HomeMy WebLinkAbout20113267 Forrn No. OFFICE OF THE STATE ENGINEER
GWS-25 COLORADO DIVISION OF WATER RESOURCES
• 818 Centennial Bldg.,1313 Sherman St.,Denver,Colorado 80203 i
(303)866-3581 EXST
WELL PERMIT NUMBER 75711 -F -- J
DIV. 1 WD 2: DES. BASIN MD J
APPLICANT
APPROVED WELL LOCATION
WELD COUNTY
NW 1/4 SW 1/4 Section 1
DAN ODELL Township 1 N Range 67 W Sixth P.M.
5406 CR 23 DISTANCES FROM SECTION LINES
FT LUPTON, CO 80621- 2320 Ft. from South Section Line
521 Ft. from West Section Line
UTM COORDINATES(Meters,Zone:13,NAD83)
(303)666-8989 Easting: Northing:
PERMIT TO USE AN EXISTING WELL
ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT Page 1 of 2
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 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 Well Construction and Pump Installation
Contractors in accordance with Rule 18.
3) Approved pursuant to CRS 37-90-137(4)and the findings of the State Engineer dated November 23,2011 for the use of an
existing well with permit no.85665.
4) The use of ground water from this well is limited to commercial and household uses,livestock and domestic animal
watering,and the irrigation of home gardens and lawns.
5) The pumping rate of this well shall not exceed 15 GPM.
6) The allowed average annual amount of ground water to be withdrawn is 3.6 acre-feet.
7) Production is limited to the Laramie-Fox Hills aquifer which is located 483 feet below land surface and extends to a depth
of 750 feet. Plain casing must be installed and grouted to prevent the withdrawal of ground water from other aquifers and
the movement of ground water between aquifers.
8) The entire length of the hole shall be geophysically logged as required by Rule 9 of the Statewide Nontributary Ground
Water Rules.
9) The owner shall mark the well in a conspicuous place with well 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.
10) This well shall be constructed not more than 200 feet from the location specified on this permit.
11) 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.
12) This well shall be located at least 600 feet from any existing well,completed in the same aquifer,that is not owned by the
applicant,excluding those wells whose owners were notified pursuant to CRS 37-90-137(2)(b)(II)(A). Notice was sent to the
owner of permit no.67416-F and no response was received.
13) Pursuant to CRS 37-90.137(9)(b)and the Denver Basin Rules,no more than 98%of the nontributary ground water
withdrawn annually shall be consumed and the well owner shall demonstrate to the reasonable satisfaction of the State
Engineer that no more than 98%of the water withdrawn will be consumed.
14) This well is subject to administration by the Division Engineer in accordance with applicable decrees,statutes,rules,and
• regulations.
APPROVED C±L.0.0;26/4„
raAn j.,, id
TLK
State Engineer a EXklR9. ON DATE
Receipt No.3652330 DATE ISSUED 11-23-2011
2011-3267
Receipt No.3852330 WELL PERMIT NUMBER 75711 -F Page 2
ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT
CONDITIONS OF APPROVAL
15) The Issuance of this permit hereby cancels permit no.85665.
NOTE:The ability of this well to withdraw its authorized amount of water from this non-renewable aquifer may be less than
the 100 years upon which the amount of water in the aquifer Is allocated,due to anticipated water level declines.
NOTE:To ensure a maximum productive life of this well,perforated casing should be set through the entire producing
interval of the approved zone or aquifer Indicated above.
NOTICE:This permit has been approved for a change in the well location from what was on the application based on the
diagram provided to Weld County for USR11-0001 . 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.) -rue, ((—z5t(J
•
•
WATER SUPPLY INFORMATION SUMMARY
• Section 30•28.133,(di, C.R.S. requires that the applicant submit to the Couniy,'Adequate evidence that a water supply that
is sufficient in terms of quantity, quality and dependability will be available to ensure an adequate supply of water.
1 "1
1. NAME OF DEVELOPMENT AS PROPOSED (-0(.(S5'0‘) AV S Elil�, ¶Ct1'k ff o kti c °de Far Ai
2. LAND USE ACTION 5e %y Se e(-At R.CvE ew
3. NAME OF EXISTING PARCEL AS RECORDED 'S 40 (o (0I,ni-7 RJ .23 , c-b.Luvw71 co 4=60621
SUBDIVISION FILING BLOCK LOT
(
4. TOTAL ACREAGE t L �9 5. NUMBER OF LOTS PROPOSED PLAT MAP ENCLOSED O YES
6. PARCEL HISTORY • Please attach copies of deeds, plats or other evidence or documentation.
A. Was parcel recorded with county prior to June 1. 1972? O YES St NO
B. Has the parcel ever been part of a division of land {lion since June 1, 1972? `O YES O NO +Jn'IN"
If yes, describe the previous action 5 d L! ♦. R4%,' liJC. .,1 'Z(7At`l C
7. LOCATION OF PARCEL- Include a map deliniating the project area and tie to a section corner.NW 114 OF SW 114 SECTION 1 ,TOWNSHIP Ci:I N OS RANGE b +t DE ISl W
PRINCIPAL MERIDIAN: 16TH 0 ltM. 0 UTE O COSTILLA
11. PLAT-Location of all wells on property must be plotted and permit numbers provided.
Surveyors plat 0 Yes O No U not, scaled hand drawn sketch Yes O No
9. ESTIMATED WATER REQUIREMENTS- Gallons per Gay or Acre Feet per Year 10. WATER SUPPLY SOURCE
EXISTING O DEVELOPED O NEW WELLS -
WELLS SPRING PROPOSED MISERS,WRECK aru
HOUSEHOLD USE # .S of units GPO (5) AF WELL PERMIT NUMBERS o AElif tAt a UPPER ARAreNUE
Q S 6 6 S 0 ante DAMSON 0 LOWARA►AHOE
o E
COMMERCIAL USE # ❑EOM 0 mete
of S.F. GPD AF D ror°'urs°" o uaA FOX Nnrs
ci ones
IRRIGATION N I of acres GPO .15 AF
STOCK WATERING N 5 of head GPO .Z5 AF 0 MUNICIPAL
O ASSOCIATION WATER COURT DECREE CASE NO.'S
OTHER - _ GPO AF O COMPANY
O DISTRICT
TOTAL GPO I AF NAME
LETTER OF COMMITMENT FOR
SERVICE O YES O NO
11. ENGINEER'S WATER SUPPLY REPORT O YES tg NO IF YES, PLEASE FORWARD WITH THIS FORM. (The may he mound before our review 4 compieredJ
12. TYPE OF SEWAGE DISPOSAL SYSTEM
SEPTIC TANK/LEACH FIELD 1 e''° ' - 0 CENTRAL SYSTEM - DISTRICT NAME
G la't 1 2-104
41,3 LAGOON O VAULT • LOCATION SEWAGE HAULED TO
❑ ENGINEERED SYSTEM IAtrceh a copy of engineering design) O OTHER
State of Colorado Water Resources - View Well Details: Receipt 9065790 Page 1 of 1
Colorado Department of Nano&RPADurce, Cohmdo qnv C.nntnd Us
• :0)6J )Ii1J:s) 11�Vji JJiJ J1
Colorado's Well Permit Search
Well Constructed Help ' Last Refresh:3/30/2011 12:01:06 AM
Receipt: 9065790 Division: 1
Permit#: 85665-(10 Water District: 2
Well Name/*: County: WELD
Designated Basin: Management District:
Case Number:
WDID:
[ ) APpant/Owners History
Date Range Applicant/Owner Name Address City/State/Zip
Unknown-Present WIEIAND ROBERT 5406 WELD CO.RD.23 FT.LUPTON,CO 80621
I[-] Location Information
Approved Well Location:
Q4O Q160 Section Township Range PM Footage from Section Lines
NW SW 1 1.0N 67.0W Sixth 1700 S 625 W
Northing(UTM y): 4436345.2 Fasting(UTM x): 513085.9
Location Accuracy: Spotted from section tines
Physical Address Subdivision Name
City/State/Zip Filing Block Lot
Parcel ID: Acres in Tract: 17
[-1 Permk Details -
Date Issued: 08/23/1976 Date Expires: 08/23/1978
Use(s): DOMESTIC AquiferLA IE FOX HILLS
• Special Use: (a):
Area which may be irrigated: 1 ACRES
Maximum annual volume of appropriation:
Statute:
Permit Requirements: Totalizing Flow Meter Geophysical Log Abandonment Report
No No No
Cross Reference Permit Number Receipt Description
Permit(s):
Comments:
[-1 Construction/Usage Details
Well Construction Date:12/07/1976 Pump Installation Date:
Well Plugged: 1st Beneficial Use:12/07/1976
Elevation Depth Perforated Casing(Top) Perforated Casing(Bottom) Static Water Level Pump Rate
680 484 680 145 15
Lic* Name Address Phone Number
Driller 9 BUTT,KENNETH L 8108 TURNPIKE URIVI.WESTMINSTER,CD 80030 303-429-1464
[-1 Application/Permit History —
Well Construction Report Received 12/14/1978
Frst Beneficial Use 12/07/1976
Well Constructed 12/07/1976
Permit Issued 08/23/1976
Application Received 07/12/1976
[-1 Imaged Documents -
Document Name Date Imaged Annotated
Qogindl File 12/05/2007 No
Copyright O 2009 Colorado Division of Water Resources.AU rights reserved.
home I Contact Us I Help J Water Links I Colorado.gov i DNR I Privacy Policy J Transparency Online Project(TOP)
•
mhtml:file://C:\Users\tcwoods\Desktop\23\CO well receipt.mht 5/27/2011
t:"4s` * sY,4�°�Yiy t' fin' ?f"F' '4"a4k '� s- rah N -Y ,p,..fip 3 f .
,...� ..:n`fis.43' • /,VF Y T :`H
f
•-::-,:;.--.:?;;; . Xe Y .Ry _: x
... ✓3 '" K
f ! z 3 F F S
9 ry
^+itr'r+
{ ads n-e"
iefaewil,:F jW 9' x
si: J --!:,....-,.---•--..t4:::
" fx yn
•
rd[ ,i • Z-r. rewA s'
h
at - a4 53,atx » .wtR .
i' Y
a • r 3 w...,w 4 �, Y K ,fw wx ZF
J. ar �.4-� 'E"
b ' ,F ;C.f.' r'sa Vki ew3t*aa.�q Mr.ay' K d _
i ,:F if J r £! J * aW Y 4 C id ^i.k:' ...ti".:',.;'',',:::
..,K4n r � `Y3 '.^„,
Y :s'4s` ��L � �. � �, ....
s Y" • --,• ••i'.,....-J ."•,.•.s.-. kN• i #, 8 • ;bra T�3• a �Y c'aro f 7r a i4T.t �.
q r .� wed Z : „u;y 9h:. z. s 'k
< ! '; ₹ - �' xx � +.> ;- ire .ii'
'f'"'ra s 'a.„, " � G ,' ������.-r^-*aivv" �y b'��
Y£ ;.. F� �- 4 +" t 1 S- r," u ^'a ..l';',"4"::::::.;;-t
, .+ ` race P.hs E N§ Y'; �TK asp �A+ .i
c `g;._'.'-':..."---"--
3S^•
yA n r a , b aK
£1 • J_?; s ... ,,_;;; a Rises s:rr 7ras�s mn .1,.;,...0.,...,,,,,;-;.;,•:.,44.
�4
y
a
;1111:41-,•
y. • L # ''a1 f tv i'YA' ✓''
• ti 9 yd 3 s
z may. . rte' a r i,, a *, -..1.'.g';'"`":4;
9 " '::::;;;. ,•-.4t
f
3 • *.x* • .C. '& ,�,.� v3Fs R6"r xw< a ,Ya ' fry' .
s. • •:•1'1,.5.• •3 �q3 Y L M1 ff' a�w.bG'
- "£ s �' � vsb °+i s q Y fie ' %� k*"hi;t:A & ``` s� r • ii r� �,., ''Y` 3..
L t t taxir� mr -:::4 .:yYr i-v >✓ '-'
Scanning Cover Sheet
for
Septic Permits
Permit # G19722104
Permit Type: Health / EHS History/ EHS Conversion History
Situs Street Address 5406 CR 23
Situs City, State, Zip
Sec/Town/Range: 01-01N-67W Application Status: Finaled
Application Date: 03/11/1996
Parcel # (12 digits) 146901000085-R0126789
•
Owner Full Name: HAMILTON MAX R
Owner Address: RT.1 BX 214H
FORT LUPTON,CO 80621
Owner Phone #: 303 8574468
Contact Name:
Contact Address:
Contact Phone#
Information above has been Verified in Accela by employee noted below
X April 06, 2009
Processed by: Date
•
Report ID: EHS00024v003 Page 1 of 1
Print Date-Time: 4/6/2009 12:25:24PM
/ WELD COUNTY HEALTH DEPARTMENT
1555 17th Ave. 3,) 99s
�// a
• Greeley, Colorado No. (>9/ Q
Application for Permit to Install, Construct, Alter or Repair Individual Sewage isposal (1)-2-\stem.
pyivn_7e�dr�lor Spo Addr Phone
/ / I 5
� sd41 Y-5�r
F �
Address of Site
Mailing Address ��'"�' U� -S �9
General Information Septic Tank
1. Living Units 1. Liquid Capacity DODO Gallons
2. No. of Bedrooms 494— 2. Dimensio L D
3. No. of Baths C�'� 3. Material
4. Basement Drain . 4. Type Inlet
5. Automatic Dishwasher4✓ r Type Outlet
.
6. Garbage Disposal e.,/ p J >(4 Q_/
7. Automatic Laundry Second ry Treatment
•
8. Size of Lot //f�
9. Type of Soil %�� — Field )�'7� Bed
"E
10. Percolation Test I s /
1. No. of distrib ion lines 41.
ate• -- 111f a2
11. Water Supply '. ' _
2. Trench: Width f ;Length
12. Lot Grade 3. Type Filler Material uW16q' 4� 7/t4 A , < Q
13. Water Table Depth 4. Depth of Filler Material wUna. a"Cv-C. tc
14. Other 5. Gravel Size r;'/-ai''
7 0 co ct a I 6. Type Tile y"
• 7. Depth of Cover
8. Other /.2,q tp C-P f
The Permit is to remain in full force and effect for six (6) months from date, until revoked for non-compliance.
This system will be constructed in accordance with the above specifications and regulations governing non-
municipal sewage disposal systems, in accordance with Regulation No. 1 of the Weld County Health De-
partment. !!�� y� / L
Date: • / >I/ Aq 7: Applicant? -Id //. .fvzmtjC�
The plans a specifications as shown are approved, pending payment f pe it
Sanitarian •
Date: / /trrA- J /772-
The above system ilnsppcted an ound•to comply with the plan and description.
Installed by (� -- r Date: a "( ��
O 0 Sanitarian:
PERMIT FEE $ - e _ /�
Received by -lai Date 2 / (�
• Please use reverse side for lot Plan or us( parate sheet of paper.
1/2- _ P ° ASS
r - • ,44.4,. -tu_a z:•.O.,3„
. P . ni-ed- e—ec_d
°
1
ipoD
Scanning Cover Sheet
for
• Septic Permits
Permit # G19770233
Permit Type: Health I EHS History/EHS Conversion History
Situs Street Address 5406 CR 23
Situs City, State, Zip
Sec/Town/Range: 01-01N-67W Application Status: REVOKED
Application Date: 03/11/1996
Parcel # (12 digits) 146901000085-R0126789
•
Owner Full Name: WIELAND ROBERT
Owner Address: 5406 W.C.R. 23
FORT LUPTON,CO 80621
Owner Phone #: 303 8574586
Contact Name:
Contact Address:
Contact Phone#
Information above has been Verified in Accela by employee noted below
X ' „J' February 05, 2009
Processed by: Date
•
Report ID: EHS00024v003 Page 1 oft
Print Date -Time: 2/5/2009 3:52:30PM
1516 Hospital Road 77 2.33
> Greeley. Colorado PERMIT
Ph, 353-0540
r Application for permit to Install, Construct, nn Individual Sewage Disposal System.
• Owner �(7heY it T. L 1i etc, ncei Address 5Lh'x, ( leap 0 3 Phone `r 57 —/�/4�:o�
Direction to site: Hwy Rd. N 1-1 mi., E_mf., �n'�I., W mi.
Legal Description: Pin 5(A) ��- Sec. , T+N, V.I.W Subdiv. Lot Blk
General Information Dept. Use Only
•
No. Bedrooms f No. Persons I Perc, Rale (Avg. of 3) � .rm 6-5wh
No. Bolhs_ ' Basement Plumbing Soil Type__.__.._522d td
Size of Lot I ll 0 r r.06 H_0 Table Depth 7 pr
H_O supply (if well give depth) l�/e ! — CQ ri0 — Lot Grade ^-' ,6- a/New Home Mobile Home Y Modular Add'n Requires Engineer Design YesX No
Type of sewage disposal requested: If yes — reason
Septic tank4._Privx�_- . ___Other_.......-___..___ Comments:
Thfs i s ter, 7 +hgf -the !system /u��J -
Is Nor wifhin goo' of Ftibhc Sevier ,,,, P .
• nn Installation Instructions: (Minimum Requirements)
Septic Tank '/5b Gals. Absorption Trenches . /O�5 Sq. Ft.
Or
Other Secpoge bed I Sq. •Ft.
Special Instructions •
This system will be constructed and installed in accordance with the above specilicolions and regulations re-
pouting individual sewage disposal systems it, Weld County, Colorado
This permit shall expire in the same time as the building permit, or, if in building permit is issued, the permit
shall expire 120 days after its isuance if construction has not been comm aced.
q- I.- -)-7 Owner: � /
Date:
Applicant:
The plans and specifications as shown are approved pending payment of permit fee.
Dale: 9- G-/77
Sanita /p w rian 'wed,-
The above system inspected and loured to comply with pion and description. /
Systems Contractor: Dole: L -7 -1
Sanitarian:
Engineer Review:
motel ISi noturcI
• Permit Fee: $ 5() oo
Received by; ^/,SL0 v-`-Ct, Kt-C{/11„,64,,s, Date: OF - / - 77
b
l
• •
•
O 0 — \
vvi
/ 8bz
•
(Q tic,. -I-o Mann nn it
a
Fri ii(,\, ER �s'"4 ' 7E---;,
ro Department of Planning Date
October 16, 1986
.• Y 1c Q
COLORADO From Health Protection Services - Wes Potter 1 0v cam\
subject. I.S.D.S. Evaluation -- Robert Wieland
OWNER: Robert Wieland
ADDRESS: 5406 WCR 23 - Ft. Lupton, CO 80621
LEGAL DESCRIPTION: SW4, 1-1-67 .
The septic system identified above X is, is not of sufficient size to
accomodate the proposed alteration(s indicated below to the structure(s) served
by this system.
CURRENT FLOW: ADDITIONS: PROPOSED TOTAL:
Persons 2 2 2
Bedrooms 2 0 2
Bathrooms 1 1 11
III Est. .GPD
Permit on Record: NAME Robert Wieland NO. 770233-G
System Size: TANK 1000 gal . FIELD 180 sq. ft.
However, we cannot certify that the system will function as intended in the
future. If loading changes or malfunctions occur to the system, we require that
our office be notified so that a review of the system's adequacy be made.
The existing septic system requires the following to accomodate the proposed
alterations to the structure(s) served:
•
0
• .� • 1 . J :
INDIVIDUAL SEWAGE DISPOSAL SYSTEM EVALUATION
d
• ccqq •
8411
Date Received 'Q �"� ��{p Received by \JA Q
Evaluation Date tic 69q Done by cc5in / Qi14r4
OWNER: 1\1 T f 'V 1Jdl�+l: I' Ynn� I �11 r7 r� I l
MAILING ADDRESS: 54()(0 (. JCR tn�) \- LliLt)Y) PHONE: .5;7 't.Cgo
C ‘14.I\ I
LEGAL DESCRIPTION: P1 Sb3µ P2 Sec ! TWP 1 RNG 671
Subdivision: nIA, / /A Lot I Block Filing
WATER SUPPLY: P" UJ.c PI ! Rn It Quo
Use Type: .1(164.UYIy, ai Lot Size 4. a0 aCAP,O)
The septic system identified above is, is not of sufficient size to
accommodate the proposed alterati (s) indicated below to the structure(s)
served by this system.
CURRENT FLOW: ADDITIONS PROPOSED TOTAL
Persons C2.-4 2. Z.
• Bedrooms Al,1, e Q
'Bathrooms I,
Basement Plumbing MO
Est. GPD (p� I n
Permit on Record: NAME RUlw - Wt Jrn1(l. NO. 6 -'7 f6 33
System Size: TANK /one gal. FIELD /g6 sq.ft. ABSORPTION BED sq.ft.
Percolation Rate .icr MIN. PER INCH
Engineer Design: Yes No X Soil Type Sirr4 /ir
Percent Ground Slope :I S% Direction
The existing septic system requires the following to accommodate the
proposed alterations to the structure(s) served:
ADDITIONAL COMMENTS AND DIAGRAMS
5'7g- '7803 - S.. rA.)
• ;73 - S71,<Wo - 6�1 v\Jl 1nKA
Hello