HomeMy WebLinkAbout20041663.tiff /►_ �'� City of Greeley Statement of Account for
►��}� Director of Finance
P.O. Box 1928 Municipal Service(s)
Gape O f Greeley,CO 80632-1928
reley
Account Number YOUR ACCOUNT IS PAST DUE . PAST DUE
069-778001 -01 AMOUNT MUST BE RECEIVED IN FINANCE BY
DUE DATE TO AVOID DISCONNECT.
KEBERLEIN, TOM )
6110 LESSER DR
GREELEY CO 80634 DUE BY
02/19 26. 28
Service 7710 37 ST
Location
S4 411x1 11.,45- x ., - ``y``1/21r. it' "rt,r. .�., , . ag Previous Chatie",
�... ,.. 1 ._.
95568860 )1 /30 361 12/30 360 1 Bat Fwd 14 . 18
METER 0.00
OUTRESWT 12 . 10
FOR THE NEXT 12 MNTHS YOUR SEWER CEILING Current Charges t�, 12.10 -k
WILL BE SET BASED ON YOUR JAN-FEB USAGE. DUE BY
CREDIT CARD PYMTS CALL 350-9722/350-9723 02/19 26. 28
QUESTIONS? CAII ANNE 970-350-9779
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DETACH AT PERFORATION AND RETURN BELOW PORTION WITH YOUR REMITTANCE
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--• --. --- ••-..,a 3roaoltniu NEW HORIZONS
PAGE 01/i)1
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DEPARTMEN F PI IC HEALTH&ENVIRONMENT
1555 N. 17n4 AVENUE
GREELEY COLORADO 80631
WEBSITE^ ADMINISTRATION
N(970)304.64:0
WILD970)304-6416
ADON&NURSING(970)304.6410
PUBLIC HEALTH EDUCATION&NURSING(970)304.6420
FAX ENVIRONMENTAL HEALTH SERVICES(970)304-641:5
COLORADO SEPTIC LOAN APPROVAL FAX(970)304-641
CLOSING DATE: 10-17-03 REQUEST NO. : 03-039
NSW LOAN DATE RECEIVED: 9-11-03
FEZ: 100.00ms
TO WHOM IT 13AX CONCERN: Review and inspection report regarding water and the sewage
disposal system for an existing dwelling:
Mail To: +
Owner No. : (H)
Owner No. : (W)
Fax To: Realtor No. , 970-519-5046
Pick Up: John Donley Fax No. :
INFORMATION: Address: 7710 Nast 37 Street, I
eAcreels Legal: PT: PT: Y Age of Septic: 1976
Subdivisions SEC' 29 TNN: 5 N RNG: 66 W
Property Owner: The Estate of Charles licba LOT: ELK: FLG:
Tank Pumped On: 6-6-03 By: Suc N Up Original Owner: KLicensed: Larry
Livaasad:Xes XZ No
PERMIT ON RECORD; Names 1Cammersell, Larry
•^ PERMI Bathrooms: Permit No. : 019760013 S.O.E. : NO
1 Bedrooms: 3 Total Acres: 1.51 Dete of Final Inspection: 10-19-76
Mater Supply:_g _
oP Greelev
Teak Capacity: Well Permit No. : N/A
Tank 1250 gallons Leachfield Size: 936
Square Feat
INSPECTION rxmlimso Data of Inspection: Se t
SOIL CONDITIONS: Dry XX Saturated_._ embSn 16 Sere
RESIDENCE: Occupied XX V Snow-covered
SEWAGE DISPOSAL Vacant
SYSTEM: Satisfactory XX Other
BACTERIOLOGICAL WATER TEST: Acceptable XX Other
,
DATE:--a11.--1&:1 ( --
SIGNATDRE: •''` ' .1 _ .)
i�•`o
Envi ' ma al Health Specialist
Neither the County of Weld, nor any of its agents or employees undertake or assume any
liability to the owner of the above property, to any purchaser Of the above property or to
any lending agency making a loan on the above property in connection with either its
examination of the property or in the report.
This inspection was conducted solely for the purpose of detecting health hazards
observable at the time of inspection, and does not constitute a warranty that the system
is without flaw or that it will continue to function in the future. Inspections requested
during periods of snow cover and high soil saturation may be of questionable value to
potential buyers due to adverse conditions. Water sample reports reflect the
bacteriological quality of the water supply at the time the sample was taken. Evaluations
based on Statements of Existing (S.O.E.) relies on information the property owner
provides, under oath, indicating current status of the system and representing to the best
"-"if his/her knowledge the system is not failing to function properly.
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