HomeMy WebLinkAbout992551.tiff Weld 9unty Health Department
ENVIRONMENTAL HEALTH
1517 16TH AVENUE COURT
GREELEY,COLORADO 80631
(303)353-0635 phi
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EJCIMIT
992551 I
Form No. OFFICE OF THE ATE ENGINEER
GWS-25 COLORADO DIVISION OF WATER RESOURCES
818 Centennial Bldg., 1313 Sherman St., Denver, Colorado 80203
(303) 866-3581
LR
WELL PERMIT NUMBER 211139 - -_
APPLICANT DIV. 1 CNTY. 62 WD 1 DES. BASIN MD
Lot: Block: Filing: Subdiv:
APPROVED WELL LOCATION
WELD COUNTY
STANLEY & LORI WADDELL NE 1/4 NE 1/4 Section 31
18920 WCR 100 Twp 9 N RANGE 65 W 6th P.M.
NUNN CO 80648-
DISTANCES FROM SECTION LINES
(970)897-2721 99 Ft. from North Section Line
473 Ft. from East Section Line
REGISTRATION OF EXISTING WELL
ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT
CONDMONS 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 the
permit does not assure the applicant 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) The construction of this well shall be in compliance with the Water Well Construction Rules 2 CCR 402-2, unless
approval of a variance has been granted by the State Board of Examiners of Water Well Construction and Pump
Installation Contractors in accordance with Rule 18.
3) This well is recorded, and permit approved, in accordance with CRS 37-92-602(5) for historic use as indicated
herein and described in CRS 37-92-602(1)(b), being a well producing 15 GPM and used for ordinary household
purposes inside one (1) single family dwelling, fire protection, the watering of domestic animals and poultry, and
the irrigation of not more than 1 acre of home gardens and lawns.
4) The date of first beneficial use, as claimed by the applicant, is April of 194O 7/a./9S
EXHIBIT
OWNER'S COPY
APPROVED E ' . ' J
JSG .T,IQ/
State Engineer 998 BY
J U L 0 8 1
Receipt No. 0432240 DATE ISSUED EXPIRATION DATE tki
Init :
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WELD COUNTY HEALTH DEPARTMENT (970) 304-6415 RECEIPT
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Receipt Number: 99001340 Amount : 315 . 00 07/12/1999 10 : 19
Payment Method: CHECK Notation: 513 User : RBUSTILL
Owner Name : WADDELL STANLEY K & LORI J
Applicant Name : WADDELL STANLEY K & LORI J
Permit No : SP-9900331
Parcel No: 0457 31 00.0004 0373586
Site Address : 18920 WCR 100 WEL
Location : 18920 WCR 100 NUN 31-9-65
Total Fees : 315 . 00
This Payment 315 . 00 Total ALL Pmts : 315 . 00
Balance : . 00
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Account Code Description Amount
256041400-4221-400 New Septic Permit 315 . 00
256041400-4221-400 Repair Septic Permit . 00
256041400-4221-400 Vault Permit . 00
256041400-4221-400 Site Evaluation . 00
256041400-4730-400 Potable Water Sample . 00
Description: COMMERICAL NORTHERN CO POULTRY SHOP/OFFICE
Commercial (Y/N) : Y Residential (Y/N) : N Acres : 6 . 00
Number of Persons : Basement Plumbing (Y/N) : N
Number of Bedrooms : Bathrooms-> Full : 3/4 : 1/2 : 1
Water Public (Y/N) : N Utility Name :
Water Private (Y/N) : N Cistern (Y/N) : Y Well (Y/N) : N
Water Permit No : .
NOTICE
Applicant acknowledges receipt of the individual sewage disposal system guide and that the completeness of this application is
conditional upon further mandatory and additional tests and reports as may be required by the Weld County Health Department to be
made and furnished by the applicant or by the Weld County Health Department for purposes of the evaluation of the application; and
the issuance of the permit is subject to such terms and conditions as deemed necessary to insure compliance with rules and
regulations adopted under article 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 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 Health Department in evaluating the
same for purposes of issuing the permit applied for herein. I further understand that any falsification or misrepresentation may
result in the denial of the application or revocation of any permit granted based upon said application and in legal action for
ry as provided by law. This application expires one year from the signature date.
A . 10--�.'� ^f\ .7-D-9 ciextnerr
OWNER/APPLICANT Date
2'7
WELD COUNTY HEALTH DEPARTMENT
1517 16TH AVENUE COURT, GREELEY, CO 80631
(970) 353-0635 EXT 2225 FAX (970) 356-4966
Permit # : SP-9900072 Sec/Twn/Rng: 31 09 65 PERMIT
Permit Type : RREP C=commercial, R=residential + NEW, REPair, VauLT
Applied: 02/16/1999
Parcel No: 0457 31 000004
Expires: 02/11/2000
Location: 18920 WCR 100 NUNN 31 09 65
Legal Desc : 14824A PT NE4 31 9 65 BEG AT NE COR S323 ' W820 ' N
18920 100 CR WELD
APPLICANT QUALITY LIVING HOMES
500 1ST AVE, GREELEY, CO 80631
OWNER WADDELL STANLEY K & LORI J
18920 WELD CO RD 100, NUNN CO 80648
Description: HOUSE
Commercial (Y/N) : N Residential (Y/N) : Y Acres : 3 . 00
Number of Persons : 3 Basement Plumbing (Y/N) : N
Number of Bedrooms : 3 Bathrooms-> Full : 1 3/4 : 1/2 :
Water Public (Y/N) : N Utility Name :
Water Private (Y/N) : Y Cistern (Y/N) : N Well (Y/N) : Y
Water Permit No:
Percolation Rate : 2CO Limiting Zone : lg ft _ in Desc : •
96 Ground Slope : Dir : Soil Suitable (Y/N) :\(j
Engineer Design Req' d (Y/N) :AtC In 100 Yr Flood Plain (Y/N) : ) O
From the application information supplied and the on-site soil percolation data the following minimum installation specifications
are required:
Chambers
Septic Tank : � O -!(--e5gallons, Absorption Trench sq. ft . (2
E-2.<611/1MEM \ or .Absorption Bed sq. ft .
In addition, this 1permCitt is subject to, the following additional terms l.. wand
conditions : Y�X-CC O cJl,1bLl tk V , P..eV t`�X. 4e. od `)Ce Y tk S- btu j p✓.�f
�dtG. Q c LQ j 'lwc L- arrc, 1
NOTICE
This permit is granted temporarily to allow construction to commence. This permit may be revoked or suspended by the Weld County
Health Department for reasons set forth in the Weld County individual sewage disposal system regulations including failure to meet
any term or condition imposed thereon during temporary or final approval. The issuance of this permit does not constitute
assumption by the department or its employees of liability for the failure or inadequacy of the sewage disposal system.
This permit is not transferable. Before issuing final approval of this permit the Weld County Health Department reserves the right
pose additional terms and conditions required to meet our regulations on a continuing basis. Final permit approval is
agent upon the final inspection of the completed system by the Weld County Health Department. This permit expires one year
. the signature date. XWALCAWIL
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Environmental Specialist Date
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