HomeMy WebLinkAbout20060060.tiff Form No. OFFICE OF THE STATE ENGINEER
GWS-25 COLORADO DIVISION OF WATER RESOURCES
818 Centennial Bldg.,1313 Sherman SL,Denver,Colorado 80203
(303)866-3581
LR
WELL PERMIT NUMBER 261997 - -_
APPLICANT DIV. 1 WD2 DES. BASIN MD
APPROVED WELL LOCATION
WELD COUNTY
SE 114 SE 114 Section 19
WELD COUNTY SCHOOL DISTRICT RE-8 Township 1 N Range 66 W Sixth P.M.
301 REYNOLDS ST DISTANCES FROM SECTION LINES
FT LUPTON, CO 80621- 663 Ft. from South Section Line
134 Ft.from East Section Line
(303)857-3200 UTM COORDINATES (Meters,Zone:13,NAD83I
REGISTRATION OF EXISTING WELL Easting: 516123 Northing: 4431243
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 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) Construction details for this existing well have not been provided to this office;therefore,it is not known if 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 contamination of the groundwater source results from the
construction 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 State Engineer,for historic use as indicated herein. This
well produces 15 GPM,and is used for drinking and sanitary facilities as described in CRS 37-92-602(1)(c),in an individual
commercial business. Water from this well shall not be used for any uses outside the 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 acre parcel,described as 2107 WCR 27,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 Jan. 1, 1818.
7) 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.
NOTICE:This permit has been approved for a change in the use from which you applied. Irrigation is not allowed under a
commercial exempt permit. 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.)
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2006-0060
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State Engineer By .
,Receipt No.0535046 DATE ISSUED 03-01-2005 EXPIRATION DATE • ✓ / H
WELD COUNTY DEPARTMENT OF PUBLIC HEALTH &ENVIRONMENT
1555 NORTH 17TH AVENUE, GREELEY, CO 80631 PHONE: (970) 304-6415 FAX: (970) 304-6411
)YEBSITE: WWW.CO.WELD.CO.US
APPLICATION/RECEIPT
Initials: SG
Permit Number: SP-0500383 Receipt Number. HAP-05390
10-25-2005 Amount: $400.00 Payment Method: Check Notation: 4910
Owner Name: MEDLIN WAYNE &PATRICIA
Applicant Name: MEDLIN WAYNE
Parcel Number: 147119000073
Location: 2101 WCR 27,FT LUPTON
Account Code Description Amount
2560-41400-4221-4203 New Septic Permit $0.00
2560-41400-4221-4203 Repair Septic Permit $400.00
2560-41400-4221-4203 Vault Permit $0.00
2560-41400-4221-4203 Variance Request $0.00
Description: OLD SCHOOL
Commercial: (Y/N) Y Residential: (Y/N) N Acres: 4.25
Number of Persons: 16 Basement Plumbing: (Y/N) Y
Number of Bedrooms: 0 Bathrooms: Full - 4 3/4: 0 1/2: 0
"Tater Public: (Y/N) N Water Supply:
dater Private: (YIN) Y Cistern: (Y/N)N Well: (Y/N) Y Well Permit Number: 261997
TERMS AND CONDITIONS
A permit fee,as set by separate ordinance of the Board of Weld County Commissioners,shall be required of applicants for new individual sewage
disposal systems(ISDS),payable at time of application.Remit fees are non-refundable;permit applications are non-transferable.If both a
building permit and an ISDS are issued for the same property and construction is not commenced prior to the expiration date of the building permit,
the ISDS permit shall expire at the same time 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 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 if:
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 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 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 underarticle 10 title 25,CRS as amended.The applicant certifies that the proposed system
will not be located within 400 feet 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
WC evaluation for purposes of iss ' the permit applied for herein.Applicant further understands that falsification or misrepresentation
may esult in e denial of the plication r cats n of any permit granted,and in legal action of perjury as provided by law.
Owner/ licant Date
Form:RT_HAPP Ir
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