HomeMy WebLinkAbout20001048.tiff WRJ-5-73 . CO: IAUO DIVISION OF WATER RESOU: _S
300 Columbine Bldg., 1845 Sherman St., Denver, Colorado 80203 f [®
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PERMIT APPLICATION FORM 11•—. 4ppticotion must complete where ( ) A PERMIT TO USE GROUND WATERa1 )
applicable. Type or (x ) A PERMIT TO CONSTRUCT A WELL
print in BLACK FOR: ( ) A PERMIT TO INSTALL A PUMP
INK. No overstrikes x W
or erasures unless '--
initialed. Proper fee ( I REPLACEMENT FOR NO. ~-
must be submitted
with the application. ( I OTHER
(1) APPLICANT - mailing address FOR OFFICE USE ONLY: DO NOT WRITE IN THIS COLUMN
NAME WILLIAM L. RHOTON Receipt No. ,jt' Ze C /
STREET 10932 ROSALIE DRIVE Basin Dist,
CITY NORTHGLENN, COLO 80233
(State) (Zip) CONDITIONS OF APPROVAL
TELFPHONF NO,..-452 265 ..._..,.._....._. _ . ---.. This well—Shall he.,r!red:.-in sash-a. wa' as to.ea.M -.
no material injury to existing water rights. The
(2) LOCATION OF PROPOSED WELL • issuance of thipernmit3oes not assure the applicant
that no injury will occur to another vested water
right or preclude another owner of a vested water
County WELD right from seeking relief in a civil court action.
SW ; of the SW %,Section 22
Approved per (3) (b) (ii). CRS148-21.45: this well
Twp. 6 N Rng. 62 W 6 P.M, to be the only well on a tract of more than 35 acres
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designated as that..._9_0 .acres in_451.11-2,5_12.1
- '3) WATER USE AND WELL DATA ,=_/.-.6Z.W...-..Gth P.-N1-,-...__:-�_ V
Proposed maximum pumping rate (gpm) 15
APPROVED FOR DOMESTIC PURPOSES WITH THE
IRRIGATION USE LIMITED TO NOT MORE THAN
Average annual amount of ground water
to be appropriated (acre-feet): one ONE (1) ACRE OF HOME GARDENS AND LAWNS.
Number of acres to be irrigated:
Proposed total depth (feet): 220'
Aquifer ground water is to be obtained from:
gravel eq, sandstone
O. -'t::.volt deli nat;o i -- — - - __-_ 2000-1048
GROUND WATER TO BE USED FOR:
( ) HOUSEHOLD USE ONLY - no irrigation (0) EXHIBIT
( x) DOMESTIC (1) ( I INDUSTRIAL (5)
( 1 OMMERI L ( I IRRIGAMUNICIPAL
( )
6)
( 1 COMMERCIAL (4) ( ) MUNICIPAL (81
( ) OTHER (9) APPLICATION APPROVED
I.D. / W.D. / _ COUNTY 4 a.
(4) DRILLER PERMIT NUMBER 73419
Jame A & J DRILLING CO DATE ISSUED FEB 2 8 1974
Street 8 WAY EXPIRAT,FQRI DATE FEB 2 b 1976
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City WESTMINSTER, COLO 80030 VT_dl/i
(state) (Zip) •
428-3279 711 DEPUTY (ST E ENC NEE )
Telephone No. Lic. No.
BY
WELD COUNTY HEALTH DEPARTMENT 114003 (
die"-- 1555 17th Avenue ;' 2
Greeley, Colorado i3
Ph. 353-0540 RECEIPT NO. j ;� `;�
I N Application for permit to Instal onstruct, Alter, or Repair an Individual Sewage Disposal System. .I —
Owner rcy �
f .moo to�v Address �h( '3a-4,c-ittAtt C "hone7S€Q-�/„ I i*1X
Direction to situ i,i-r r_r1�r err( /�'n,c '.�7-fii,: J:. . Legal Description' )p_,. , `1 t .0 p I I/_,,4.1 e. -x_. 4( 1 it 2" . x , —
General Information i' � IRui
Dept. Use Only 2 , ('
No. Bedrooms ` t No. Persons c f Perc.',Rate (Avg, of 3) 1 !iJcU/1d PlrAl) a
iI
No. Baths c-Y Basement Plumbing,„ yt.--!) Soil Type SWaJL�, �;g
Size of Lot ,,:4- r c"/ill P ic/ 112O Table Depth e> � , 1,-..",.H2O supply (if well give depth) y O / _ Lot drade � r� } i
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Type of sewage disposal requested = Requires Engineer Design_Yes X No
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I
Septic tank c.-m' Privy Other If yes — reason °I E
ti
Comments: I
I
Installation Instructions: I*.Ir ‘1,-1 ,,..
QQ I≤ • Imo ,
Septic Tank 1 OnD Gals. Absorption Field i/5 Sq. aI
n I k,,N
Other Seepage bed 644/5-1 Sq. Ft. 1 i > V")
Special Instyructions - S } t i Z ...., ..je 3 I
sThis system will be constructed and installed in accordance with -the above specification and regulations - ) in = '., �+ 0 II ,
r regarding individual sewage disposal systems in Weld County, Colorado. I) j h o t;
4, This permit. shall expire at the me time as the buil ing permit, ar, if n1 building permi is iss ed the permit r'
shall expire 12 days after its is4uance, if constt-rtucttio has not been com enc . 1u
x a: /i e i S i l / >`' Owner: , ,'
Date: �t-2�-�� I
—� N ,
1,- ; Applicant: sl \ , °r `\ r. ,
• e plans and specifications as Shown are approved pending payment of it fee. dg �
Date:
t
.'"t Sanitar n.
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