HomeMy WebLinkAbout20011188.tiff ' WRJ-5•Rev. 76 DORADO D!'afYSION OF WATER RES ACES RECE
818 t entennial Bldg., 1313 Sherman St., Denver,Colorado 80203
� "` JUN 12 1987
bE PERMIT APPLICATION FORM WM ��
Application mus sun.!e
be complete where ( ) A PERMIT TO USE GROUND WATER COLO.
MAR 18 1987 applicable. Type or ( ) A PERMIT 0 CONSTRUCT A WELL
print in BLACK FOR: ( )hA P - ii.1i O INSTALL A PUMP 03-18-87 12`45
INK.No overstrikes WATER 1 eam " ' % 032472 25.3C
ij or erasures unless STATE• ,14 1�Ft • E NT FOR NO. I 'TiF° P0012
initialed. ��` O'('IH R use change ifom prmit *45201 0C
WATER COURT CASE NO. _)~_aiE
r TV
(1) APPLICANT- mailing address FOR OFFICE USE ONLY: DO: NO7 tt(RITE 1N THIS COLUMN
..,,,,n.-1 743845
NAME John Hnr hmi 11 tar Receipt No. -7 3 2"5 /
7
STREET 19640 WCR 28 Basin Dist. •
CITY Hudson CO 80642
(stain (z(o) CONDITIONS OF APPROVAL
TELEPHONE NO. 534-5102 This well shall be used in such a way as to cause
no material injury to existing water rights. The
(2) LOCATION OF PROPOSED WELL S issuance of the permit does not assure the applicant
that no injury will occur to another vested water
Weld right or preclude another owner of a vested water
County right from seeking relief in a civil court action.
NE of the SE 'h,Section 32 1) APPROVED FOR THE EXPANDED USE OF AN EXISTING
WELL PURSUANT TO C.R.S. 37-90-137(4) AND THE
Twp. 3 N, Rng. 65 _IL, 6th P.M. FINDINGS OF THE STATE ENGINEER DATED 6/30/87.
AMOUNT OF WATER
IN.S) (E.W) TO THE ALLOWED AVERAGE
B WITHDRAWNBY THISANNUAL
WELL IS 1 ACRE-FEET.
(3) WATER USE AND WELL DATA 3) THE MAXIMUM PUMPING RATE OF THE WELL SHALL
NOT EXCEED 15 GALLONS PER MINUTE.
4) GROUND WATER PRODUCTION FROM THIS WELL SHALL
Proposed maximum pumping rate (Wm) 15 BE LIMITED TO THE LARAMIE-FOX HILLS AQUIFER
WHICH IS LOCATED 340 FEET BELOW LAND SURFACE
Average annual amount of AND EXTENDS TO A DEPTH OF 660 FEET. PLAIN
g ground water . 1 CASING MUST BE INSTALLED AND SEALED TO PREVENT
to be appropriated (acre-feet): THE WITHDRAWAL OF GROUND WATER FROM OTHER
AQUIFERS QND WATER
Number of acres to be irrigated: 1 BETWEEN AQUIFERS.
THE MOVEMENT OF GROUND AQUIFERS.
5 A TOTALIZING FLOW METER MUST BE INSTALLED.
Proposed total depth (feet): ii00t 6) USE OF THIS PERMIT CANCELS PERMIT NO. 135201
NOTE: NON-CONSTRUCTION CONDITIONS IN
Aquifer ground water is to be obtained from: FINDINGS). xk'r/ 7/// Si
Fox Hills
Owner's well designation Rear 40 Acres 2001-1188
GROUND WATER TO BE USED FOR:
1 1 HOUSEHOLD USE ONLY - no irrigation (O) EXHIBIT
( ) DOMESTIC (1) ( ) INDUSTRIAL (5) 1
( ) LIVESTOCK (2) ( ) IRRIGATION (6) /
( XI COMMERCIAL (4) ( ) MUNICIPAL (8)
( ) OTHER (9) APPLICATION APPROVED
DETAIL THE USE ON BACK IN (11) 031956 _F
PERMIT NUMBER
(4) DRILLER JUL OZ1987
DATE ISSUED
_ Name Licensed EXPIRATION DATE JUL 0 21988
Street •\ a .
,/y n _ n /
ra
•
City AT EN INEERI a
(state) ale) �
BY ` 1 \����� l^•^\ A
W
• Telephone No. Lic. No.
LD. / .- O X COUNTY ( 2-
(pU (S QG
ELD COUNTY HEALTH DEPARTME,
1516 Hospitalp Road "•
r w x> �x � ,,,.4....,,:,
zt
Greeley, Colorado .ry -if- PERMIT NO.�r= `/ CO
Ph. 353-0540 " .
Application/�for
permit t Install, Construct, an Individual Sewage Disposal System
OwnerVOAn 0 l7/44z /9D 16 GU WO �P one-27 o� �J d.•
/� Address
Direction to site: Hwy Rd. 1/4,421 N_mi., E_mi., S mi., W mi.
Legal Description: Ptn a" V ec. , TN, W Subdiv. Lot Blk
I General Information r,
Dept. Use"'Only
No. Bedrooms � No. Persons / vg Perc. Rate (A .'"of 3) '' l" 4% 7.w...
m ---s"—**No. Baths cr)Z, B seent Plumbing > ---s"—** Soil Type
Size of Lot 0 &`"C,A.t_...-'
/ H2 Table Depth` —753
H2O supply (if well give depth) r.%//).G,/4t2 _''CO Lot Grade ° Level
New Home Mobile Home ./.••••°"°Modular Add'n
Requires" Engineer.:; Design_Yes No
Type of sewage disposal requested: • If yes — reason
ose
Septic tank Privy Other Comments:',�
Installation Instructions: (Minimum Requirements) `°
Septic Tank P te9 Gals. i Absorption Trenches „',23 Sq. Ft.
Other or
Seepage !bed Sq. Ft.
Special Instructions
This system will be constructed and installed in accordance with the above specifications and regulations re-
garding individual sewage disposal systems in Weld County, Colorado
This permit shall expire at the same time as the building permit, or, if no b ding,permit is sued,.t rmit
shall expire 120 days after its issuance, if cons
l' construction has not be m ed.
Date: 27etC. 07 C /7,7st Owner: ita,."��
APP t:
The plans and specifications as shown are approved pending payment of permit fee
k { Y
Date: 5fst llc
Sanitarian ' 'S'; 3•
t
The above system inspected and found to comp) with plan and description". ` * '
Systems Contractor: Sc./Y— jotiAde� Date: 3 Qr '/' -
Sanitarian: / _ ��
Engineer Review:
(Dote) I M (Sigure) �'L,,
- S .PE -0 ' nat ' +.3+x•" ,., u
Se-2-S• t
•
Permit Fee: /J I � r
Received by: P L��L� 4�[�' Date: ic ) /off � 5'4 °"
Comp 1-d8-S 1 QC-
WELD COUNTY.; HEALTH D,EPARTN f x,s< : : : � J =,l
1516' Hospital Road z
Greeley,-;Colorado= k PE,' ITz.,N�Oaar + 010 «
Ph. 353-0540 7 x a ^1 c < , d' r '^ , '� :
Application for permit t Install, Construct, an Individual Sewage Dtc isposal+System =�* e ,r
Owner�� N h ��#/ �� /� Address / O y4 /� ,�7jt/O q }:Phone-77 - �J L
Direction to site: Hwy Rd. /V/��� " N_mt , E_{mi. S `mi , W mi I
�< ,a °
Legal Description: Ptn a t„; ,ec. Wiz, T3 N, [ W Subdiv X "`�""r'""+' Latt •Blk
,fs, a f - ,1
General Information r {} _ . -r''
� Dept Use 'Only
No. Bedrooms No. Persons ,c� I r''' 5` i' ' ' , c
1 , , Perc ',Rate (P yg !of.,3) c.+ 7n�
No. Baths +'"'Z' B sement Plumbing Soil Type ' +�.�o&. ; —
Size of Lot to n'.C,4-e-e_/ ux # yF w
,� H2O :Table Depth 7 g
I-120 supply (if wellgive depth) `tp? ?c ' Roth " 'o ' '*
pP Y P . Lot Grade era L 0'
New Home Mobile Home L�Modular_Add n t� vti ,
Regwres�Engmeer,�Destgrt Yes` No
Type of sewage disposal requested: ! f )ye - f ip �" ci. 'g `'f '�
YP 9 P q )f yes reason XF ar x
Septic tank Pri Other _ A �Ittge, ,t �` ,
P vy Comments ' t r
Installation lnsfructions: .(Mmimum Requiremenls)� �•` E:
Septic Tank Gals. Absorphon,Trenches / -25 q
orr*+a too.,'!''c ,.y�&, _ .41.4-..--, ,,,,'
wi; a s
Other . ... s -' '""J Sq. Ft
Special Instructions �; f�t /�i•�
I ;
This system will be constructed and installed in accordance with the above specifications and regulations re-
gording individual sewage disposal systems in Weld County, Colorado , <*
This permit shall expire at the same time as the building permit, or 1.-f"tna_!b' ding permit is sued,-t rmit
shall expire 120 days after its issuance, if construction has not be m ed r.. c': . 't
Date: �7 c=7 , _ ,,,74-- Owne� rY
App nt: t .
I CY Tt
The plans and specifications as shown are approved pending payment1ope mlt fee' r, �r a f
p� r�I nk, w;a
Date 3 5 �L�-9I i 'a..� S ,:,,� . r n
Santtartan'�z4 .ala t'
'%.
` 3. r • '^f4 , ,h, Y '"sue'
The above system inspected and found to campI with plan and descnptto$j'� Y� "k"�
Systems Contractor: S.�5—j..,14g Date• 3
.rt
- � {eS`rites aka t -�
Sanitarian , a< ',' ' S�
Engineer Review: � q , at `a St j ,
(Date) u T `M- (Signature , }4-t+' 7 r` ,.t -
Permit Fee: $c72--) •B-E/
Received by: �2ei ��/ � Date
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