary Public ,19 71 5. Attached is the Assessor's Map showing all properties next to us. Daniel and 1 own 100% of the mineral rights for this 20 acres. Encana has them leased at this time, but as far as ownership it's just the two of us. Here is a list of all landowners within 200 feet of our property line - 178 Steven and Pam Leuallen 0318 County Road 303 Parachute, CO 81635 158 Barbara Lou and Donald Max Allred 0421 County Road 303 Parachute, CO 81635 129 Watson Ranches LTD PO Box 586 Meeker, CO 81641 177 William Dominguez 304 County Road 303 Parachute, CO 81635 005 Brian S Trani 047 Bryan Loop Parachute, CO 81635 009 William and Arianna Lightfoot 123 Rosewood Way Parachute, CO 81635 010 Dave Wasserman 017 Monument Ridge LLC 1586 County Road 300 Parachute, CO 81635 081 Sharon Gardner 1236 County Road 302 Parachute, CO 81635 Z0'd 2SVZS8Z0L6 Z13NQ21171D J 110H Wd Lb= b0 800Z-i'0-Ntif JAN -24-2008 08:35 AM HOLLY GARDNER • Garfield County Road and Bridge Department P.O, Box 426 Rifle, CO 81650 Phone -(970)625-8601 Fax- (970)625-8627 9702852453 Invoice Driveway Permit Number: GRB08-D-4 Invoice Date: 1/8/2008 Bill To: Mark and Holly Gardner 3312 CR 306 Parachute , CO 81635 $75.00 per Driveway Permit. Driveway Permit Fee: Total Due: Thank You! $75.00 $75.00 JAN -04-2008 09:38 AM HOLLY GARDNER 9702852453 ,`. 54 U 0 ,,-, ......) ,vo coo _P ,i,, A t v 41oz,: ._8t \& co ct 0 Ct ccl N F qj D.EC-28-2007 03:15 PM HOLLY GARDNER 9702852453 P.02 91702852453 P.01 DEG -1i-2007 1014, AM HOLLY GARDNER To Whom It May Concern, I am aware that Mark and Holly Gardner are in the process of applying for an "Accessory Dwelling Ute" and have no objections to them balding a home on their poverty off of Gardner Lane. Deco: 1 ql l020 I a7 Addy. Q atk CO' Date: Nan*: Z27 -t3 -14a2 A��r r of DEC -28-2007 03:16 PM HOLLY GARDNER DLC -19-2007 10:47 AM HOLLY GARDNER Date: __ / Name: )e v 9702852453 4702652453 Address: L/C2e _ e.,./3leP • r -a rl\ Co, 8012.55— Date: 1 .55— : Name: Ades:'„� :1 3.. Data: Name: P_03 P. fDZ DLC -181-2007 12:35 PM HOLLY GARDNER 9702852453 P-01 Parcel Detail Page 1 of 3 Garfield County Assessor/Treasurer Parcel Detail Information Assessoerreas{ Pr.o.ptiti.._Starch f ASS.CSSOt _S.ubset Query. 1 Assessor Sales Search Clerk Recorder Reception Search Basic Boi.4ling.Chxrcteristics I. Tax Information Parcel Detail 1 Value Detail 1 Sales Detail 1 Residential/Commercial Improvement Detail Land Detail 1 Photographs Tax Area 047 Account Number Parcel Number Mill Levy R270252 240720200048 39.826 Owner Name and Mailing Address GARD4R,1vIA�tK E & DANIEL R :1236 COUNTY ROAD 302 PARACHUTE, CO 81635-9210 _moo Legal Description SECT,TWN,RNG:20-7-95 DESC: E1/2NWNW K:0518 PG:0451 BK:1903 PG:766 RECPT:719209 BK:1903 PG:767 RECPT:719210 BK:0936 PG:0234 A Location Fh >9ica1 Address: PARACHUTE Property Tax Valuation Information http://www.garcoact.com/assessor/parcel.asp?ParcelNumber-240720200048 12/18/2007 DtC-16-2007 12:36 PM HOLLY GARDNER rarmei 1JCCM 1 9702852453 Basic Building Characteristics Number of Residential 2 Buildln : Number of Comm/Ind 0 3uildings w Tax Information Tax Year Transaction Type Amount 2006 Tax Payment: Whole ($201.52) P.02 Page 2 of 3 http://www.garcoact.con iassessor/parcel.asp?ParceiNumber--240720200048 12/18/2007 Residential Build Occurrence 1 Characteristics TOTAL HEATED AREA: 950 ABSTRACT CODE: LFARM/ItANCH RESIDENCE- MPS ARCHITECTURAL STYLE: 1 -STORY EXTERIOR WALL: AVERAGE ROOF COVER: COMP SHNGL _. ROOF STRUCTURE: GABLE INTERIOR WALL: DRYWALL FLOOR: SHT VINE", FLOOR: CARPET HEATING FUEL: GAS HEATING TYPE: WALL&FLOOR STORIES: STORIES LO BATHS: 1 ROOMS: 6 WN1M . UNITS: 1 BEDROOMS: 3 YEAR BUILT: 1930 Tax Information Tax Year Transaction Type Amount 2006 Tax Payment: Whole ($201.52) P.02 Page 2 of 3 http://www.garcoact.con iassessor/parcel.asp?ParceiNumber--240720200048 12/18/2007