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Home My WebLink About20130512.tiffDec 03 12 03:04p RUTH HARDING 303 940 4922 303 940 4922 p 5 IT�i�,w 1 Wilk COLORADO 10-02-09 Mrs. Ruth Harding, Owner Crow Valley Cafe PO BOX 11 Briggsdale, CO 80611 DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT 1555 N. 17th Avenue Greeley, CO 80631 WEBSITE: wwtv.co.weld.co.us ENVIRONMENTAL HEALTH SERVICES: (970) 304-6415 FAX: (970) 304-641 1 RE: Design and Construction Plans Review for Crow Valley Cafe Dear Mrs. Harding: The water treatment facility Design and Construction Plans submitted by the Colorado Rural Water Association by way of Randy Thielemier and received on 9-28-09 for the listed above facility was recently reviewed by Mark Thomas of the Weld County Department of Public Health and Environment in accordance to the Colorado Primary Drinking Water Regulations and regulations adopted pursuant to Title 25-1.5-203 C.RS., and the retail food establishment regulations pursuant to article 1.2.2(48) of the Colorado Primary Drinking Water Regulations, stating that a retail food establishment shall provide adequate treatment on a continuous basis and bacteriological samples analyzed at a minimum of once per quarter and Nitrate analyzed annually or at a frequency determined by the Department. The design of the system as submitted is hereby "approved" and is subject to approval according to the following conditions: 1. The system as designed is for a minimum of 0.5mg/L residual chlorine and is to be maintained as such. Realizing that residual chlorine below 0.5mg/L is inadequate. Therefore, approval is subject to maintaining a residual chlorine as the system is designed, at or above 0.5mg/L If you have any questions or need additional information, please call me at 970-304-6415. At this time I want to thank you for your time and cooperation during the inspection. Sincerely, o Digitally signed by Mark Thomas Date; 2009.10.02 1O03:54 -0600' Mark Thomas Chemist Weld County Department of Public Health and Environment cc: file copy cc: Randy Thilemier M:IENVIRONMENTAL HEALTH SERVICESV-AB\NON COMMUNITY GROUND WATER\2009 NCGW Inspections\Crow "alloy Caretdesigi approval letter.docx Dec 03 12 03:03p RUTH HARDING 303 940 4922 303 940 4922 p3 ets • 6; Colorado Analytical �LaDoro:C: ;2E. In:. Report To: Ruth Harding Company: Crow Valley Cafe, Inc. 5435 Field Ct. Arvada CO 80002 Analytical Results TASK NO: 120227042 Bill To: Ruth Harding Company: Crow Valley Cafe, Inc. 5435 Field Ct. Arvada CO 80002 L Task No.: 120227042 Client PO: Paid Check 8199 Client Project: Crow Valley Caf� Date Received: 2/27112 Date Reported: 2/29/12 Matrix: Water - Drinking i Lab Number [Customer Sample ID 120227042-01 Crow Valley Cale Sample Date/Time 1 Test I 2/27/12 2:40 PM Total Goliform E-Coli Result Absent Absent Method ! Date Analyzed SM 9223 SM 9223 2128/12 2/28/12 �2 t�i pit C ?2,E { l/IGtic-�bc cii- iM zc lc� E� L-ksCz011 .mot- /ciao. Abbreviations/ References: Absent = Coafomr NW Detected Present a Cokbnn Detected . Chlorinabon Recommended Date Analyzed = Date Test Completed SM +'Standard Methods for the Examination of Water and Wastewater" APHA; 19th Edition; 1995 DATA APPROVED FOR RELEASE BY i Page 1 oil 240 South Main Street / Brighton, CO 80601-0507 / 303-659-2313 Mailing Address: P.O. Box 507 / Brighton, CO 80601-0507 / Fax: 303-659-2315 120221042 Nov 13 12 03:41p Diane Johnson 970-356-6110 p.1 Form No G WS -25 APPLICANT OFFICE OF THE STATE ENGINEER COLORADO DIVISION OF WATER RESOURCES 610 Conternial BMg., 1313 Sherman St.. Denver, Colorado 90203 1303) 065-3561 RANDOLPH J. CASS 43251 HWY 392 BRIGGSDALE, CO 80611- (970) 656-3559 REGISTRATION OF EXISTING WELL ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT CONDITIONS OF APPROVAL 1) This well shall be used in such a way as Ie cause no material Injury to existing water rights. The issuance of this permit does nol ensure that no injury will occur to another vested water right or preclude another owner of a vested wafer right from aeeking relief In a civil court action. 2) Construction details for this exlsiing well have not been provided to IhIs orllco; therefore, it Is not Known If the eonstrudion of this well is in compliance with the Water Wall Construction Rules, 2 CCR 402-2, The issuanco of this permit does not relieve the wee owner of responsibility or liability In the event contem,nadon of the groundwater source results from the construction or use of this well, nor dons the State Engineer assume any responsibility or habllhy should contamination occur. 3) Recorded pursuant to CRS 37.92.602(5), and the policy of the State Engineer, for historical use as indicated herein. This wee produces 15 GPM, and is used for ordinary household purposes inside one single family dwelling and for drinking and sanitary facilities es described in CRS 37.92.G02(1)(c), in an individual commercial business. This business Is described as a caf�. Water from this well shall not be used for any uses outside the dwelling or business building structure(s), Including lawn or landscape irrigation, or animal watering. 4) Approved as the only well providing water to this business, which is on a 4.00 acre parcel. described as tot A recorded exemption RECX12-0079, Weld County. reference attached exhibit A. 5) The average annual amount of ground water to be appropriated shall not exceed one (1) acre -fool (325,050 galons). 6) Tne date of first beneficial use, as claimed by the applicant, Is the 1950's, 7) The return flow from the use of this well must be through an individual waste water disposal system or the non -evaporative type where the water is returned to the same stream system In which the well is located. 8) 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 welt owner (recorded et least annually) and submitted to the Division Engineer upon request. 9) Approved for the use of en existing wall constructed under permit no 164248-A. The Issuance of this permit hereby cancels permit no. 164248.A. NOTICE: This permit has been approved for indoor use only. You are hereby notified that you have the right to appeal the Issuance of this permit, by filing a written request with this office within sixty (60) days of the date of issuance, pursuant to the State Administrative Procedures Act. (See Section 24.4.104 through 106, C.R.S.) } LR WELL PERMIT NUMBER 289676 DIV. 1 WD1 DES. BASIN MD APPROVED WELL LOCATION WELD COUNTY SE 1/4 SE 114 Section 20 Township 8 N Range 62 W Sixth P.M. DISTANCES FROM SECTION LINES 150 Ft. from South Section Line 150 Ft. from East Section Line UTM COORDINATES (Meters,Zone:13,NAD831 Easting: Northing: APPROVED SRS Receipt No 3657438A Suite Eng DATE ISSUED 10.30.2012 XPIRATION DATE NA Weld County Environmental Health Services Department 1555 N. 17th Avenue Greeley, CO 80631 Phone: (970) 304-6415 Fax: (970) 304-6411 RECEIPT November 06, 2012 Application Number: SP -1200243 App Type: Health\ Commercial\Repair\Septic Owner Name: CASS RANDOLPH J & JUDY C 43251 HIGHWAY 392 BRIGGSDALE, CO 80611 Site Address: 37967 HWY 14 WELD, CO 80611 Rcpt M Pmt Type Pmt Method B!!! Pmt Date Amount Cashier EHS-1200345 Paid Check 7244 11/06/2012 $850.00 MSWAIN Total Payments: $650.00 Comments Report ID: EHS00054v002 Page 1 oft Print Date Time: 11/6/2012 4:08:06PM Weld County Environmental Health Services Department 1555 N. 17th Avenue Greeley, CO 80631 Phone: (970) 304-6415 Fax: (970) 304-6411 Web: wwxwco.weldheaRRorg Septic Permit Application Application Number SP -1200243 App Type: Health \ Commercial \RepairlSeptic MARK TAYLOR ALLES TAYLOR & DUKE LLC 3610 35TH AVE UNIT #6 EVANS, CO 80620 Owner Name: CASS RANDOLPH J & JUDY C Parcel 054520000007-R0567086 Legal Desc: 6282 S2SE4 20 8 62 (3R) Site Address: 37967 HWY 14 WELD, CO 80611 App Specific Info: 1/2 Bathrooms 1 3/4 Bathrooms 0 Basement Plumbing No Full Bathrooms 0 Location Description 37967 HWY 14, BRIGGSDALE Number of Bedrooms 0 Parcel Acres 3.57 Private Water Supply Well Public Water Supply No 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 (1505), 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 end construction is not commenced prior to the expiration date of the building permit, the ISDS permit shall expire at the same lime 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 it construction an 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 Iron the Health Officer or hlsrher designated agent. Expired permits can be renewed by payment of the permit fee only if: A There has been no change to the plans end specifications of the proposed system as set out in the original application or such change is reviewed end 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 Heafh and Environment (WCOPHE). The issuance of the permit is subject to such terms and conditions as deemed necessary to insure compliance wilh 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 feel 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 � w. �) z��+�. Owner/Applicant / Date Report la EHS00056v003 Print Date Time: 11/6/2012 4.05:18PM Page 1 of 1 RECEIPT November 06, 2012 Application Number: SP -1200242 App Type: HealtMResidential\Repair\Septic Owner Name: CASS RANDOLPH J & JUDY C 43251 HIGHWAY 392 BRIGGSDALE, CO 80611 Site Address: 37967 HWY 14 WELD, CO 80611 Weld County Environmental Health Services Department 1555 N. 17th Avenue Greeley, CO 80631 Phone: (970) 304-6415 Fax: (970) 304-6411 Jtcut # Pmt Type Pmt Method Ref /I Pmt Date mount Cashier EHS-1200344 Paid Check 7244 11/06/2012 $750.00 SCERRILLO Total Payments: $750.00 Comments Report ID: EHS00054v002 Page 1 oft Print Date Time- 11/6/2012 4-03.02PM Weld County Environmental Health Services Department 1555 N. 17th Avenue Greeley, CO 80631 Phone: (970) 304-6415 Fax: (970) 304-6411 Web: www.co.weldhealth.org Septic Permit Application Application Number: SP -1200242 App Type: Health\Residential\Repair\Septic MARK TAYLOR ALLES TAYLOR & DUKE LLC 3610 35TH AVE UNIT #6 EVANS. CO 60620 Owner Name: CASS RANDOLPH J & JUDY C Parcel#: 054520000007-R0567086 Legal Desc: 6282 S25E4 20 8 62 (3R) Site Address: 37967 HWY 14 WELD, CO 80611 App Specific Info: 1/2 Bathrooms 0 3/4 Bathrooms 0 Basement Plumbing No Full Bathrooms 1 Location Description 37967 HWY 14 BRIGGSDALE CO Number of Bedrooms 3 Parcel Acres 3.57 Private Water Supply Well Public Water Supply No 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 nomrefundsble; permit applications are nontransferable If both a building permit and an ISDS are issued for the same properly and construction is not commenced prior to Me expiration date of the building permit, the ISDS permit shall expire al the same time as the building permit If an IS05 permit is issued for e 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 it: 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 hes not changed so -as -to cause the onginal 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 ceMies that the proposed system will not be located within 400 feet of a community sewage system. The undersigned certifies that WI 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 Lt;. Owner/Applicant Q Date Report ID: EHS00056v003 Print Date Time 11/6/2012 4'03.45PM Page 1 of 1 f /d (j SEPTIC PERMIT INFORMATION FORM 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_ V 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.: 0 SVS2 0000001 _ (12 DIGIT NUMBER) LEGAL DESCRIPTION: SECTION cRO TOWNSHIP 8 RANGE 4t _ ACRES 3,57± SUBDIVISION LOT BLOCK FILING THIS INFORMATION CAN BE OBTAINED FROM THE ASSESSOR'S OFFICE AT (970) 353-3845 EXT 3650 SITE ADDRESS .3'7t '7 .✓ y /Y ,. $C • fl.s4(a�e, CO B04,!/. DIRECTIONS TO SITE 75016,E of Tnierltc Len er >L i>/ y /j'l Mor3YZ 'VS L lo/cct/ion Nw Cernsir of -CA<es, a. R4r-nio./ 17 ✓., i' 4t4,(_y &, t s s MAILING ADDRESS: '!/j ZS/ _ </,,.�/ .J1JZ CITY ery /i ST Co ZIP ROIP /` HOME PHONE: (PO) ..59,-.6.40 a WORK PHONE (970) 3'/ -SGoZ FAX ( _) EMAIL ADDRESS:_ APPLICANT NAME:_ MAILING ADDRESS _ _ _ CITY ST ZE(' HOME PHONE: ( 1 WORK PHONE ( ) _ _ FAX ( . )_ EMAIL ADDRESS. _ DESCRIPTION OF BUILDING (EX: HOUSE, MOBILE HOME, MODULAR, SHOP, OFFICE) Ram, / 54re_ PROPERTY OWNER IF OBTAINTNG A REPAIR PERMIT, WHAT IS BEING REPAIRED? _ NUMREF OF PERSONS '�LMBP:R OP BEDROOMS PASEMENTEl.WRING YESte EATIROOMS. FULI. PUP__ IC WAIE2 SUPPLY YE, !CI NAME -- _- PRT,,A'E I),'ATER.SUPPLI' 9 /HO FR.I1CI::I r]'rl IN FLOOD PLAIN AREA? _YES /N0 i✓o `u_M5Aeri f'/ootp/t.n Map PERCOLATION HOLES MUST BE MARKED FOR INSPECTION OR A $50.00 FEE WILL BE CHARGED CENSUS TRACT P-:RMIT # c?89676, PLEASE DRAW A MAP TO YOUR PROPERTY. f59 tocfr" CT" (tut/fir CAA. �1123 l�o.s{ Hwy / AXLES TAYLOR & DUKE, LLC 3610 35TH AVE. UNIT #6 LICENSED PROFESSIONAL ENGINEERS EVANS, 80634 LICENSED PROFESSIONAL LAND SURVEYORS 970-330-0308 October 25, 2012 Mr. Trevor Jiricek Weld County Department of Public Health & Environment 1555 North 17th Avenue Greeley, Colorado 80631 RE: Septic Design - Randolph & Judy Cass 37967 HWY 14 Briggsdale, CO 80611 Lot "A", RECX 12-0079 Pt S '''A, SE Y , Sec 20, TSN, R62W, 6th P.M. Retail Space (Liquor Store) Dear Sir: The following commercial septic design for Randolph & Judy Cass is submitted for your review and approval. 1. I preformed a percolation test for the site on October 22, 2012 and the percolation rate obtained was 28.80 Min./in., use 30 min./in for design, see attached computations. The soil profile is as follows: 0" - 10" Top Soil, 10" - 26" Loam, 26"- 41" Sandy Loam with a trace of Clay, 41" - 82" Sandy Loam, light tan in color, 82" - 96" Clay, dark brown. 82" to 96" is considered as a limiting layer. No groundwater was observed in the 8' soil profile pit. 2. From table Appendix 30-A, 0.1 gallons per SF of retail space, (Liquor Store, assumed 800 SF) 800 * 0.1 = 80 gallons, 2 employees, 15 gallons per 8 hour shift, (assumes 2, 8 hour shifts) 2* 15 = 30 gallons. The total waste water load (Q„"g,) is 80 gallons + 30 gallons = 110 gallons per day. Qmaz= Q„„g. * 1.5 = 110 gallons * 1.5 = 165 gallons per day. 3. The existing septic tank is in poor condition. The required septic tank size = Qmac * (30/24) = 165 gallon * 1.25 = 206.25 gallons. Per Weld County Code, the minimum septic tank size is 1000 gallons. A new 1000 gallon septic tank is required. 4. An absorption trench system has been selected. The absorption area is determined using the equation Atrench ch = (Qm„x*t05)/3.5 = (206.25*30°5)/3.5 = 322.765 SF. A Quick 4 Infiltrator system is to be used, the reduction factor is 0.5. 322.765 SF * 0.5 = 161.38 SF. The number of Quick 4 Infiltrators required = 161.38 SF/ (9.2 SF/Unit) = 17.54 Units. Use 18 Quick 4 Infiltrator units in a single trench configuration. A distribution box will be required as a change of use; (back to a restaurant) would require an absorption trench expansion and multiple trenches being added to the absorption system. Due to the limiting layer of Clay located at 6.8', the maximum depth of cover over the Quick 4 Infiltrators is 1.8' as measured from the crown of the Quick 4 Infiltrator (Standard). 2012-115 Commercial Nc! 0 , ALLES TAYLOR & DUKE, LLC 3610 35TH AVE. UNIT #6 LICENSED PROFESSIONAL ENGINEERS EVANS, 80634 C LICENSED PROFESSIONAL LAND SURVEYORS 970-330-0308 5. The absorption field and septic tank shall be constructed and installed in accordance with Weld County Health Department regulations. 6. The absorption bed/trench shall be place a minimum of 100 feet from any existing water well. 7. No traffic shall be permitted on the new absorption field after construction. If you have any questions, please contact me. Respectfully submitted, Mark Taylor Colorado P.E. 46065 2012-115 Commercial i l SEPTIC DESIGN RANDOLPH & JUDY CASS, 37967 HWY 14, BRIGGSDALE, CO 80611 A 1000 GALLON SEPTIC TANK IS REQUIRED, TABLE 30-2. THE EXISTING 1000 GALLON SEPTIC TANK IS NOT ADEQUATE. A NEW 1000 GALLON SEPTIC TANK WILL BE REQUIRED. 1= 30 MIN/IN, Q = 165 GALLONS. AREA (TRENCH) =(Q * P0.5)/3.5 = (165*30^0.5)/.1.5 = 322.765 SF. QUICK 4 INFILTRATORS REDUCTION FACTOR = 0.5, 322.765 SF * 0.5 = 161.38 SF. 161.38)9.2 = 1734 UNITS, , USE MININMUM OFI8INFILTRATOR UNITS. THE PROPOSED ABSORPTION TRENCH SYSTEM SHALL BE CONFIGURED TO FIT THE EXISTING SITE CONDITIONS. THE ABSORPTION TRENCH CONFIGURATION SHALL BE ONE ROW OF 18 UNITS. SEPTIC FIELD MUST BE A MINIMUM OF 20 FEET FROM ANY OCCUPIED BUILDING, 10 FEET FROM PROPERTY LINES, 100 FEET FROM ANY WATER WELLS AND 100 FEET FROM ANY IRRIGATION PONDS. DRAINAGE SHALL BE SLOPED AWAY FROM ABSORPTION TRENCH SYSTEM. 503 EXISTING 100+ SEPTIC TANK TO BE ABANDON L EXISTING ABSOR. TRENCH TO BE ABAND. ABSORPTION TRENCH 5, 5'M IN: 5'M1N. EXISTING PROFILE COMM. HOLE & TRUCTURE PROPOSED 1000 GALLON SEPTIC TANK 4 • 6 DIST NTS IBOX PROVIDE ��ROOM FOR ADDITIONAL SEPTIC TANK (FUTURE EXPANSION) WATER WELL HWY 14 (ROW 100') PAVED Typical TRENCH SYSTEM CONFIGURATION 6' min. - UNDISTURBED SOIL ABSORPTION TRENCH 6' min. — UNDISTURBED SOIL ABSORPTION TRENCH PERC TEST MIN/IN 1 0-1/4" 2 0-1/2" 3 0.11/16" 4 0-11/16" 5 0-3/16" 6 0-13/16" AVE = 28.800 MIN IN USE 30 MIN/IN FOR DESIGN ' -1--- MAX 1.0' MINIMUM COVER \\ //^\\ i 1 1 I5 1.5' 6' MIN. I I- ----1 X- SECTION - NTS EXISTING GROUND q LIMITING NO GROUND LAYER WATER AT 8' 2012-115 COMM. Nov C2 12 10:27a Diane Johnson 970-356-6110 p.1 Form No GWS-25 APPLI CANT OFFICE OF THE STATE ENGINEER COLORADO DIVISION OF WATER RESOURCES ere Centennial Bldg. 1313 Sherman St., Denver, Colersae 80203 taco) 866-3501 RANDOLPH J. CASS 43251 HWY 392 BRIGGSDALE, CO 80611- (970) 656-3559 REGISTRATION OF EXISTING WELL r LR WELL PERMIT NUMBER 289676 DIV. 1 WO 1 DES. BASIN MO APPROVED WELL LOCATION WELD COUNTY SE 1/4 SE 1/4 Section 20 Township 8 N Range 62 W Sixth P.M. DISTANCES FROM SECTION LINES 150 Ft. from South Section Line 150 Ft. from East Section Line UTM COORDINATES (Meters,Zone: t 3,NAD83) Easting: Northing: ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT CONDITIONS OF APPROVAL 1) This vial 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 ownor of o seated water right from seeking relief in a civil court action. 2) Construction details for this existing well have not been provided to this office; therefore, it is not known It the construction of this well is in compliance with the Water Well Construction Rules. 2 CCR 402-2. The issuance of this permit does not relieve the well owner of responsibility or liability in the event contaminadon of the groundwater source results from the cons huc1ion or use of this well, nor does the State Engineer assume any responsibility or liability should contamination occur. 3) Recorded pursuant to CRS 37-92.602(5), and the policy of the Slate Engineer. for historical use es Indicated herein. This well produces 15 GPM, and is used for ordinary household purposes Inside one single family dwelling and for drinking and sanitary facilities es described in CRS 37.92.602(1)(c), in an individual commercial business. This business is described as a cafe. Water from this well shall not be usod for any uses outside the dwelling or business building structure(s), including lawn or landscape irrigation, or animal watering. 4) Approved as the only well providing water to this business, which is on a 4.00 acre parcel, described as lot A, recorded exemption RECX124079, Weld County, reference attached exhibit A. 5) The average annual amount of ground water to be appropriated shall not exceed one (1) acre-foot (325,850 gallons). 6) The date of first beneficial use, as claimed by the applicant, is the 1950's. 7) The return flow from the use of this well must be through an individual waste water disposal system of the non -evaporative type where the water is returned to the same stream system in which the well is located. 8) A totalizing Bow meter must be installed on Ns 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_ 9) Approved for the use of en existing well constructed under permit no. 104240-A. The issuance of this permit hereby cancels permit no. 104248-A. NOTICE: This permit has been approved for Indoor use only, you are hereby notified that you have the right to appeal the issuance of this permit, by filing a written request with this office within sixty (60) days of the date of issuance, pursuant to the State Administrative Procedures Act. (See Section 24-4404 through 106, C R.S.) APPROVED SRB ‘Receipt No.3657438A Slate frightcEt� DATE ISSUED 10.30.2012 EXPIRATION DATE AA WLORADO an ORA DO SEPTIC PERMIT INFORMATION FORM 1 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, er repair of an existing system. The following information must be provided on the septic information form. COMMERCIAL PERMIT NEW or REPAIR $850.00 VAULT PERMIT NEW or REPAIR $250.00 RESIDENTIAL PERMIT V_ NEW or REPAIR $750.00 MINOR REPAIR PERMIT $100.00 PARCEL NO.: 05t,/- 2 OOO00O7 _ (12 DIGIT NUMBER) LEGAL DESCRIPTION: SECTION 20 TOWNSHIP 8 RANGE to Z ACRES ,3,574 SUBDIVISION LOT BLOCK FILING THIS INFORMATION CAN BE OBTAINED FROM THE ASSESSOR'S OFFICE AT (970) 353-3845 EXT 3650 SITE ADDRESS _3 7 9491 F7//�' 15 y 8s-? �ysdale. Co 8064 DIRECTIONS TO SITE' 750'Llad OIL Ina≤ -/ ,4'&y./f t# ' 3y2 an '72I Loea./:ern ft -O? use_ ora- stile e/' <<nee., �y /V PROPERTY OWNER: /3nc{o// j. JAY C. La 55 _ MAILING ADDRESS: _.13 ZS/ }!w�/ .3f2 _ CITY ,t5/11p,stak ST_CO ZIP BO4e Z/ HOME PHONE: (9;GJ 381-54'67 WORK PHONE (770 ) 38/ -Soot. FAX ( )_ EMAIL ADDRESS: APPLICANT NAME: MAILING ADDRESS: CITY HOME PHONE: ( ) WORK PHONE ( j_ EMAIL ADDRESS: _ ST ZIP FAX( ) DESCRIPTION OF BUILDING (EX: HOUSE, MOBILE HOME, MODULAR, SHOP, OFFICE) IF OBTAINING A REPAIR PERMIT, WHAT IS BEING REPAIRED? _ _ Au, e. NUMBER OF PERSONS NUMBER OF BEDROOMS J22 BASEMENT PLUMBING YES BATHROOMS: FULL _ _'/ '/, PUBLIC WATER SUPPLY YES /0 NAME -- PIUVAIL WAFER SUPPLY / NO WELL /CISTERN IN FLOOD PLAIN AREA? YES /NO W6 Pa 6AsAro� "%ad p‘, , n Map PERCOLATION HOLES MUST BE MARKED FOR INSPECTION OR A $50.00 FEE WILL BE CHARGED CENSUS TRACT PERMITN 0789 676 PLEASE DRAW A MAP TO YOUR PROPERTY. 6,5 ALLES TAYLOR & DUKE, LLC 3610 35TH AVE UNIT 96 LICENSED PROFESSIONAL ENGINEERS EVANS, 80639 LICENSED PROFESSIONAL LAND SURVEYORS 970-330-0308 October 22, 2012 Mr. Trevor Jiricek Weld County Department of Public Health & Environment 1555 North 17th Avenue Greeley, Colorado 80631 RE: Septic Design - Randolph & Judy Cass 37967 HWY 14 Briggsdale, CO 80611 Lot "A", RECX 12-0079 Pt S '/1, SE 1/4 , Sec 20, T8N, R62W, 6th P.M. Residential (3 Bedroom House) Dear Sir: The following septic design for Randolph & Judy Cass is submitted for your review and approval. 1. I preformed a percolation test for the site on October 22, 2012 and the percolation rate obtained was 15.16 Min./in., use 20 min./in for design, see attached computations. The soil profile is as follows: 0" - 11" Top Soil, 11" - 31" Sandy Loam, 31"- 45" sandy silt and black clay, 45" - 63" Sandy Silt with a Trace of clay, 63"-96" Sand/Sandy Loam. No limiting layer in the soil to be used for absorption trench was observed and no groundwater was observed in the soil profile pit. 2. For a three (3) bedroom house, 287 SF of trench absorption, Table 30-2, is required for each bedroom. The required square footage of absorption trench is 861 SF, 3 * 287 = 861 SF. Quick 4 Infiltrators will be used at the site, reduction factor = 0.5, 861 * 0.5 = 430.5 SF, and a minimum of 47 Quick 4 Infiltrators will be used, 430.5 /9.2 = 46.8 units, use a minimum of 47 infiltrator units. The absorption trench configuration shall be built to fit the existing site conditions. 3. The existing 1000 gallon septic tank is in poor condition. A new 1000 gallon septic will be required per Table 30-1. 4. The absorption field and septic tank shall be constructed and installed in accordance with Weld County Health Department regulations. 5. The absorption bed/trench shall be place a minimum of 100 feet from any existing water well. 6. No traffic shall be permitted on the new absorption field after construction. If you have any questions, please contact me. Respectfully submitted, Mark Taylor c, -- Colorado P.E. 46065 2012-115 Residential SEPTIC DESIGN RANDOLPH & JUDY CASS, 37967 HWY 14, BRIGGSDALE, CO 80611 A THREE (3) BEDROOM DWELLING. A 1000 GALLON SEPTIC TANK IS REQUJRED,TABLE 30-2. THE EXISTING 1000 GALLON SEPTIC TANK IS NOT ADEQUATE. A NEW 1000 GALLON SEPTIC TANK WILL BE REQUIRED. 20 MIN/IN = 287 SQ. FT./BEDROOM (TRENCH) 3' 287 = 861 SQ. FT. QUICK 4 INFILTRATOR SYSTEM, REDUCETION FACTOR = 0.5, 861 ' 0.5 = 430.5 SF. 430.5/9.2 = 46.8 UNITS, USE MININMUM OF 47 UNITS. THE PROPOSED ABSORPTION TRENCH SYSTEM SHALL BE CONFIGURED TO FIT THE EXISTING SITE CONDMONS. THE ABSORPTION TRENCH CONFIGURATION SHALL BE TWO ROWS OF 16 UNITS AND ONE ROW OF 15 OR CONFIGURED TO FIT THE AVAILABLE AREA WITH AN EQUAL NUMBER OF INFILTRATOR UNITS IN EACH TRENCH. SEPTIC HELD MUST BE A MINIMUM OF 20 FEET FROM ANY OCCUPIED BUILDING, 10 FEET FROM PROPERTY LINES, 100 FEET FROM ANY WATER WELLS AND 100 FEET FROM ANY IRRIGATION PONDS, DRAINAGE SHALL BE SLOPED AWAY FROM ABSORPTION TRENCH SYSTEM. NTS ABSORPTION TRENCH DIST BOX EXISTING PROFILE 1000 GALLON HOLE SEPTIC TANK TO BE ABANDON 5T 30 5'MIN. 14't 27' PROPOSE' 1000 GALLON SEPTIC TANK WATER WELL HWY 14 (ROW 100') PAVED Typical TRENCH SYSTEM CONFIGURATION 6' min. - 0 y 2 6 O_ 0 r7 6' min. ABSORPTION TRENCH 50t PERC TEST MIN/IN 1 1-1/4" 2 1-1/8" 3 1-1/8" 4 1-0" 5 0-7/8" 6 0-9/16" AVE = 15.158MIN IN USE 20 MIN/IN FOR DESIGN 2' MAX 1.0' MINIMUM COVER 4' 1 � 1 1.5' I 1.5' Imo- 6' MIN. -TI X- SECTION - NTS EXISTING GROUND NO GROUND WATER AT 8' 2012-115 RES Nov 02 12 10:27a Diane Johnson 070-356-6110 p.1 Form No, GWS-25 APPLICANT OFFICE OF THE STATE ENGINEER COLORADO DIVISION OF WATER RESOURCES ens Centennial Bldg 1313 Snormen St., Denver, Colorado 80203 (203) 866-3501 RANDOLPH J. CASS 43251 HWY 392 BRIGGSDALE, CO 80611- (970) 656-3559 REGISTRATION OF EXISTING WELL ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT CONDITIONS OF APPROVAL 1) This well shall be used in such a way as to cause no material injury to existing water rights. The issuance of this perms does not ensure that no injury wilt occur to another vested water right or preclude another owner of a veoted water right from seeking relief In a civil court action. 2) Construction details for this exlsr;ng welt have not been provided to this office: therefore, it is not known If the construction of this well is in compliance with the Waler Well Construction Rules, 2 CCR 402-2. The issuance of this permit does not relieve the well owner of responsibility or liability in the event contamination Otte groundwater source results tram the construction or use of this well, nor dyes the State Engineer assume any responsibility or liability shotsd contamination occur. 3) Recorded pursuant to CRS 37-92-602(5), and the policy of the State Engineer, for historical use es indicated herein. This well produces 15 GPM, and is used for ordinary household purposes Inside one single family dwelling and for drinking and sanitary facilities as described in CRS 37-92-602(1)(c), in an individual commercial business. This business is described es a caf�. Water from this well shall not be used for any uses outside the dwelling or business building struclure(s), including lawn or landscape irrigation, or animal watering. 4) Approved as the only well providing water to this business, which is on a 4.00 acre parcel, described as lot A. recorded exemption RECX12-0(179, Weld County, reference attached exhibit A. 5) The average annual amount of ground water to be appropriated shall not exceed one (1) acre -loot (325,850 gallons). 6) The date of first beneficial use. as claimed by the applicant, is the 1950's. 7) The return flow from the use of this well must be through an individual waste water disposal system of the non -evaporative type where the water is returned to the same stream system In which the well is located. a; 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 wet owner (recorded at least annually) and submitted to the Division Engineer upon request. 9) Approved for the use of an existing well constructed under permit no. 164248-A. The issuance of this permit hereby cancels permit no. 164248-A. NOTICE: This permit has been approved for Indoor use only, you are hereby notified that you have the right to appeal the Issuance of this permit, by filing a written request with this office within sixty (60) days of the date of issuance, pursuant to the State Administrative Procedures Act. (See Section 24-4.104 through 106, C R.S.) LR r WELL PERMIT NUMBER 289676 DIV. 1 WD 1 DES, BASIN MD APPROVED WELL LOCATION WELD COUNTY SE 1/4 SE 1/4 Section 20 Township 6 N Range 62 W Sixth P.M. DISTANCES FROM SECTION LINES 150 Ft. from South Section Line 150 Ft. from East Section Line UTM COORDINATES (Metere.Zone:13,NADe31 Ea sting: Northing: APPROVED - SRB State EnpNte ,ReceiptNo.3657438A DATE ISSUED ByJ 10.30.2012 XPIRATION DATE NA Hello