HomeMy WebLinkAbout20001069.tiff ra� LEFT HAND WATER DISTRICT
January 18, 2000
Ronald and Claudia Olson
3019 WCR 204
Longmont, CO 80504
Re: 3019 WCR 204
TO WHOM IT MAY CONCERN:
The property located at the above address or legal
description is within the "SERVICE AREA" of Left Hand
Water District. The tap fee for the above named property
has been paid. This entitles one living unit to receive
water service at this location.
If you have further questions regarding this matter, you
may contact me at the District office .
Sincerely,
— a_
Kathryn A. Peterson
General Manager
2000-1069
EXHIBIT
( 5
P.O. Box 210 •Niwot CO. 80544•(303) 530-4200 • Fax (303) 530-5252
LEFT HAND WATER DISTRICT
P.O. Box 210 Niwot, Colorado 80544-0210 - Phone: 530-4200 - Fax: 530-5252
The undersigned for valuable considerations exchanged
NAME(S): ROBERT E. NASH _-
ADDRESS: 3019 WCR 20 L'2,
LORGMOVII. CO 8004 TELEPHONE:
LEGAL DESCRIPTION:_ OT -A- OF RECORDED EXEMPTION NO 1313-15-2-RE 1060
SECTION:_15_ TOWNSHIP: .21 RANGE:_ 68 .�.-
SUBDIVISION: BLOCK LOT:
METERiM: ACCOUNT #:
herewith represents and makes
--- .uwamwrsrals.Wn•••u ----. -•
-
OAPPUCATION FOR _ TAP(S)
Applicant herewith tenders tap fee in the amount of$
Owater transfer Big T Left Hand
Oevidence of ownership Date 19
OAPPUCATION FOR TRANSFER OF ORR TAPS(S)
Date of transfer__. JULY 28- 1999 19.`
°water service paid
transfer fee of S__ 60_OO
.Opvtdence of ownership (copy warranty deed or equal)
7ppew owters
NAME(S)_ RONALD L., OLEO. . AND CLAUDIA_L_SILSOll
ADDRESS 1(119 WCR 201/2
LORRROIQT, CO 8n504 —T_ TELEPHONE_—_and acknowledges that this APPLICATION IS (1) executed subject to the policies and bylaws o` the Left Hand Water District and (2) not effective
until executed by the appropriate represeditative of District
,
SIGNATURE(S): -v.its"
LEFT HAND WATER DISTRICT
By•
this day of --
The aforesigned hereveth agrees) to abide by and acknovdedge(s) that from time to time the District or its Board of Drectors may
(a) adopt various different rates andjor classification for water usages
(h) promulgate various changes in District policies and bylaws
• (c) set assign. or otherwise convey a portion of its water service systems to another entry
The district shall be responsible only to make available to applicant such water at such pressure as may be available at the oont of delivery as a
—result of the Districts normal operation of its water distribution system The District may temporarily discontinue the flow of water in the main at the
faint of delivery rn order to repair maintain. improve. or replace the main or other portions of the District's water distribution and supply system
The applicant shall indemnify the District from any and all claims or liability for loss or damage to any persons or property resulting from. arising out
o' or connected wt the rendition of any obligations herein undertaken ay the Applicant
Note: Water service charges begin upon actual connection or as otherwise be provided for by the applicable
DISTRICT s rules and regulations
•
I-I... I '.y6r1_, INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT N r.
WELL) COUNTY-HEALTH DEPARTMENT • NEW PERMIT
ENVIRONMENTAL HEALTH SERVICES
1516 HOSPITAL R(.1AD . • GREEI...EY . CO 00631
353-0635 -X. 2 2 2 5
OWNER JACOB EON .. ,.IC-ilii:! 73 . 95TH w . ,.
ADDRESS �r •_w0 4J� A'v'I�r�llJk. 1��'I"1 i.,�V::�) 4."-y5.-.µ2
BROOifF:I:EL..I) CO 80020
ADDRESS OF PROPOSED SYSTEM 3019 ip{jWCR' 20•-1 /2 COl/80 -
I_.ONGMON I O 50 I • •
LEGAL DESCRIPTION OF SITE : W2 NW4 SEC 15 TkIF 2 RNG 68
SUBDIVISION : • LOT 0 BLOCK 0 FILING '0
USE TYPE : RESIDENTIAL
SERVICES : PERSONS . BATHROOMS i ,00 LOT E1:ZI::: :`.?.,0':) ACRES
BEDROOMS 2 BASEMENT PLUMBING WO IxlAI'Lr SUPPLY I...F..T-I••II'i
APPLICATION FEE I::: s 0:.0 0
R f t I-C ' n BY 'COrFLF::Y . 1),I.r'ENNL:• •E.I.GNE.11
DATE
0i /27/88 I !:�`i� JOHN JACOBSON.
DATE DATE 0i /27/08 . .
PERCOLATION RATE 10..0 MIN PER INCH i..::Ni:I:.i..:i:NG ZONE 0 FEET •
S[,t]:I... TYPE SUITABLE (PERCENT• ;F;I::iuND SLOPE 0% DIRECTION
REQUIRES ENGINEER DESIGN NC)
FROM THE: APPLICATION INFORMATION SUPPLIED AND THE ON—SITE S0IL• PERCOLATION . DATA
THE FOLLOWING I.,.IOWING MINIMUM INSTALLATION SPECIFICATIONS ARE REQUIRED:
SEPTIC TANK 1 000 GALLONS , ABSORPTION O TRENCH 4°.?0 SQ.. FT,
OR
ADSORPTION BED SQ. FT.
IN ADDITION , THIS II hi I. I IS SUBJECT TO THE FOLLOWING ADDITIONAL.. TERMS AND
CONDITIONS :
fl-IIS PERMIT IS GRANTED TEMPORARILY T'0 ALLOW CONSTRUCTION TO COMMENCE THIS PERMIT
MAY BE REVOKED D OR SUSPENDED D BY THE WELT) COUNTY HEALTH DEPARTMENT FUR REASONS S'I'T
FORTH IN THE WELD COUNTY INDIVIDUAL SEWAGE DISPOSAL SYSTEM REGULATIONS INCLUDING.
FAILURE TO MEET ANY TERM OR CONDITION IMPOSED THEREON DURING TEMPORARY Ufi• FINAL..
APPROVAL , THE IE: ISSUANCE OF THIE PERMIT DOES NOT CONSTITUTE ASSUMPTION BY THE
•
DEPARTMENT OR ITS EMPLOYEES OF LIABILITY FOR: THE FAILURE OR INADEQUACY OF THE
SEWAGE DISPOSAL. SYSTEM.
SCOTT PERK INS 01 /27/88
ENVIRONMENTAL SPECIALIST:::[AL.:IST DATE
11.12:S PERMIT IS NOT TRANSFERABLE AND SHALL BECOME VOID IF SYSTEM CONSTRUCTION HAS
NOT COMMENCED WITHIN ONE YEAR OF ITS ISSUANCE. BEFORE: ISSUING FINAL. APPROVAL OF
THIS PERMIT THE. WELD COUNT HEALTH DEPARTMENT RESERVES THE RIGHT ru IMPOSE ADDI..-.
i IONAi._ TERMS AND CONDITIONS REQUIRED TO MEET OUR REGULATIONS ON A CONTINUING :(:.N•...
r'}.`'' FINAL PERMIT AlI RO Y'A1... IS CONTINGENT NT UPON .I.1•.IF FINAL INSPECTION OF THE COM-
PLETED:I) SYSTEM BY THE WEI D COUNTY HEALTH DEPARTMENT,
SYSTEM INSTALLER UNKNOWN
FINAL INSPECTION DATE 01 /27/88
SYSTEM ENGINEER
APPROVAL SCOTT PERKINS
TYPE OF SYSTEM INSTALLED TANK • ENVIRONMENTAL SPECIALIST
TI.- ISSUANCE OF THIS PERMIT DOES NOT I.MPLY COMPLIANCE WITH OTHER STATE . . COUNTY .
0F, ....00'ril... REGULATORY OR BUILDING REQUIREMENTS . NOR SF•IAI,_I... fl ACT TO CERTIFY THAT
THE SUBJECT SYSTEM WILL OPERATE 1:N COMPLIANCE WITH APPLICABLE STATE , COUNTY AND . -
LOCAL... REGULATIONS ADOPTED Eli F'EREU N T TO ARTICLE 10 , TITLE 25 , CRS 1973 . AS. AMENDED,
EXCEPT FOR THE PURPOSE OF ESTABLISHING F=INAL.. APPROVAL OF AN INSTALLED SYSTEM FOR
:ISSUANCE OF A LOCAL. OCCUPANCY PERMIT PURSUANT TO i:;RS 1 973 25-10-111 (2) .
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