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Mar 04 10 02:11 p Summit Engineering . 17195896633 p.5 <br />Type of Sewage Disposal ( XX ) Septic tank and leach field <br />() Central system with return to river <br />() Other describe <br />-I certify that the above information is complete and true to the best of my knowledge. <br />&=?&/ <br />Participant <br />Date i - /,V- )_0% <br />STATE OF COLORADO <br />)ss. <br />n <br />?tn?g11 L. ?Ob?ns <br />bin <br />The foregoing was acknowledged before me by <br />this day of 2011Q. Witness my hand and official seal. <br />COUNTY OF ' an <br />Notary PUblic <br />My coaunission expires; - 30 rf a-- <br />Address; ? b b q1 I ? 4an sn Go !WI <br />The above-described property was included in the District's boundaries by order of the <br />court dated Dscember 2. 1997. <br />61i6? ?? <br />Dist retary