HomeMy WebLinkAbout20030437.tiff WELD COUNTY DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT
1555 NORTH 17TH AVENUE, GREELEY, CO 80631
PHONE: (970) 304-6415 FAX: (970) 304-6411
WEBSITE: WWW.CO.WELD.CO.US
ISDS APPLICATION / RECEIPT
•
10-15-2002 Payment Method: Check • Notation: 7458 • Initials: SC
ISDS EVALUATION NO:02-093 Receipt Number: ISDS-0092
Charles Greenman
Location: 13518 CR 1 30-03-68
Account Code Description Amount
2560-41400-4410-4203 ISDS Evaluation $95.00
Description of Building:
Current Flow Additions Proposed Tftifij
Desc HOME/SHOP R1/PUD HOME/SHOP
Persons 2 0 2
Bedrooms 3 0 3
�.. Bathooms 1 0 1
Bsmt Plumb N N
Water Source: Longs Pe
NOTICE
The undersigned hereby certifies that all statements made, information and reports submitted herewith and required to be
submitted by the applicant are, or will be, represented to be true and correct to the best of my knowledge and belief, and are
designed to be relied on by the Weld County Department of Public Health and Environment in evaluating the same for purposes
of septic systems compliance. I further understand that any falsification or misrepresentation may result in the denial or
revoca • n of any evaluaf on granted based upon said evaluation and in legal action of perjury as provided by law.
/0/
X ,,t r�i� i/2, 1 ' )
Owner/Applicant Date
Form RT LSDS
,
leer
I
2003-0437
HSP106P INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT NO. G-939120
WELD COUNTY HEALTH DEPARTMENT NEW PERMIT
ENVIRONMENTAL HEALTH SERVICES
1517 16TH AVENUE COURT, GREELEY, CO 80631
353-0635 EXT.2225
)WNER GREENMAN, CHARLES D ADDRESS 13518 WCR 1 PH (303 ) 772-969.
LONGMONT CO 80504
)DDRESS OF PROPOSED SYSTEM 13518 WCR 1
LONGMONT CO 80504
EGAL DESCRIPTION OF SITE : SEC 3d TWP 3 RNG 68
,UBDIVISION: LOT • 0 BLOCK 0 FILING 0
JSE TYPE: RESIDENTIAL LOAN #195-93
;ERVICES: PERSONS 2 BATHROOMS 1 .00 LOT SIZE 3. 50 ACRES
BEDROOMS 3 BASEMENT PLUMBING NO . WATER SUPPLY LNGPK
APPLICATION FEE $0.00
'EC' D BY MORRISON,LORRAINE SIGNED BY CHARLES D. GREENMAN
DATE 08/02/93 DATE 08/02/93
'ERCOLATION RATE 0.0 MIN PER INCH LIMITING ZONE 0 FEET
TOIL TYPE SUITABLE PERCENT GROUND SLOPE 07. DIRECTION
EQUIRES ENGINEER DESIGN NO IN 100 YEAR FLOOD PLAIN ZONE NO
ROM THE APPLICATION INFORMATION SUPPLIED AND THE ON-SITE SOIL PERCOLATION DATA
HE FOLLOWING MINIMUM INSTALLATION SPECIFICATIONS ARE REQUIRED:
SEPTIC TANK 1000 GALLONS, ABSORPTION TRENCH 750 SQ. FT.
OR
ABSORPTION BED SQ. FT.
r <1DDITION, THIS PERMIT IS SUBJECT TO THE FOLLOWING ADDITIONAL TERMS AND
:L JITIONS:
HIS PERMIT IS GRANTED TEMPORARILY TO ALLOW CONSTRUCTION TO COMMENCE. THIS PERMIT
lAY BE REVOKED OR SUSPENDED BY THE WELD COUNTY HEALTH DEPARTMENT FOR REASONS SET
ORTH IN THE WELD COUNTY INDIVIDUAL SEWAGE DISPOSAL SYSTEM REGULATIONS INCLUDING
ALLURE TO MEET ANY TERM OR CONDITION IMPOSED THEREON DURING TEMPORARY OR FINAL
;PPROVAL. THE ISSUANCE OF THIS PERMIT DOES NOT CONSTITUTE ASSUMPTION BY THE
iEPARTMENT OR ITS EMPLOYEES OF LIABILITY FOR THE FAILURE OR INADEQUACY OF THE
;EWAGE DISPOSAL SYSTEM.
PAM SMITH ' 08/02/93
ENVIRONMENTAL SPECIALIST DATE
HIS PERMIT IS NOT TRANSFERABLE AND SHALL BECOME VOID IF SYSTEM CONSTRUCTION HAS
IOT COMMENCED WITHIN ONE YEAR OF ITS ISSUANCE. BEFORE ISSUING FINAL APPROVAL OF
HIS PERMIT THE WELD COUNTY HEALTH DEPARTMENT RESERVES THE RIGHT TO IMPOSE ADDI-
IONAL TERMS AND CONDITIONS REQUIRED TO MEET OUR REGULATIONS ON A CONTINUING BA-
'IS. FINAL PERMIT APPROVAL IS CONTINGENT UPON THE FINAL INSPECTION OF THE COM-
'LETED SYSTEM BY THE WELD COUNTY HEALTH DEPARTMENT.
SYSTEM INSTALLER UNKNOWN FINAL INSPECTION DATE 08/02/93
SYSTEM ENGINEER APPROVAL PAM SMITH
YPE OF SYSTEM INSTALLED TANK ENVIRONMENTAL SPECIALIST
HE ISSUANCE OF THIS PERMIT DOES NOT IMPLY COMPLIANCE WITH OTHER STATE, COUNTY
iR LOCAL REGULATORY OR BUILDING REQUIREMENTS, NOR SHALL. IT ACT TO CERTIFY THAT
i� SUBJECT SYSTEM WILL OPERATE IN COMPLIANCE WITH APPLICABLE STATE, COUNTY AND
U ML REGULATIONS ADOPTED PERSUANT TO ARTICLE 10, TITLE 25, CRS 1973, AS AMENDED,
XCEPT FOR THE PURPOSE OF ESTABLISHING FINAL APPROVAL OF AN INSTALLED SYSTEM FOR
SSUANCE OF A LOCAL OCCUPANCY PERMIT PURSUANT TO CRS 1973 25-10-111 (2) .
ORIGINAL-APPLICANT; COPY-WCHD WCHD-EHS MAY, 1984
LONGS PEAK WATER DISTRICT
• 1
9875 Vermillion Road • Longmont, CO 80504 • (303) 776-3847 office • (303) 776-0198 fax
September 18, 2002
•
Mr. Charles Greenman
13518 Weld County Road#1
Longmont, CO. 80504
f: RE: Confirmation of Service
Dear Mr. Greenman:
iThis letter is in response to your request that the District provide proof that it will continue service
to your property at the above address with respect to the zoning change you are attempting with
Weld County.
It is our understanding that you are requesting a zoning change from residential to commercial. We
have no objections to that change and will continue to provide service as we have in the past in
accordance with District Bylaws, Policies and Regulations.The zoning change will have no impact
on your service.
I hope this provides the information you need. If not, please contact our office.
• Best regards,
. B Dykes
Gene ager
Hello