HomeMy WebLinkAbout20040945.tiff r LEFT HAND WATER DISTRICT
6800 NIMBUS RD. LONGMONT, CO. 80503
P.O. BOX 210 NIWOT, CO. 80544-0210
(303) 530-4200 www.lefthandwater.dst.co.us
OFFICE HOURS MONDAY-FRIDAY 8:30 AM-4:30 PM
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eliOVESFORYOUTH 11/21/2003 3134.01
9201 W 44TH AVE
WHEAT RIDGE CO 80033-3006
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--PLEASE RETURN TOP PORTION WITH YOUR PAYMENT---
LEFT HAND WATER DISTRICT
P.O. BOX 210
NIWOT, CO. 80544-0210
e" (303) 530-4200
www.lefthandwater.dst.co.u s
ACCOUNT NUMBER DATE BILL MAILED SERVICE SERVICE NUMBER DUE DATE
FROM TO OF DAYS
3134.01 10/31/2003 09/26/2003 10/27/2003 31 11/21/2003
PREVIOUS READING PRESENT READING UNITS USED DESCRIPTION AMOUNT DUE
3,776 3,793 17,000
If your present reading a 0, your account was estimated.- .00
WATER BASIC FEE 15.00
100000 WATER USAGE 62.90
ACTIVATION FEE .00
50000 - n n� SHUTOFF CHARGE .00
I I MISCELLANEOUS .00
0 —Nov Dec Jan Feb Mar Apr May Jun Jul I I• Sep Oct
Water 1000 gal)
ADDRESS 745-747 E HWY 119 TOTAL AMOUNT
SERVICE 77.90
DUE
Your Water Usage Rate is. 320 Please see Rale Table below.
IMPORTANT INFORMATION
310 Commercial 320 Multiple Housing 330 Dual System
300 Residential
1st 4,000 2.45/th All Usage 3.70/th All Usage 3.70/th 1st 4,000 2.45/th
Next 16,000 3.25/th Next 8,000 3.25/th
Next 30,000 4.10/th Over 8,000 11.20/th
Over 50,000 5.10/th
See Reverse Side for Important Information
2004-0945
-v-
St. Vrain
SANITATION
DISTRICT
July 14,2003
Alternative Homes for Youth
745 Highway 199 East
Longmont,Colorado 80504
Re: Sewer connection
To Jean Osbourn, cc File
St.Vrain Sanitation District(SVSD)Staff has previously reviewed the service lateral video inspection of
the new building. The integrity of the pipe and connections are satisfactory. The service lateral is a four
(4)inch pipe. This flows east to the line extension from Concepts Direct. SVSD is not responsible for the
service lateral. The connection of the old building to the system was part of an understanding before my
employment between Alternative Homes for Youtlyrepresentative and SVSD. SVSD does not allow two
buildings on the same lot to be served by the same sewer tap anymore. The Plant Investment Fee(PIF)will
not increase as long as the flow from the property remains within the purchased allotment. If flow does
increase,addition PIF will need to be purchased.
In addition, SVSD must inspect the new connection of the old building before it can be backfilled. The
number to call for an inspection is 303-774-6162. Please have your contractor draft an asbuilt of the
connection and forward a copy to SVSD.
Please feel free to contact St.Vrain Sanitation District at 303-776-9570 with any further questions or
comments.
Sincere)
Robert'Fleck
District Engineer
436 Coffman Street Suite 200 P.O. Box 417 Longmont,CO 80502-0417
Phone: (303) 776-9570 Fax: (303)485-1968 Email: steve@stsan.com
•
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St. Vram
SANITATION
DISTRICT
June 2,2003
Alternative Homes for Youth
745 Highway 199 East
Longmont,Colorado 80504
Re: Sewer connection
To Cory Johnson, cc File
St.Vrain Sanitation District Staff has reviewed the service lateral video inspection. The integrity of the
pipe and connections are satisfactory.
Please feel free to contact St.Vrain Sanitation District at 303-776-9570 with any further questions or
comments.
Sincerel
)171
Robert Fleck
District Engineer
r
N
436 Coffman Street Suite 200 P.O.Box 417 Longmont, CO 80502-0417
Phone: (303)776-9570 Fax:(303)485-1968 Email: steve@stsan.com
ALTERNATIVE HOMES FOR YOUTH 39740
OUR BER YOURIER INVOICE INVOICE DATE INVOICE AMOUNT AMOUNT PAID DISCOUNT TAKEN NET CHECK AMOUNT
NUMIJER, + NUMBER
Sal-641'r w Le P oa 30, a (o.on
WELLS FARGO WEST
ALTERNATIVE HOMES FOR YOUTH 23-7/1020
9201 W.44TH AVENUE 39740
WHEAT RIDGE,CO 80033 CONTROL(303)940-5540 CHECK DATE NUMBER AMOUNT
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PACT`'1 I f l 1rik o LA-6.0-4-elTwo n u Il I op 4-
TO THE S+. e4 r 0.1 14 S a-491%.-Ve t �-• ) IS#C to VOID IF NOT CASHED WRHIN 90 DAYS
ORDER _ x
OF
AUTHORIZED NATURE
a SECURITY FEATURES INCLUDED.DETAILS ON BACK.a
9'0397400' 1: 1020000761: 3L28007720n. 225Co
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CCoUE
ST FOR SEWER C NNECTION— Year 2002 Ts Customer #
ere' dustrial User Single Family Equivalents: I.i',0,
/
Sewer Line:n I y G . 2_5(c,2_5(c,To be determined by District) v
Fo owing are the instructions and procedures for obtaining a commercial/industrial sewer tap from the St. Vrain Sanitation District and
-r.(or making connections to the District's sewer lines. This information is effective as of January I,2002 and is subject to change.The
istrict reserves the right to monitor flows and re-evaluate the P.I.F(Plant Investment Fee)at the Districts discretion. We recommend
that you contact the District office if you have any questions. Office: (303)776-9570
I. Sewer Tap Application. This"Request for Sewer Connection"is to be completed, signed and submitted to the District office together with
the information requested on the Request form and the appropriate fees. Checks for fees should be made payable to "St. Vrain Sanitation
District".
_ 2. Fees. The schedule of fees is set forth below. All fees are based upon Single-Family Equivalents(SFE)as defined in the District's rules and
regulations. /
Plant Investment Fee: 64 Se- M (✓ 4442e - $ 3Q / ,�y �o.oj S"F Ef/�6f
Inspection Fee: $ 60 G
TOTAL TAP CONNECTION FEE/SFE: $ '3 0 2.1O applicable fee(check)
(Add if applicable)
Line Extension Fee, If South of Hwy 52(5525 in 2003/04): _ (SFEs)' X $ 500 = $
Line Extension Fee($525 in 2003/04): _ (SFEs) X $ 500 = $
TOTAL TAP CONNECTION FEE/SFE: $ IO2/D applicable fee(check)
3. Inspection of Connection. All connections from trunkline to residence must be approved by the District's inspector. Inspections can be
arranged by contacting Mark Wilson at (303)588-1998. Call at least 48 hours in advance.
4. Service Charges and Billing. The District currently charges $22.00/month per Single Family Equivalent(SFE). Statements will be sent to
you quarterly at the address set forth on your approved Request for Sewer Connection. SERVICE CHARGES WILL BEGIN ON THE
FIRST DAY OF THE MONTH FOLLOWING TAP PURCHASE. Quarterly payments are due by the 20`h of April, July, October and
January,and shall be applied for service charges incurred(in arrears). Annual payment option is available only one time per year in February.
Notify the District within seven(7)days of the transfer of ownership or change in the billing address.
5. Rules and Regulations. Connection and service are subject to the Rules and Regulations of the St. Vrain Sanitation District as they may be
amended from time to time. Copies are available upon request at the District office.
TO: St. Vrain Sanitation District
i Coffin=Street,P.O.Box 417 Longmont,CO 80502-0417 Phone: (303)776-9570 FAX: (303)485-1968
I/We hereby apply for issuance of a Sewer Connection and herewith tender the sum of$ 304,a t 0 dollars to pay for the Plant Investment Fee and Inspection Fee,
and Line Extension Reimbursement Fee(if applicable),for said Connection.Applicant gants�St.Vrain Sanitation District the right to gather water usage information,
including records from the water purveyor for the purpose of determining effluent flow.I/We acknowledge that the Connection if issued will be subject to all Rules and
Regulations of St.Vain Sanitation District,and all County and State Health Department rules and regulations,and in particular,it is understood that the applicant at his/her
own expense must bring his/her service lines to the service lines of the District.
e-Company Name: AI-i- ro :via go"neg. fte \IouJ-k. Date: L,— 1 '3—O >-
Applicant Na e(Please Print): • Legal Description:
Signature: -7
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Service Address: '74 3 t gku5 a�,.) it i 4 Billing Address: ( 1��-?L yy t/Q�u..�
}W ac-At per. Co C.L i 2..oif - �r de? , Co coO..3
Telephone:( 3,,Ol!3) '-7-7/,-,. 9Qa T�lpphone:(4 ) 9+O-6S`�-o
Wastewater Questionnaire: Received Waived /
/ I
/A
'
APPROVED �1��
Number of Employees: 113 - Date
The connection will not be made until after inspection of the service lines by the Inspector for the District. I/We hereby agree not to backfill the service line until after said
inspection,and further agree not to make the connection to the District sewer line except in the presence of the Inspector for the District. The service lines,taps,tapping
saddle and connection have been inspected by the District and have been approved as satisfying all District requirements.
APPROVED: •
Mark Wilson,District Inspector Date
_District Copy Applicant Copy Inspector Copy
File:lace/mydocuments/st.vainstuff/formcopies Revised: 12/18/01
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