HomeMy WebLinkAbout20020052.tiff LEFT HAND WATER ' 'ISTRICT
+• P.O.Box 210•Niwot, CO 80544
�!I (303)530-4200 . 530-9825
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TRAUPE ,TOHN & RUTH
904 WL...D CO RD 7
E.Ra:t:::,, CO 005:1.6•-••"l908
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U ' DALE BILL MAILED SERVICE FROM __ SERVICE TO BAYS USED DUE DATE
00004405 07/30/0:1 06/25 07/24 29 08/2:1/01
46j4001Mlb 4, �`.;PRESENT READING UNITS USED ` DESCRIPTION AMOUNT DUE
762 000 76700(? 5000
WATER CHARGE 1.2...:1.8
BILLING & METERING 14. 10
Waters' Usage Breakdown
9.28 on 4000 @ 2.32 per :1.000
2.90 on 1000 @ 2.90 per 1000 USAGE LAST YR 10000.00
SERVICE ADDRESS ► 984 WLD CO RI) 7 AMOUNT BY DU DATE
DUE 26.28
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KEEP THIS PORTION FOR YOUR RECORDS
2002-0052
MINT
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AUG-24-2001 FRI 10:01 AM ENVIRON HEALTH SERVICES 9703046411 P. U1
STAFF APPROVAL OF ENGINEER-DESIGNED SYSTEM
Owner Name: John and Ruth Traupe
Location Address: 984 WCR 7 Erie
The engineer-designed Individual Sewage Disposal System proposed for the above
property, and designed by Edward 0. Church is hereby approved subject to the
following conditions: Construct according to the engineer design. All Weld County ISDS
regulations apply.
<h fret .r -e •for I.S.D.S. Permit No.: SP-0100439
br �) �� P . owner�appu„an,
under the provision of the Weld County Individual Sewage Disposal System
-.w
Regulations, do hereby understand and ayiee that after approval by the Director of
Health Protection Services, I may proceed with the construction of my engineer-
designed sewage disposal system prior to approval by the Weid County Board of
Health, but that the Board of Health reserves the right to disapprove any or all parts of
the system design when it considers my application. I understand and agree that I
proceed at my own risk and that I may be required by the Board to remove any or all of
the system installed prior to Board of Health consider? ' n of my application.
-22
Envi nm ntal Specialist caner/Applic�rr[
-2.4-01 ?///e/
Date uate
^.
WELD CQUNTY DEPARTMENT OF PUBLIC HEALTH&ENVIRONM..NT
1555-NORTH 17TH AVENUE,GREELEY, CO 80631 PHONE: (970) 304-6415 FAX: (970) 304-6411
WEBSITE: WWW.CO.WELD.CO.US
APPLICATION/RECEIPT
Initials: SKE
Permit Number: SP-0100439 Receipt Number HAP-01436
08-14-2001 Amount: $315.00 Payment Method: Check Notation: 1451
Owner Name: TRAUPE JOHN & RUTH
Applicant Name: TRAUPE JOHN&RUTH
Parcel Number: 1467-34-2-02-018
Site Address:
J nation: 984 CR 734 01 68
Total Fees: $315.00 Total All Payments: S315.00
This Payment: $315.00 Balance: $0.00
Account Code Description Amount
2560-41400-42214203 New Septic Permit $315.00
2560-41400-4221-4203 Repair Septic Permit $0.00
2560-41400-4221-4203 Vault Permit $0.00
2560-41400 4410-4203 Potable Water $0A)0
r1
Description: HOUSE/SHOP
Commercial: (Y/N) Y Residential: (Y/N) N Acres: 4
Number of Persons: 4 Basement Plumbing: (Y/N) Y
Number of Bedrooms: 3 Bathrooms: Full - 1 3/4: 1 1/2: 0
Water Public: (Y/N) Y Water Source: LEFT HAND
Water Private: (Y/N) N Cistern: (Y/N)N Well: (Y/N) N Well Permit Number.
EalICE
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 Department of Public
Health and Environment to be made and furnished by the applicant or by the Weld County Department of Public Health and
Environment for purposes of the evaluation of the application;and the issuance of the permit is subject to such terms and conditions u
deemed necessary to insure compliance with rules and regulations adopted under article 10,title 25,CRS as amended. The applicant
certifies theat the proposed system will not be located within 400 feet of a community sewage system. The uadasigasd hereby
certifies that all statements made,information and reports submitted herewith and required to be submitted by the applicant ere,or will
be,represented to be true and correct to the best of my knowledge and belief,and we designed to be relied on by the Weld Canty
Department of Public Health end Environment in evaluating the same for purposes of issuing the permit applied for boreal Stier
understand that any falsification or misrepresentation may result in the denial of the application or revocation of any permit granted
based upon said applicaion and in legal action of perjury as provided by law. r tiffs a�oli�.tlnn��L...see ve r flee t>fe aima�.m
date
s A/
wner/Applicant Date
Form:RTJtAPP
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