HomeMy WebLinkAbout20012551.tiff i--ISF'10c6F INDIVIDUAL SE:_WA(:;F:: DISPOSAL SYSTEM PERMIT NO. G-900180
EXHIBIT WEL.I) COUNTY HEALTH DEPARTMENT NEW PERMIT
1 ENVIRONMENTAL HEALTHSERVICES� 1I.'17 16TH AVENUE COURT, GREELEY, CO 80631
353-0635 EXT.2 22,:
OWNER TATEYAMA, ROBERT H. ADDRESS 20680 WCR 43 PH (303) 834.245
AUL.T CO 80610
ADDRESS OF PROPOSED SYSTEM 39713 WCR 43
AOLT CO 80610
...!:::C;'il... DESCRIPTION OF SITE : NE4 SE(:: 16 T'WP 7 RNG 6'>
SUBDIVISION : LOT 0 BLOCK 0 FILING 0
'..+:"'E" TYPE : RESIDENTIAL.. HOUSE
:'I:::RV:ICIES : PERSONS 3 (BATHROOMS 2.50 I_.UT SIZE: 3.00 ACRES
BEDROOMS 3 BASEMENT PI...UMI :I:NG YES WATER SUPPLY NWCWD
APPLICATION FEE $150.00
I''I:::+:" ' D BY COFFEY, I):I:ANNE SIGNED BY TERRY I.... ,.JACCA(JD
DATE 08/27/90 DATE 08/27/90
PERCOLATION RATE 20.3 MIN PER INCH LIMITING ZONE 8 FEET
SOIL. TYPE SUITABLE PERCENT ENT GROUND ELOPE 0 DIRECTION S/W
REQUIRES S ENGINEER DESIGN
FROM THE APPLICATION ON INFORMATION SUPPLIED AND 'till" ON-SITE SOIL PERCOLATION DATA
THE FOLLOWING MINIMUM INSTALLATION SPECIFICATIONS ARE REQUIRED :
SEPTIC TANK 1000 GALLONS, ABSORPTION TRENCH 651 SQ. FT.
OR
ABSORPTION BED 846 SQ . FT .
ADDITION, THIS. PERMIT IS SUBJECT TO THE F"(:)I...I...OW:I:NG ADDITIONAL TERMS ANT)
CONDITIONS : ...._...._.....__.._.._...__.._.._._.._. _.._........ _._._. __ _...__.._._...................... -----
THIS PERMIT IS GRANTED TEMPORARILY TO ALLOW CONSTRUCTION Ti) COMMENCE. THIS PERMIT
MAY BE REVOKED OR SUSPENDED BY 1111: WELD COUNTY HEALTH DEPARTMENT MIENT FOR REASONS SET
FORTH IN THE: WELD COUNTY :1ND:IVIDUA1... SEWAGE DI:SPOSAI... S'YST'EM REGULATIONS :INCLUDING
FAILURE II F 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 OFF THE
: !:::WAGE DISPOSAL SYSTEM. AA
-T e obi..- /1- ;2 "9e WES POTTER 09/06/90
ii , 5 .. 90 eI I:_NVIRENVIRONMENTALSI SPECIALIST DATE
(�v���.
THIS PERMIT IS NOT TRANSFERABLE AND SHALL_ BE:COME VOID IF SYSTEM CONSTRUCTION HAS
!(:).,.' COMMENCED WITHIN ONE YEAR OF ITS ISSUANCE. BEFORE IS'S'UING FINAL_ APPROVAL OF
THIS PERMIT THE WII...D COUNTY HEALTH DEPARTMENT RESERVES THE RIGHT TO IMPOSE ADDI-
TIONAL TERMS AND CONDITIONS REQUIRED TO MEET OUR REGULATIONS ON A CONTINUING BA-
SIS. F:INAI... PERMIT APPROVAL. IS CONTINGENT UPON THE F:I:NAI... INSPECTION ON OF THE COM-
i';...!ETE:D SYSTEM BY THE WELD COUNTY HEAL.•rF•I DEPARTMENT,
YE EM INSTALLER .. ......... 0.4...... ` ........F•J:)�!AL INSPECTION DATE: _...
SYSTEM ENGINEER _.-_.._...... ............................................_..._API APPROVAL -- -
T'.(I:'E: OF SYSTEM INSTALLED 77-7 ENVI MENT SPECI _:EST
7J-+I=' ISSUANCE OF THIS PERMIT DOES NOT IMPLY COMPLIANCE WITH OTHER STATE, COUNTY
I...00AI_ REGULATORY OR BUTI...DINI; REQUIREMENTS, NOR SHAL.l... IT ACT TO CERTIFY THAT
THE SUBJECT SYSTEM WILL OPERATE IN COMPLIANCE WITH APPLICABLE STATE, COUNTY AND
!...00AI... REGULATIONS ADOPTED II:::RS(IANI TO ARTICLE 10, TITLE 25, CRS 19"r3, AS AMENDED,
. .X(:;I-:Ir FIJIFOR THE PURPOSE: OF ESTABLISHING FINAL AlP OVAi OF AN INSTALLED SYSTEM FOR
< 9 25-10-411 ,
.�.�.. UANCI: OF A i_OC;AL.. OCCUPANCY PERMIT PURSUANT TO CFi.:, 1973 (:� ) .
2001-2551
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WELD COUNTY DEPARTMENT PUBLIC HEALTH AND ENVIRONb..iNT
1555 NORTH 17TH AVENUE
GREELEY, CO 80631
PHONE(970) 304-6415 FAX (970) 304-6411
Permit#: G19909025 Sec/Twn/Rng: ?? Status: FINAL
Owner: TATEYAMA ROBERT Applied: 03/28/1990
Applicant: TATEYAMA ROBERT Issued: 03/28/1990
Permit Type: C=Commercial,R=Residential+NEW,REPair,VauLT Finaled:
Parcel #: 0709-16- - -
Location: 39505 WCR 43 AULT CO 80610
Installer:
Description: I.S.D.S/S.O.E.
Commercial: N Residential: Y
#of Persons: 2 Basement Plumbing: N
#of Bedrooms: 2 Bathrooms: $1.00
Water Public: Water Source:
Water Private: Cistern: Well: Well Permit#:
Percolation Rate: 0.003
% Ground Slope: 0 Dir: Soil Suitable: (Y/N) S
ngineer Design Required: (Y/N) N In 100 Year Flood Plain: (Y/N)
Actual Installation
Septic Tank: 1000 gallons Absorption Trench: 0 square feet
Absorption Bed: 350 square feet
Design Type:
NOTICE
The issuance of this permit does not imply compliance with other state,county or local regulatory or building requirements, nor shall it act
to certify that the subject system will operate in compliance with applicable state,county and local regulations adopted persuant to Article
10,Title 25,CRS as amended,except for the purpose of establishing final approval of installed system for issuance of a local occupancy
permit persuant to CRS 1973 25-10-111 (2).
This permit is not transferable, The Weld County Department of Public Health and Environment reserves the right to impose additional
terms and conditions required to meet our regulations on a continuing basis. Final permit approval was contingent upon the final
inspection of the completed system by the Weld County Department of Public Health and Environment.
X
Environmental Health Specialist Date
Form:H_PLAN
BOARD OF DIRECTORS NORTH WELD COUNTY WATER DISTRICT
GARY SIMPSON 33247 HIGHWAY 85 • LUCERNE, CO 80646
ROBERTARNBRECHT �
W.M. McKAY DON POSSELT, DISTRICT MANAGER
CHARLES ACHZIGER
RALPH PRIOR P.O. BOX 56 • PHONE(970)356-3020 • FAX(970)395-0997
e-mail: water@nwcwd.org
March 7, 2001
Sharon Frazier
Ag Pro
4311 Highway 66, Suite 4
Longmont, CO 80504
Re: Tateyama Farms
39971 WCR 43
Ault, CO 80610
Meter Number: 6300
North Weld County Water District currently provides domestic water service to 29971 WCR 43
under meter number 6300 and the name of Tateyama Farms.
Respectfully,
Colleen McGehee
EXHIBIT
�3
rills FORM MUCI BE
nE EXPIRATI0NROFnTHE COLORADO DIVISION OF WATER RESOURCES RECEIVED
PE hMIT TYPE OR 300 Columbine Bldg S
^HUNT IN BLACK INK. , 1345 $Lerman St.
Y or ACCEPTED Denver, Colorado 80203 t
EMENT MAILED r fl22 78
AEOUEST. STATE OF COLORADO AFFIDAVIT
SS. nnt,g=sUURCC5
_COUNTY OF gp1E ENGINEf11
ICDLO.
STATEMENT OF BENEFICIAL LSE OF GROUND WATER
AMENDMENT OF EXISTINGRECORD
83517
PERMIT NUMBER SATE REGISTRATION LOCATION DF WELL
THE AFFIANTIS) Hiroshi Tnteyamn c.,vnty Weld
whose mailing
address is Rt• 1 ➢ox1GR '.Af .1 Me NE
City Ault, Colo♦ P05i10 • T,„F. 7 N o?„ B5 Yr B_ P.M.
being 4u ly sworn upon oath, deposes and says shot he (they) is (are) the owner(s) of the well described herqyn the well is
2100 ' ~
located as described above,at distances of 200 feet from the North section line and 44151jek feet from the
. TEast section line;ware' from this well was first applied to a beneficial usefor the purpose(s) described herein on the_ f
•
day of Sptinrc , 19 22 ; the-maximum sustained pumping rate of the well is 50 gallons per minute, the pumping
rate claimed hereby is gallons per minute; the total depth of the well is 30' feet; the average annual amount
of water to be diverted is 5 acre-feet; for which claim is hereby made for T tsmstia, em shi ng dove barn,
fill sprayers and irrir to gardon.
purpose(s); the legal description of the land on which the water horn this well is used is
NY{-3, of the !i Ea of Section 16, T7N,. R65WN which totals
40 acres and which is illustrated on the map on the reverse side of this form; that this well was completed in compliance
a the permit approved therefor; this statement of Lenefi ci of usea4 ground water is filed in compliance with low; he (they)has
(have) read the scat ents made hereon, knows the content thereof; and that the same are true of his (their) knowledge.
J .L'[:
r
Signature • '�- f.o—CJ[C I<w�� ' ol G(
Subscribed anskswarn � FOR OFFICE USE-ONLY
to Lefore me on this ,'e-/ day of (L',tt e. 1976;
Court Cote No.
My Commission expires:
Me.
D.. fly.
ACCEPTED FOR FILING BYTHE STATE ENGINEER OF COLORADO
PURSUANT TO THE FOLLOWING CONDITIONS. See.
ACCEPTED PURSUANT SO CRS 1973, 37-92-602 FORR-THE WATERING f
OF LIVESTOCK ON A FARM OR RANCH AND FOR DOMESTIC USE, IN— Well ute. --
CLUDING SHE IRRIGATION OF NOT OVER ONE ACRE OF HOME •
GARDENS AND IAWNS. Do..
nDn ,11Q7R ��1U '_r•
•_.( � WW2
EXHIBIT
(5) THE _LOCATION OF THE , )SEO WELL tol ti-- arca on (611 . LL MUSTBE LOCATEDBELOVV-much the ourtor wilt b_ P•od or a le. r is Irodltai pirlIflo di.eira-, blrlow by no.l.incro horo er :hue Imes.
, Use the CENTER SEC 11011 II sri unit, RIO arsusl ht the well In.:Yon
200 It Iwo, North sec.line
I. I' - - - - II I -1 I — ', ,„aril n,sm.'- I It___ I MILE.52ROFE fT--_ p- I ___._-_ ft. horn_ _ East _.see.line
-{- �' I- - -Ileast of west)
I. LOT __BLOCK FILING♦
I I
- _. -I _ NORTH SECTION LINE SUBDIVISION
I I♦ ♦ I
(7)TRACT ON WHICH WELL WILL BFI ( her
NonrH TId lo.akr, LOCATED
n No.of acres 40
.Will this be
I z I
e w urn holy,well nn this n No - Thoro is an
f _.._ - -_._ I -'__-y I rice r>st orml �on nn nnt�sous wo 1--
oz (8) PROPOSED CASING PROGRAM
I w r- I Plain Casing .
l - _ - + f 4 in.from 0 ft.to 20 It.
I I I
in.from It.to ft.
+ '- -I-- - - I I j - -I_ __ 1 Perforated casing
sOOHI SECTION LINE 11
1I 5 in.from ft 20 It.to 30 .
-r- + 1 f I- -- 4- -I' 1 i- -F _.In,from---- ft.to ft.
F . I 'F. c,r;1I-
191fDR REPLACEMENT WELLS give distance r
.--,'_tLk _ s•t' I and diteelion from old well and plans forsalugging
- - _� __ -{_ _I_ -+i- ._ .+ it
The scale of the dlagr,un is 2 inches I mile Es required in the Root of Rules
Each small square replesenls 40 acres.
and rotiulntions. The new well ie to
wntEn EMOvnto t TABLE IRounnrd R4�uep i I
i'An acre-loon va s Ie,l le of Ian,I l loot deep, be moved 600, due `t' o away
t cubic mot per word O'PIM. „ ,Got
A ramav of Swal�r 'Si MO --Wet
I ac n.loot. .435601culotfel•natJ�J51900 ganol nl w.wan,um year �L)m contamination.
1.000nlmDumped connn, u,Is lo,one day "o'l,,, 449
(10) LAND ON WHICH GROUND WAT-ER WILL-BE USED: •
•
-Owner)sl: Ste No.of acres: 40
,gal description,_ NW'' of tho tie' of Socti on 16, T'7NJ RS511 of the 6th Rd
(11)QETAILED DESCRIPTION of d,a use nt ryn„.N rover IPrnsclndn use rind d:•me•nc s wens mug pnd2alo type of ddpawl System
to he 'acrd. Water is to bo used as historically boon used. The existing savage system
is to be used, (-no changes)
(12) OTHER WATER RIGHTS aasrd an mi. Irma, mclnd.ne wens.
Tyre of right I Lea I., Inunx,-rl Lmal Drscnpl .n of lend on which used
unregistered Tenant house well
(13)THE APPLICANTS) STATE(S) THAT THE INFORMATION SET FORTH HEREON IS
TRU TO TFL BEST OF HIS KNOWLEDGE.
-- 1
SIGN. LIRE OF an ICANTISI
.. , .. ,rtls=ktt tiLstp-'RCLS
30)--, ;ire Bldg.. 1045 SF t.n,.m 5t., Denver, Co, . 1203
.
PERMIT APPLICATION FORM RECEIVED
App lioness uu RECEIVED
1.• ourydCPP Will,: I I A HEItM1 T TO UST GROUND WATER
Type a ,�5QO
pint,°ohet T ( )APEI{MITTOINSI tIWCTA WELL [1r�221V I '
pi pot BLACK FOR: ( I A PE R MIT 10 INS I ALL A PUMP
INK Ni useistrikes
unless
noled�Proper Ice 1 I REPLACEMENT FOR NO. late Ro6istorod amts Nr5ouahU /`
teclmust be submitted 907E eta. (A
wills the applicotion. I I OTHER COLO.
(1)APPLICANT.mailing address FOR OFFICE USE ONLY. DO NOT WRITE IN THIS COLUMN
, .
NAME Hiroshi Tetoyana '
Receipt No. 1-17(t F A /
SRiEET Rt. 1 Box 165 Basin
Dist.
CITY Ault, Colo. 80610
(Stale) Iz,pl CONDITIONS OF APPROVAL
TELEPHONE NO. 834-2457 This well shall be used in such a way as to-cause
no material injury to existing water rights. The
(2) LOCATION OFPROPOSED WELL issuance of thepermit does not assure the applicant
that no injury will occur to another vested water
right or preclude another owner of a vested water C.
County hold right from seeking relief in a-civil court action.
WI '4 of the NE ',Section 16
Two. 7 N Ting._._B5 17 6 P.M. APPROVED AS A REPLACEMENT OF WELL NO, Filar/ ,
THE=TING WELL MUST RE-PLUGGED ANDABANDONEO
(3) WATER USE AND WELL DATA ACCORDING TOTIJE REVISED AND AMENDED RULES AND
REGULATIONS FOR WATER WELLAN:d PUMP INSTALLATION
CONTRACTORS. THE ENCLOSED AFFIDAVIT MUSTBE
Proposed-maximum pumping rate loom) 50 SUBMITTED WITHIN SIXTY(60)DAYSAfT£fl THE
CONSTRUCTION DFi THE NEW WELL,AFFIRMING THAT
r raappo appropriated
(acr -1 ground water 5 WELe NO. $1s/ 7 WAS PLUGGED AND ABANDONED,
^alarms l-am-amount
a f ground
tNumber Of acres to be irrigated: ono •
Proposed total depth Ileetl: 301 VVV
-- Aquifer ground water is to be obtained from: •
Alluvium
Owner's well designation
GROUND WAT£RTO BE USED FOR:
( I HOUSEHOLD USE ONLY-no irrigation(01
Ix DOMESTIC III ( I INDUSTRIAL IS)
IX I LIVESTOCK 171 I I IRRIGATION (RI -
I I COMME HCIAL(41 I I MUNICIPAL (NI
( )OTHER (9) APPLICATION APPROVE L.:1-2..—r-11.
D
I.D. - ..'___ W,D. . O/ COUNTY '
(Q) DRILLER
NUMBER J,577
Lash Drilling Company DATE ISSUED AC t�DO 71 8 8 6 '
Name
Street BOX 56 EXPIRATI ),TE
CityAult, Colo. 60610 /y'LC{.C.,e.6 r lag
Isbtel 611,1
a1FitU:C2$IS?AJE ENGI EERI
Telephone No._ 8311-2868 tic.No. 21X(S A
BY
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