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Home My WebLink About991805.tiff 1- WELD COUNTY HEALTH DEPARTMENT 1517 16TH AVENUE COURT, GREELEY, CO 80631 (970) 353-0635 EXT 2225 FAX (970) 356 -4966 Permit # : SP-9700140 Sec/Twn/Rng: 19 07 67 Status : ISSUED Permit Type : RNEW c commercial, R-residential + NEW, REPair, VauLT Applied : 04 /03 /1997 Parcel No : 0705 19 000012 Issued : 04 /10 , 1097 Finales : Location : 38568 WCR 13 FT COLLINS/19-07-67 Legal Desc : 23688-B A PARCEL OF LAND IN NW4 19 7 67 COMM NA .7 38568 13 CR WELD APPLICANT EICHHORN JOHN J & MICHELLE A 38568 COUNTY RD 13 , FORT COLLINS CO 80524 OWNER EICHHORN JOHN J & MICHELLE A 38568 COUNTY RD 13 , FORT COLLINS CO 80524 SEPT-INSTL MILLER' S BACKHOE SERVICE Phone : (970 ' 1E2-0359 30867 ROCKY RD, GREELEY CO 80634 Description : APARTMENT AND GARAGE Commercial (Y/N) : N Residential (Y/N) : Y Acres : 1CC . 00 Number of Persons : 3 Basement Plumbing (Y/N) : N Number of Bedrooms : 2 Bathrooms-> Full : 1 3/4 : 1 / 1 : _ Water Public (Y/N) : Y Utility Name : NORTH WELD titer Private (Y/N) : Cistern (Y/N) : Well ,Y/A) : Water Permit No : Percolation Rate : 15 . 0 Limiting Zone : >08 ft 00 in Desc : 9-6 Ground Slope : 5 Dir : S Soil Suitable (Y/N) : Y Encineer Design Req' d (Y/N) : N In 100 Yr Flood Plain ;Y/ y:) : Minimum Installation Septic Tank : 1000 gal Absorption Trench : 418 so . ft . Absorption Bed : 564 sq . ft . Actual Installation Septic Tank : L W gal Absorption Trench : _ sq . ft . Absorption Bed : u$ sq wooer NOTICE I 2,O The .sssance of th:s pernir does not imply compliance with other state, county or local regulatory o. trio sca.1 tt act to certify that the subject system will operate in compliance with applicable stare, county a. , advµ_ed -ersaant to Article 10, Title 25, CRS as amended, except for the purpose of establishcng final aorracal of .. . .__._ syste.r ;o_ cssuar.ce of a local occupancy permit persuant to CRS 1973 25-10-111 (2) . -.'.ts :ernc rs not transferable. The Weld County Health Department reserves the right to amiss ads^_wn c, a ' 'on , -.. _y_ i to meet our regulations on a continuing basis. Final permit approval was cortinyen_ upon :ne fi t _ „ vn)_,r-3 systec by the Weld County Health Department. Environmental Specialist J3 '''.f4 t.. 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'°iy ' 5 ‘-ti' .s} .., 1- WELD COUNTY HEALTH DEPARTMENT' 1517 16TH AVENUE COURT, GREELEY, CC 80631 (970) 353-0635 EXT 2225 FAX (970) 356 -4966 Permit # : SP-9700140 Sec/Twn/Rng: 19 07 67 Status : ISSUED Permit Type : RNEW C-commercial, R=residential + NEW, REPair, VauLT Applied : 04 /03 /1997 Parcel No : 0705 19 000012 Issued: 04/15/1917 Finaled : Location : 38568 WCR 13 FT COLLINS/19-07-67 regal Desc : 23688-B A PARCEL OF LAND IN NW4 19 7 67 COMM NW C 38568 13 CR WELD APPLICANT EICHHORN JOHN J & MICHELLE A 38568 COUNTY RD 13 , FORT COLLINS CO 80524 OWNER EICHHORN JOHN J & MICHELLE A. 38568 COUNTY RD 13 , FORT COLLINS CO 80524 SEPT- INSTL MILLER' S BACKHOE SERVICE Phone : ( 973 352- 0559 30867 ROCKY RD, GREELEY CO 80634 Description : APARTMENT AND GARAGE Commercial (Y/N) : N Residential (Y/N) : Y Acres : 101( . 00 Number of Persons : 3 Basement Plumbing (Y/N) : N Number of Bedrooms : 2 Bathrooms- > Full : 1 3/4 : Water Public (Y/N) : Y Utility Name : NORTH WILD ater Private (Y/N) : Cistern (Y/N) : Wei: I N t : Water Permit No : Percolation Rate : 15 . 0 Limiting Zone : >08 ft 00 in Desc : Ground Slope : 5 Dir: S Soil Suitable (Y/N) : Y Engineer Design Req' d (Y/N) : N In 100 Yr Flood Piair_ (Y Minimum Installation Septic Tank : 1000 gal Absorption Trench : 418 sc . ft . Absorption Bed : 564 sq . ft . Actual Installation Septic Tank : b gal Absorption Trench : sq . ft . b Absorption Bed : pK sc . ft . NOTICE The .=ojance of this permit does not imply compliance with other state, county or local reguia: .ly or D4-i..), r. ou sha:. ._ act to certify that the subject system will operate in compliance with applicable ataco' county .t9 l:_,. I s- edoptec persuant co Arc c'_e 10, Title 25, CRS as amended, except for the purpose of establishing f.na_ 31t t:'a_ _ cyst er t_r Issuance of a local occupancy permit persuant to CRS 1973 25-10-111 (2) ;Nis permit _s not transferable. The Weld County Health Department reserves the righ: co it c e acJ_t_omi �_. , _ rei 1O meet our regulations on a continuing basis. Final permit approval was coltingen. ul.mn Inc t . 3. c o'm� _c oe1 system by the weld County Health Department. XPa.ASI _ k Environmental Specialist 99/ s/!3 JY. • :f ? t ! t • Wag'P,' y`A Y, 7Pi t h r n rt� i of �t� m. 0�e l'4 "f� ' 1�� '1Arip� ',l rte _t h}h'v.; gat?.. Ski a ) +i a�fik { i, � ?fit ,,••••••••••••••I l ) a 1'� fit i'W 12I4i/IY'f;,* 420,41 „ .� ,S{ •'/C407.41.,( ;• ,1 :.td i 1(9 ab:4 mJ•a1 j .(at��yy1y��1.,,,�, 1 D� qF i.4 b� �. • l �'f]2 9/ 10 1 ' • '�A x •(';',0,f-•('' 4(1414 y,. � , t h S S ₹ 1 3 W. . • 4l L y i , i -�.,r , �-t-i r y:r k7�.n. 'i 3,YE t 'F ' ,�;,�1 v w E? L B1 t ' ' r ;t E , .nn a ' l t Fi - t yrt - p.{.W.,.64,�•. .F,t�4 TAk•�Ec.'k§' •1s•.s l �,� i ��Y:Alf`K/ �'♦ r.l F ' S ( y 7:41 e 4 A �^ ys wy •� -1--1• •o V'71V) r p{7 � f5. f ;;•.; $ e • x1r r..f Wilk ..._._ . .- .. n ` �(.,n � lJ • ;:4ty1•q'` r� y2 '12C+ iVtet..0141b"t IIIA tt r6 .1 � � �, � -1 E d x .r. , t F '? 1 jl '� • �vE��( ,v -, (1Q y ,�,d .i^-:f �fi2 tr -,. i ,+ ,414 9fi, Y' IL I ;P :ii6P INDIVIDUAL SEWAGE DISPOSAL.. SYSTEM PERMIT NO . G-060042 klGa...1:) COUNTY HEALTH DEPARTMENT NEW PERMIT Ii::iNV:I:RONMIii:NTA1... HEALTH SERVICES 1 :`.;'16 HOSPITAL ROAD) , (:;REEL EY, CO 80631 353---0635 EXT„ ?2 25 OWNER MICHELE A , L f CI JI IORN ADDRESS 202.9 EAGLE DRIVE PH 0.3 ) - 9'5 ; FT. COLLINS CO 80525 ADDRESS HI PROPOSED SYSTEM ;3056V W . (;,R. 13 F T . COLLINS CO 80521 LEGAL.. DESCRIPTION OF SITE : NW4 SEC 19 '1W!:: 7 RNG 67 SUBDIVISION :ON NO LOT 0 BLOCK 0 F:1:LIN(:; 0 USE TYPE : RESIDENTIAL SIii:Ii1•'I:(.;li_S . PERSONS 6 DATH O MS 1 .'5i) L_(]1 SIZE 5O . 0O ACRES BEDROOMS 3 BASEMENT PLUMBING YES WATER SUPPLY NW(::WD APPLICATION f1:::1::: il1 :i>i).OO RI:C; ' ) BY RAiN(:;EL , MARY SIGNED BY JOHN J . EICI-IHORN DATE 02/26/86 DATE 02/26/86 I :RLI:11 c 1 ICM RATE 30 . 1 : MIN N PER INCH LIMITING ZONE 9 FEET SOIL. PYRE SUITABLE PERCENT GROUND SLOPE _5 DIRECTION SW REQUIRES IEN',:I:NI:i:II:F{ DESIGN NOT, FROM THE APPLICATION INFORMATION SUPPLIED I:::D AND TI-II::. ON-SITE l l SOIL PERCOLATION DATA THE FOLLOWING MINIMUM I.NYTAI.. LALJON SPEC F'ICAT`TON,S ARE: REQUIRED : SEPTIC TANK 1 000 GALLONS! ABSORPTION TRENCH I 1.50 SQ . F T OR 9D5.S q, itIZ� (CEO -(3N-BED D) �i� I'� ,' � . Iii ADDITION , THIS. PERMIT IS SUBJECT TO TH. I-(II...IIi:11CT.ING A77D, I MINAL TERMS AND CONDITIONS : THIS PERMIT IS GRANTED TEMPORARILY TO ALLOW CONSTRUCTION TO COMMENCE . THIS PERMIT MAY Tin::. REVOKED OR SUSPENDED BY 1'1-11::: WELD COUNTY HEALTH DEPARTMENT FOR REASONS SET FD]R J O TN THE WIii:I...ii COUN 'T'Y INDIVIDUAL SEWAGE DI:SPOSA1... SYSTEM REGULATIONS INCLUDING FAILURE:: TO MEET ANY TERM OR CONDITION IMPOSED THEREON DURING TEMPORARY OR FINAL APPROVAL , HIP ISSUANCE OF THIS PERMIT DOES NOT CONSTITUTE ASSUMPTION BY THE DEPARTMENT AR M1 NT OR S EMPLOYEES LOYEES OF LIABILITY FOR THE FAILURE OR INADEQUACY (11 THE SEWAGE DISPOSAL SYSTEM , TC. -4«-aI-%'l DG MARY KT.)I-II...Ii::NI. ERG--WCIDTKE ('1.3/07/(06 et P A•d1-81p ENVIRONMENTAL SPECIALIST DATE' THIS PERMIT MI1 IS NOT TRANSFERABLE AND SHALL. BECOME VOID IF SYSTEM CONSTRUCTION HAS N(1 I COMMT.NCED WITHIN ONE YEAR OF ITS ISSUANCE . BEFORE ORE ISSUING FINAL APPROVAL. OF THIS PERMIT THE WELD COUNTY Y HEALTH TH DEPARTMENT iN T RESERVES 1111.: RIGHT TO :1:111 'IS'lii: ADDI- TUMNAL TERM;` AND CONDITIONS REQUIRED TO MEET OUR REGULATIONS ON A CONTINUING BA- SIS . PERMIT APPROVAL IS CONTINGENT UPON THE FINAL INSPECTION OF THE CON 1E I E FINAL PIED 5511: M BY TH1.. WELD COUNTY HEALTH DEPARTMENT . rM NS AI Q / I .I:NAI :I:NSI-I::.(.:T .I(:1 tII. f� f��//r�Gi A�. C'c c{{��. / SYSTEM Nl Lill I. ��,ll / .._....._......•APP'Fif.1VA . .1 TYPE E 111 SYSTEM fi INSTALLED ....4:0t,70.7255:0.4 ,�� I:::NV:LFtONMI:..IdTAI... .;I 'E"(.,.Lril_.:IS.T. iII' ISSUANCE OF THIS PERMIT DOES NOT IMPLY COMPLIANCE WITH OTHER STATE , COUNTY OE J.:IC:AL REGULATORY n1URY OR BUILDING REQUIREMENTS, NOR SHAL..L. IT ACT Iu CERTIFY THAT THE SUBJECT SYSTEM WI.I...I... HI•IRAll.. IN COMPLIANCE WITH APPLICABLE I: STATE , COUNTY AND IIiL'Nii.. RFC:NATIONS ADOPTED IIi..I.SUr,N1 TO ARTICLE 10, TIT1.I:.. :'S, CI, ' i 73. , i1" AMENDED , EXCEPT FOR THE PURPOSE (.11 ESTABLISHING I' 1NA1... APPROVAL OF AN :IN,>' lullID) SYSTEM FOR ISSUANCE OF A LOCAL OCCUPANCY PERMIT PURSUANT TO CRS 1973 25-10-11i ( :: ) , q'9 /SVS 2 l i'P 1 i6P INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT NO . G-060042 WELD COUNTY I-IEAL.TI-I DEPARTMENT NEW PERMIT ENVIRONMENTAL HEALTH SERVICES 1516 HOSPITAL ROAD, GREELEY, CO 80631 353-0635 EXT a .'. .'25 OWNER n l.(:;I-Ilii .li:: A , EICHHORN ADDRESS 2829 EAGLE DRIVE (Ii ( 303 ) 223-959 FT . COLLINS CO 80525 ADDRESS OE PROPOSED OSEED SYSTEM 38>68 W.C. R . 13 FT. COLLINS CO 80521 LEGAL DESCRIPTION OF SITE : NW4 EEC 19 1WP 7 RING 67 SUBDIVISION : NO LOT 0 BLOCK 0 FILING 0 USE TYPE RE;sIDENT:I:AI... SER11:LCE S PERSONS 6 BATHROOM:. 1 .50 LOT SIZE :50. 00 ACRES .€'EDROOMS 3 BASEMENT PLUMBING YES WATER S(II::PL..Y NWCWD APPLICATION E lii:lii: $150 . 00 P:EC ' D BY L'RANGli:L , MARY SIGNED BY JOHN J . EICHHORN DATE 02/26/86 > DATE F/::./126/l3ti PERCOLATION RATE ::30 , 1 ; MIN PER INCH LIMITING :ZONE: I 8 FEET SOIL. IYPE SUITABLE ; PERCENT GROUND SLOPE % DIRECTION SW REQUIRES I NG.I.NEER DESIGN NO .; FROM THE APPLICATION INFORMATION SUPPLIED AND THE: ON-SITE SOIL PERCOLATION DATA THE. IULLOW [NG MINIMUM INSTALLATION SPI (,JI ( CATIONS ARE REQUIRED : SEPTIC TANK 1000 GALLONS, ABSORI T ION TRENCH 750 SO . E�TPT1 OR /O-0-S��' �f ItlCiflf i i:1N BED 9 /5 c' ,, . li, Ai)1 ITI (:iN , THIS PERMIT IS' SUBJECT TO Thl FULL:UMNt.. AUDI I IL(NAL. TERMS AND CONDITIONS : ................................._................._....................._..........................._........................._......_.........._._.............................................................._......_................ ................ THIS PERMIT IS . GRANTE_D TEMPORARILY TO ALLOW CONSTRUCTION TO COMMENCE. THIS PERMIT MAY BE REVOKED OR SUSPENDED :Hi THE WELD COUNTY HEALTH DEPARTMENT FOR REASONS [;ET I UR'IM IN THE WELD COUNTY INDIVIDUAL SEWAGE DISPOSAL SYSTEM R.EGI..JI...AiTIONS INCLUDING FAILURE TO MEET ANY TERM OR CONDITION IMPOSED THEREON DURING TEMPORARY OR FINAL. APPROVAL , THE ISSUANCE OF THIS PERMIT DOES NOT CONSTITUTE ASSUMPTION IOiN In' 1111: DEPARTMENT OR ITN EMPLOYEES- OF LIABILITY FOR THE FAILURE ORE:: OR INADEQUACY r OF THE SEWAGE I)l:SPOSAI._ SYSTEM . -17. .. s,-;�l .-3'T DG MARY I<o1-1LEiNI.)E:RG--WoDTKIT: 03/07/06 c� vp4a1-g o ENVIRONMENTAL SPECIALIST DATE' TILLS: PERMIT IS NOT TRANSFERABLE AND SHAL _. BECOME VOID IF SYSTEM CONSTRUCTION HAS NOT COMMENCED I I) WITHIN ONE YEAR OF ITS ISSUANCE . BEFORE IS ' HINt, FINN_ APPROVAL. OF HII:;'S I ( HINT THE WI.i:H' COUNTY HEALTH DEPARTMENT RESERVES TI"II::. RIGHT TO IMPOSE ADDI- TIONAL TERMS ANT) CONDITIONS REQUIRED TO MEET OUR REGULATIONS ON A CONTINUING BA- TS , FINAL i I::Ri' I1 Al PROVAl... IS CONTINGENT' UPON THE FINAL INSPECTION OF THE (::CM I EYED SYSTEM :BY THE WELD COUNTY HEALTH DEPARTMENT. "SYSTEM INSTALLER ,egiGi4,c LIIa.<. .... . FINAL .I:NhI'-'I:ET'.L(:1 r i I::: y l4 SYSTEM rENGINEER I f //G%,? .. . .. .... ..............._.._........_AP OVAL.. ..... : ..:,,, ,94g* .sue (c rPE O SYSTEM INSTALLED , 4, ro.rSPECIALIST ,�� ENVIRONMENTAL THE-- ISSUANCE CET: OF THIS PERMIT DOES NOT IMPLY COMPLIANCE WITH OTHER STATE , COUNTY (i] _GtAL Rlii:ISIJI...r':rTORY OR B(J.I.I._D:I:N(:; REQUIREMENTS, NOR SI-IAI...L.. IT ACT TO CERTIFY Tllt'i..l. THE SUBJECT SYSTEM WII...I... OPERATE IN COMPLIANCE WITH APP'!...:LCABI...I.E S T'A TE , COUNTY AND LOCAL ICI GIJI. AI TON.:. ADOPTED PERSUANT TO ARTICLE 10, TITLE 25 , CRS 1973 , AS AMENDED , EXCEPT FOR TIIE:: PURPOSE OF ESTABLISHING FINAL APPROVAL OF AN INSTALLED SYSTEM FOR ISSUANCE OF A LOCAL. OCCUPANCY PERMIT PURSUANT TO CRS 1973 25-l0-X11 (2) , 99/S-05 WJR-26-77 COLORADO DIVISION OF WATER RESOUrr.:ES THIS FORM MUST BE SUBMITTED 1313 Sherman Street - Room 818 WITHIN 60 DAYS OF COMPLETION Denver, Colorado 80203 OF THE WORK DESCRIBED HERE- -N.TYPE OR PRINT IN BLACK WELL COMPLETION AND PUMP INSTALLATION REPORT K. PERMIT NUMBER 147684 WELL OWNER John J- Eirbhorn SW Y. of the NW -Y. of Sec. 19 ADDRESS 2879 Ra& e 1)r- , Ft. Collins. CO 80525 T. 7 N R. 67 W 6 P.M. DATE COMPLETED Tine 3 :19 HOLE DIAMETER WELL LOG 8 in. from 0 to 23 _ft. Water 6 in. from 73 to 500 ft. From To Type and Color of Material Loc. _ in. from to —ft. 0 16ft Dirt & Clay loft. DRILLING METHOD Air --- CASING RECORD: Plain Casing 16 57ft , Brown Shale Size 6_51$"& kind Steel from +1 to 23 ft. 57 427ft Gray Shale 197f :• Size 4" & kind PVC from 10 to 360 ft. 427 438ft. Gray Sand Shale 435f .• Size — & kind from _— to ft. 438 500ft. Gray Shale Perforated Casing Size 4" & kind PVC from 360 to 500 ft. Size & kind from _ to ft. Size & kind from to ft. GROUTING RECORD Material Cement Intervals 5 to 23 fr . Placement Method Poured GRAVEL PACK: Size J12 Si lira Sand Interval 160 to 540 ft. TEST DATA Date Tested .Time 3 , 19 87 Static Water Level Prior to Test _ 3O ft. Type of Test Pump 131 ow Length of Test One Hour Sustained Yield (Metered) 2 rpm TOTAL DEPTH 500 ft. Use additional pages necessary to complete log. Final Pumping Water Level 5OO ft PUMP INSTALLATION REPORT ..:;Pt'=y. v ,fie Pump Make yV / A '-`' Type t c}rui . \� au Powered by HP • :•,,- , A Pump Serial No. r, i, W a WATER Motor Serial No. • I 3> TABLE o W w Date I nstal lea '� F cc N W' Pump Intake Depth Remarks - *i , cg a z ' Cs' Z o - a f Ii w ' •It'll 1 . " _ / r f` WELL TEST DATA WITH PERMANENT PUMP a - , :t I . E Date Tested a F CONE OF ~O a. '' ;Y DEPRESSION Static Water Level Prior to Test i— c Length of Test Hours ' tstained yield (Metered) GPM y; Pumping Water Level - Remarks1.4 r ` CONTRACTORS STATEMENT The undersigned, being duly sworn upon oath, deposes and says that he is the contractor of the well or pump installation described hereon; that he has read the statemen de hereon; knows the content theregf, and that the same is' �Q/true of his own knowledge �/ Sign ure �1 IL k iLlife 7 —4_4/C License No. 5"// / State of Colorado, County of O 444 tn.-0_4— SS (� Subscribed and sworn to betore me this I day of , 19(1" 'My CommiG&On Expires Ac 1, 19 • My Commission expires: (� X19 Notary Public e= \ , . 3.112-4 � FORM TO BE MADE OUT IN QUADRUPLICATE:: WHITE FORM must be an original copy on both sides and signed. WHITE AND GREEN copies must be filed wjtb the State Engineer.PINK COPY is for the Owner an4. [LLOW COPY is for the Driller. • NORTH WELD COUNTY WATER DISTRICT •'WAILR RAIL ) WILL GE RAI iEIJ 111/',9 i ROM • P.o.BOxs6 • . 70 CENTS. P�:R 1 .000 GALS_ TO . 7" CF=NTS. EAST CLASS MALL LUCER ._,CO BOC 16 Y US POSTAGE 56-30 PRE-SORTED RIFT 1 Cam. -I.MN .. Amou t ;. 1 � AihOure Y�: Ir AeedQtggl. F.. BF-Balance Forward 8F -24�.,.ir( 8F -245 tit) AD—Adjustment PY-Payments PY 0.0( PY WA—water 1) (7.0( RD MS—Miscellaneous AD O. 00 SC—Surcharge S C tl_i o. Sr 111E98 PREVIOUS RE4D[NG DATE • WA 4O.8C. .1.22'98 WA 5068 5034 ,ill 40. 80 51It OF .:1ACRE FEET CLASS WAU1 METER 11.13 '4 PL1J PDDF L ALLOC CRED11 325 • LE 3:3 YID USAGE .. 31.5 1 .(altr:.l 5 P=KAIei114( t;iJ rir Z7a r DUE AND PAYABLE ON THE 10TH OF THE MONTH. y T.tat•ue -.-, , 7l 4—Pay this amount after the tOth Total Due Account No. Q e . -, ' tell 1194R On I 171256F-, Wry District t Book Sequence r NWCWD t,IDoltish end wtd Return this Portton P.O.Box 56 ._ - - _ th . t O BA tMl I Payment Lucerne.CO •.S 1t•:M Wn_ 1.' • ! ;Nei t! r:7_!jl T. i ii LI i •i ? 1 IItt#1Niitttlilott �Is�hiiii1 iiiIti aitliol,pnii fiittlitttI I • `s\ Hello