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Home My WebLink About20032666.tiff f .u•^ 1 11 Sherm an :L. a•nr sr, C,.6( tt �.III `1 r J .. _ i _1 _r,_ , %.apnea ticn�n { nr rw� /t` .��'l'-E(t!.IIT APPL!C:T!CN ?Q R!,t • %i_•..L.re�i ., :;a :amnkle •..na,r �+t:-1 Y u••UUUU • •-.. — ( IAPErtMlrroUSEcec�NoWATER • r•J�'(29 In7 :nci,erute. Tyne or • ( I A PERMIT TO CONSTRUCT A WELL O4_10'd7 1Z:=; P _ print—in • nt.AC'G}UWI Z 2. lj FOR: ( ) A PERMIT TO INSTALL A PUMP Y� 2S.CO DV(Notaver :usee • U,.';7-� •�0 '' •:.roc;,. 01 natures unlenY(11C2 7.riUeaC ( •I�iEPL1,CEAICNTFOR N0. ' Ain'"[� f'ipl? "'C'ne a initlalyd. :rrC•t],cs.x�t fx) °THEftr ^>�� - n '''1' uOfc a ^err. . iL • WATCRCounr CASE NO. �Hfglc ^� • (1) A,PPUCANT• "�— 0.30 mailing addrea FOR OFFICE USE CNLY��C{ N0 ' TEiN ;HIS COLU.wv • LL- . fa:4fiI;;.31 • NAME Janaid A. Jamison Racalpt No.Z._I. .� / . SraEET 7^_1 ',j,.i l r. Rd 1R • . Satin —______: _ Olst. ' an Ft. Lunton , Colo. 80621 ' _ tsta,.1 . WI') del CONOijIONS OF APPROVAL TELEPHONE NO.1- 857-2191 or 571-574/1 This well shall be used in :uch away as to *cause no material injury to existing water rights. The • (2) 4OCaTICV OF'PAOPOSCO N [ I — • • issuance of the permit does nor assure the applicant that no injury will occur to another vested water Cavnry Ueld right or preclude another owner al a vested water right from seeking relief in a civil court action. _22,____I.1 of the. S?._`'^, S,,Ktlon 17 1) APPROVED FOR t71I? INCr2.As ? TN USE OF AN TwP, _ nng. ASZ4 • • �r i{XISif4G HRLl. PGT(SUAY 0 C. R..i, 37-40—)9T(4) " s IEwI —P"N• lag,1 7MIIINCS OF 11� STti i%GiliT9c RI' (3J '.VATEfl USE ANO 'HELL DATA ` TILL. ALLOWED AVERAGE ,ANNUAL ,LyOUM' OF 'r1ATr?it • • lb Iltf HITII➢RAy/t{ ]Y TIfIS NRLL IS 3 .{CRR-FC�'T.:1) 17➢? `LiLMLI•f ?(; mcflAmofraa ir.• rSim; • Proposed maximum pumping rata (gpm) 1 S • ' • NOT RXC!un IS CALLCNS PIE MINUTE. rl) GROUND WA•1T{Ll PRODUCTION PROM TIT'S 'WELL SHALL Average annual of ,round water D!{ LIMITER TO :TM L.AfLA.MIR-FOX !!ILLS AQUIFER 10A De apannuil amount(u of ground 1 H11IC11 IS LOCATED 320 FEET BELOW LAND SIJ VACS AND i:X NO TIiMUST wu5 1'0 A DEPTH Of 660 FILET. PLAIN Number of ac-el to be irrigated:Ynn CASI D!{ L4S T ALT 30 Alm SI;ALL ➢ TO PREVENT TAO! WtTI(➢fUHAf. Op 6110UND HAT2I( 111CM OTTER AOUIFi{7L ANII '7D; t04 `t(LN; OF CROIIN➢ WATER Proposed to 4l depthThet): 47I n ( 1,12. N AOUTr,ftS. S A '1l0TAL1ZINC rbOW METE Kos? BE INSTALLED. AquiJar ground water Is to ba ohtained from: (Ti USE Or TUTS PRLHIT CANCELS PRIC•{1r NO, 6,l,4C4. 0TU: NON-00NSTauC:I0N CONDITIONS-TN r.^' trill - Cnnl 'rLYDINCS) , • • Cwner't well designation ' SaflOUNt) WATFFl TO RF 1SFD F Ft• . • • I I HOUSEHOLD USE ONLY•no irrigation (0I " (-000MESTIC ill • (;g INOUSTRIAL (51 I, I LIVESTOCK (2( l%r COMMERGAL Id) I ' I IGATIO (6) ' MUNICIPAL tat - I I OTHER (01 • , CETAIL THE USE ON OACX IN (11) APPLICATION APP40VC0 (4) 091I•i c RERMITNUMOER 032004 `r•' OATEISSUEO J 'i i°a7 i r. Noma • r Ham. n EXPIRATION OATE ( ( a :( IICI ? Street • w1 1 1 /1)•Trlacnane 40. 25'-2733 ( '-CO • NOI 0Y `°� "(� . t l \prnn 1 . /^ d !'O' -N c:L.%i. e 2003-2666 .:71. iii_ LOCATION . OF THE: ' 'OSi:0 ...JELL and � wlli r L Ari N SN �i Ml m ins era4 on ) CC) L ',11�,�.i 1 C L's. the e enter SECTION (I s...aon,,r�,ateu un the the oewyv, C,, • �''0 suet) for he well location. , 5. ant�nect Iran '' bpn Ln. 0 7 ''== ••_ _ _ — - -r-_. -- -.d.. .._ _[., — t 1 • '---.C;r (L foram • r`" - : I ( i :.Gtr` �_.:e:.ilne •-f"—_—1MIL°,S:00 FE ET II I T • 1 • 1 !LCS_ .f. from_a i • • ( I I• LOT--_____G LOCK' 4. — -(.. — L_eIOnTH SECTION t inE I • FILING . I I •— — ,L, — . SU0CIVISION ( i ( I I 1 NORTH' . W( _ _ 1C7) 'Lc�GT ON 1y41(y 'N�1 i 'vl I ar LOCATED T — -+� +' t •Owner. Jnrraid Jamison No.olsves �0 o u I Will this S,. "i-• u — 1 ly + •—• I the only well an this tf1r,7 I ( I.° I (0) PAOPOSEO CASING PROGRAM t/ i ?— 3— .. .LI —_ 4_ �r I • Plain Casing . I ^ • . _ - 41 ' S 11 . t llfrom. . -is&C TI0t1 LIN t . ._ I}.arrbr*, o it.to �a°.-__tL — 'T I Perforated casing r 1. -I- I • I • I ! olc9trio 'n--- _`t. :o—.L•J�_h_ ' I., I' . .. I L * .r In. from_( • IIt t0.—____... _L — .,,i, ..,;•.•. :1:I (9) FOR REPLACEMENT E, ENT WELLS givedista• nce i '!- -.4-11:-..... ..4... and direction from otd well w pt,ns for plugging • .The scaleof the dt, ':1.. . •: . •. T It: ••• Exh small 7,mYt2lnflist:R'1 mile , . - ;none feorrsenll aO, H; • • •WATER E0u1VALENTS MICE•tRoundedFty,,.eel • :t•An .ve.locl coven I sere of Iu'd.1 fool deep, : I 1 cubic loot 0.,second 101..'.th 7 o.11on,p.v neinule 100mr: ; A t.m M • lly 0l5 will tul,..00ro. •fr 7.C,e.(001 of wow per yet, • , • 'I ,cr.loot...43.5d0 C0 cubic 1«1.4.375,700 1 . , 1.003 Cum 0VT0.4 COnhinuovely toe oneOell0n,. •. . . , dry WOOV Cn l,,7'e0'IML • ,(10) I ANO ON 'NHIGH r 'flan 1 r • • Ownertsl, Jnrrnld A• Jnm • , • Leg,l desertntton: /, r. • I f• • "r! Na,• of acres:� (1t) aFrA( r (+r] ' Qrnrt ' of the use of ground water: Household system to lac useHousehold use end dome nlc wills mutt Indicate type of dilp'olu d. r c • (12) 0TH -A '7ATt:q A( ••T¢ used on shit land; Inciudin 9 wells. Give Roglsiratian and 'Hater Cotrt Casa ,NtlmOafS, Type or right Used for(purpose) Wane Description of land on which used (12) THE APPLICANT(S) OF HIS STATE(S) THAT THE INFORMATION SET FORTH HEREON IS T.AUE TO THE EST OF HIS KNOYY LEDGE. �s I �r ilQN.1 rONf Of M�:r L'.ttt r(.�.1 • 1 cr.? t 1 r. •• ••ei U 1 2Pf • U1e lddldnn,t thorn cf pan , If mnre in,f. 't r-••••:..., • FINDINGS CF THE STATE ENGINEER / IN THE HATTER OF AN APPLICATION FOR A WELL PERMIT IN WATER OIVISION NO. 1 , WELD COUNTY, COLORADO APPLICANT : JARRALO A. JAMISON • AQUIFER : LARAMIE-FOX HILLS • PERMIT NO. : 32. 00 '1-- F • In compliance •with C.R.S. 37-90-137(1) and the Statewide Nontributary Ground Water Rules, Jerrold A. Jamison, 15721 Weld Co. Rd. 10, Ft. Lupton, Colorado 80621 , (hereinafter "applicant") submitted an application for a • permit to construct a well . Rased on information provided by the applicant and records of the Division of Water Resources, the State Engineer finds as follows : • 1 . The application was received •complete by the State Engineer on June 29; 1987, 2. The applicant proposes to increase and expand the use of an existing . well , Permit No. 84494. Permit No. 84494 was issued on June 23, 1976 for domestic purposes. Well construction was completed on January 8, 1978 to a total depth of 410 feet with perforated casing installed from 330 feet to 419 feet deep. 3. The well is located in the NE 1/4 of the SE 1/4 of Section 32, Township 3 North, Range 65 West, 6th Principal Meridian. 4. The well is located outside the boundaries of a designated ground water basin. • • • 5. The applicant proposes to apply the water withdrawn from the well to the following beneficial uses : Domestic, commercial, industrial , and irrigation. • 6. The proposed maximum pumping rate of the well is 1S gallons per'`•minute, and the requested average annual amount of ground water to be withdrawn Is 3 acre-feet. 7. The applicant is the owner of the land on which the well is constructed. S. The well withdraws ground water from the Laramie-Fox Hills Aquifer (hereinafter "aquifer") , which, according to the Oenver 3asin Rules, is located 330 feet to 660 feet below land surface at the location of the well . 9. The location of the well is more than 600 feet from any existing well completed in the aquifer. •.71•. 1 o j . ( ,•••••••., .• ''LW: • ' :: Applicant : Jarrald A. Jamison Pace 2 Aquifer Laramie-Fox hills — Permit No. : 3O,Oo1— i- 10. •According to a sworn statement, the applicant owns, or has consent to withdraw ground water underlying 40 acres of land as further • described in said statement, which is attached hereto as Exhibit A. 11 . Withdrawal of ground water from the aquifer underlying the land claimed by the applicant will not, within one hundred years, deplete the flow of a natural stream at an annual rate greater, than one-tenth of one percent of the annual rate of withdrawal and therefore the ground water is nontributary ground water as defined in C.R.S. 37-90-103( 10.5) . • 12. In considering whether the requested permit shall be approved the provisions of C.R.S. 37-90-137(4) and the Denver Basin Rules shall apply. Withdrawals shall be allowed on the basis of an aquifers life of 100 years, C.R.S. 37-90-137(4) (b)(1) . 13. The quantity of water in the aquifer, exclusive of artificial recharge, underlying the 40 acres of land described in Exhibit A is 960 acre-feet. This determination was based on the following as specified •in the Denver Basin Rules : • a. The average specific yield of the saturated aquifer materials, underlying the land under consideration is 15 percent. b. The average thickness of the saturated aquifer materials, underlying the land under consideration is 160 feet. 14. A review of the records in the State Engineer's office has not disclosed that there are any other existing wells or other water rights claiming or withdrawing ground water from the aquifer underlying the land claimed by the applicant. Based on the above, the State Engineer finds that there is water available .> for withdrawal by the proposed well and no material injury to vested water„ ' • rights would result from the issuance of the requested permit subject to the- following conditions: • a. The allowed average annual amount of water to be withdrawn from the aquifer by the well shall not exceed 3 acre-feet (the quantity of water requested by the applicant) . b. The maximum pumping rate of the well shall not exceed 15 gallons per minute. c. A totalizing flow meter must be installed on the well and maintained in good working order. Permanent records of all diversions must be maintained by the well owner (recorded ac least annually) and submitted to the Division Engineer upon request. Applicant : Jarrald A. Jamison Page 3 Aquifer : Laramie-Fox Hills Permit No. : .33_004-F • • • •d. Production is limited to the Laramie-Fox Hills Aquifer. The well must be constructed with plain, non-perforated casing properly grouted so as to prevent Intermingling of water between aquifers . c. Pursuant to C.A.S. 37-90-137(9) (b) and the Denver 3asin Rules, no mare than 98% of the nontributary ground water withdrawn annually shall be consumed and the applicant shall demonstrate to the reason- able satisfaction of the State Engineer that no more than 98% of the water withdrawn will be consumed. f. The owner shall mark the well in a' conspicuous place with appro- • pr.•iate well permit numbers, name of the aquifer, and court case numbers. He shall take necessary means and precautions to preserve these markings. g. Use of this permit cancels permit No. 84494. rrl Dated this qT day of 11�a , 197 • • a . 4 _ • • + s . Danielson • • State tngineer - -- n u ill 0A., Steve Lautenschlager Water Resources Engineer • Ground Water Section Prepared by: KVH 0992I/Form 10546(o) 9ihre2c ercoga eer,ra 9.7a9; 4 52a .toile -cam -• •-- -- L.ULUNAOU Ohy!SiON OF WA kart ncaUUHtjta ale Crneennw 8log.. 131 le r', St. Denver. Colorado 30203 (:1331 36d-1:41 L= • WE1! PERMIT NUMBER 039679 PFL!C.*T OIV. Z CNTY, 62 'NO 2 OES. BASIN __ MC Lou Block: Filing: Subdiv: APPRCVED WE! I LCCA T TCN CCUNre WELD v r— 1/4 SE 1/e. Section 2 JA.R.1 ai D A. JAICSC,1 15721 NCR 10 Twp 3 N , Range 65 '7 5 LU?'T-'C 1 CO 80666221 DISTANCES PROM SECTION LINES 303/654-0250 1331 Ft from Sou._h Section Line 3 77 Ft from East Section ''rue • 'ER,Mri TO CONSTRUCT A WELL ISSUANCE OF THIS PERMIT OCES NOT CCNFER A WATER RIGHT CONDfT1ONS OF APPROVAL. ) This well shall be used in such a way as to cause no material injury to existing water rights. The issuance of :he permit does not assure the applicant that no injury will occur to another vested water right cr precluCe another owner of a vested water right from seeking relief in a civil court action. The construction of this well shall be in compliance with the Water Well Construction and Pump Installation Rules 2 OCR 402.2. unless approval of a variance has been granted by the State Board cf Examiners of Water 'Neil Ccr..struction and Pump Installation Contractors in accordance with Rule 17. Approved pursuant to CRS 37-90-137(4) and the findings of the State Engineer dazed August 29, 1991. The maximum pumping rate shall not exceed 15 GPM. The average annual amount of ground.water to be appropriated shall not exceed 4 acre-feet Production is limited to the Laramie-Fox Hills Aquifer which is located 330 feet below land surface and extends to a dacch of 660 feet. Plain casing must be installed and sealed to prevent the withcrawal of ground water from other aquifers and the movement of ground water between aquifers. • The entire length of the hole shall be geophysicaily logged as required by the Statewide Nontribu tar/Ground Water Rules prior to installing casing. This well shall be constructed not more than 200 feet from the location specified on this permit A totalizing flow meter must be installed on the well and maintained in good working order. Permanent records of all civersions must be maintained by the well owner (recorded at !east annually) and submitted to :he Division Engineer upon request The owner shall mark the well in a conspicuous place with well permit number(s), name of the aquifer, and ccu t case numbers) as appropriate. The owner shall take necessary means and precautions to preserve these markings. cars e"-Lei)QI fl • • ter' s .-', r — . ' .a ✓1 . /t/ 1r :. .1 ,ti. tic c 1 C. :t`,'ci'— ., c • SISU pilgltROr av ^' - .3 ?=�'^.: ':C. Q : — —C C� — - .4. ! i •r� jll_ � II 'r'r+, -.._. . _ Applicant: Jerreld A. .'--raison Page 2 • • .. Aquifer: Laramie-Fc.. ;'' Permit No.: 341• 7€9-F 12. The quantity of water in the aquifer, exclusive of artificial recharge, underlying the 40 acres of land described in Exhibit A is 960 acre-feet. This determination was based on the following as specified in the Denver Basin Rules: a. T'ne average specific yield of the saturated aquifer materials underlying the land under consideration is 15 percent. b. The average thickness of the saturated aquifer materials underlying the land under consideration is 160 feet. 13. A review of the records in the State Engineer's office has not disclosed that there are arty exiting wells or other water rights claiming or withdrawing ground water from the aquifer underlying the [and claimed by the applicant. Well permit no. 32C04-F is valid and allows the annual withdrawal of 3 acre-feet of ground water from the aquifer underlying the land claimed by the applicant. Based on the above, the State Engineer finds that there is water available for withdrawal by the proposed well and no material injury to vested water rights would result from the issuance of the requested permit subject to the following conditions: a. The allowed average annual amount of water to be withdrawn from the aquifer by the• well shall not exceed 4 acre-feet (the quantity of water which has been requested by the applicant). b. Tne well shall be constructed no more than 200 feet from the location specified on the permit application. c. The applicant shall submit geophysical and lithologic ;acs after 'the construction of the well. The geophysical logs shall be obtained from the hole before the casings are installed. • d. The maximum pumping rate of the well shall not exceed 15 gallons per minute. e. A totalizing flow meter must be installed on the well and maintained in good working order. Permanent records of all diversions must be maintained by the well owner (recorded at least annually) and submitted to the Division Engineer upon request. f. Production is limited to the Laramie-Fox Hills Aquifer. The well must be constructed with plain, non-perforated casing properly grouted so as to prevent intermingling of water between aquifers. g. Pursuant to C.R.S. 37-20-I37(9)(b) and the Denver Basin Rules, no mere than 98% of the ncntributary ground water withdrawn annually snail be consumed and the applicant snail demonstrate to the reasonable satisfaction of the State Engineer That no more Than 98% of the water withdrawn will be consumed. Applicant: Jerrold A. Jamison Pa • Aquifer: Lam "'cox Hills • Permit No.: '307 — h. The owner shall mark the well in a conspicuous place with appropriate well numbers, name of the aquifer, and court case numbers. He shall take necessary and precautions to preserve these markincs. ��;; Dated this ?9 day of u , 19 9/6a .;� ris_ . Danielson State Engineer . 7 Bruce E. DeBrine Water Resource Engineer Prepared by: SAJ 0301 F.saj%Form #054o(o) (April 1387) i' 'STATE or COLORADO OFF1a OF THE STATE ENGINEIR DIVISION OF WATER RESOURCES NOTICE OF Cc4 'NC5MENT OF BENEFICIAL USE ' Well Permit No. 039679 -F 981L OWNER--Mailing Address lameJARRALD A. JAMISON • Telephone No. 1-303-654-0250 Uidress 15721 WCR 10 FORT LUPTON COLORADO 80621 (Street No.) (City) • (State) (Zip) • SELL LOCATION (WELD COUNTY) . • 6th NE 1/4 of the E1/4, Section 32 Twp. 3 N 65 W FM 1331 ft. from SOUTH Sec. Line & 377 ft. from EAST Sec. Line )ate of first beneficial use of ground water: OCTOBER 21 , 19 91 ism of the ground water- DOMESTIC, COMMERCIAL AND INDUSTRIAL (we) claim and say that I (we) am (are) the owner(s) of the well described' bove and that the commencement of beneficial use of ground water from this well, awfully made under the well permit, occured on the date indicated; and that the tatements made herein are true to my (our) knowledge. This notice is filed in ccordance with Section 37-90-137(3) (a) (II), C.R.S. 9-24-9/ stature o ) (Date) • NSTEUCTIONS • • his form is required for wells approved under permits issued pursuant to the rovisions of Colorado Revised Statute 37-90-137(4) and must be filed with the ivision of Water 3esauu ces within 30 days after the first commencement of use. ype or print neatly in black ink. This form may be reproduced by photocopy or ord processing tens. (DWR OFFICE USE ONLY) • • 1313 Sherman Street 8th Floor Denver Colorado 80203 (303) 865-1581 • , Sent bV: Oct' -00 01 r11an • from 30357357.0,2 paste APPLICATION F .i INDIVIDUAL SEWAGE DISK '.AL SYSTEM - NO. 7' f WELD COUNTY HEALTH DEPARTMENT New • ENVIRONMENTAL HEALTH SERVICES Repair 1518 Hospital Road, Greeley, CO 80831 - 4 3530640 EXT. 270 �y / RP OWN EFtrarrtie J 3aM Is4ADDRESS- 2to el' Me, [9t3'Yret PHONE 493'7-(]`7y`l s73•-• ?VV ADDRESS OF PROPOSED SYSTEM _42,...9F-1-11-2-C •-- L _-1�! a l LEGAL DESCRIPTION OF SITE: PTA N. 3 a_,T-'_' R 'LOT*' BLOCK FILING SUBDIVISION USE TYPE: RESIDENTIAL • hidb.tf-. __27‘a1 INSTITUTION. -- COMMERCIAL /� -. OTHER SERVICES: PERSONS -L_- . BATHROOMS_ LOT SIZE....-�/! C , - atof s , 'BASEMENT PLUMBING__22.,_____ WATER SULPP1I1,/i/' t !. 7147 B( DROOMS , r. .....444 11 e 4- _/ &rAI --- TYPE OF SEWAGE DISPOSAL REQUESTED: ---.t � Applicant acknowledges that the cornpleleilese Of this n pticallnn Is conditional upon further mandatory and additional tests and reports as may be required by the Weld County Health Department tolb am de n aandd lfurnie sheddf y the e app,lic applr icant e Weld County Health Department for purposes ot.the evaluation of the app , io suchterrms and conditions aS deemed neceaSry to insure compliance with rules and regulations adopted under Article 10, Title 25,CRS 1973, as amended. The applicant certifies that the proposed system will not be located within 400 feet of a com- munity sewage system.The undersigned hereby certifies that all atatemonta made, Information and reports submitted here- with and required to be submitted by the applicant are, or will be, represented to be true and correct to the best of my know. edge and belief, and are designed to be relied on by the Weld County Health Department in evaluating the same for purposes of issuing the permit applied for herein. I further understand that any falelficetlon or misreprasenfatlon may result In the denial of the application or avocation o y permit granted based up said applicatio n legal action for perjury as provided by law. Y1 ce-TC- T Application eft..,?/--'0'. � �� • Recd oy t-� Date /— Owner Ag 1 Ignature Dale • T • a i M ♦ w • • R • x • 9 . * * * * # i FOR DEPT. WATER TABLE DEPTH er PERCOLATION'RAT -`� tt <( PERCENT GROUND SLOPE USE ONLY AOIL7YPE-Gflr?^?'�Q'` `" '� u--"-"- -' REQUIRES ENGINEER;'DE�GN ( )YES ) No • * • • • • x * • * e • • • • a #,:•• • •ii a • • • * a * • • e * • • •. * • * * * * * * * * * * * * * * * * INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT From the application information supplied.And the,on•site soil percolation data, the following minimum Installation specifi- cations are required: 0, ,,r ._SO. FT. SEPTIC TANICI 2t[ .j.._GALLONS, ABSORPTION TRENCH ABSORPTION BED-..22/-4-60. FT. in addition, this Permit is subject to the following additional terms and conditions: . - This Permit Is granted temporarily to allow.constructton to commence.This Permit may be revoked or suspended by the Weld County Health Department for reasons set forth in the Weld County Individual Sewage Disposal System Regulations, Including failure to meet any term or condition ltilposod thereone duringitemporary liability the failure or inall approval. e Issuance o tc sewage this Permit oesrnot disposalsystem. constitute assumption by the Department or Jfs;ampl-.y Y : .. _11S-5 // ---11{:4_1-1C_ r_ t.': / S'l Environmental Specialist This Permit Is not transferrable and shall become-.Vold if system construction has not commenced within one year of Its Issuance. Before issuing final approval of this Permit.the?We1d County Health Department reserves the right to impose additional terms and conditions required to meet our regulations on a continuing basis. Final Permit approval Is contingent upon the final In- speotinn of the completed system by the WeldGounty Health Department. J SYSTEM CONTRACTOR FINAL INSPECT' ��G �I/1 l 7^5,211( SYSTEM ENGINEER —_ ,APPROVAL 1 nvironmelntal Specialist Date ial The Issuance nr nor shall it act to cert yf this rthatmit tthe'subject not Imply ystem will operate in compler lianceow with appunty or lliicable state, county and localregulations adopted pursuant to Article 10,Title 25, CRS,1973, as amended, except for the purposes of establishing final approval of an installed system for Issuance of a local occupancy permit pursuant to CRS 1973 25.1O111 12). WCHD—EHS February, 1981 Original•Appllcanl; Copy-WCND -- • bi- 11- /54 .-._ _- :....� T_. -.... x.> j ,f a f.J �� r I ✓ • N. e2`I • 4f /41, r� w 1 zSg9 J o .rte • . krof AAP° . • • •. 0wx a. 7.4>�� v 19 • •-• 4V)-. C'Ii_1/47 e an• mai V p •ISTING I25o4 al,. �P .—E.9776 -OkijK r1k utioNt 6oX_ I. M =' SITE t o° �,ta 6 1 \ ) ; \ \ ' VICINITY MAP SCALE . I' cloocit DESIGN DATA: DISTRIBUTION BOX: ALL SURFACE ABSORBTION SYSTEMS SHALL BE EQUIPPED WITH A DISTRIBUTION BOX WHICH SHALL BE INSTALLED LEVEL D UNDISTURBED SOIL. COMPACTED SOIL, OR ON A CONCRETE SLAB POURED IN L NEE TO PVIDE EQUAL FOR TESTINGDISTRIBUTION PURPOSES. AN ADEQUATE AMOUNT OF WATER ES EACH SHALL B PROVIDED TO UT 1 . DISTRIBUTION BOXES OF THE I O THE LEVEL BOXES SHALLHAVE R VEABLE COVERS LINES. 2. EACH LATERAL SHALL BE CONNECTED SEPERATELY TO THE DISTRIBUTION BOX. 3. THE INVERTS OF OUTLETS SHALL BE AT THE SAME ELEVATIONS A ND ITHE INLET INVERT NVERTS. TUE OUTLET NINVERTS SHALL BE AT LEAST THREE 1 ) INCH AE THE T BE AT LEAST ONE (3) INCES ABOVE THE BOTTOM OP THE DISTRIBUTION ONfBOX'I IGHT AND ALL PIPES SHALL4. THE DISTRIBUTION BOX SHALL BE BE GROUTED OR CEMENTED. THE BOX SHALL BE LOCATED A MINIMUM OF FIVE (5) PEET FROM THE SEPTIC TANK. X 5. SOLIOD TALL PIP FROM FO THE MINIMUM OFDISTRIBUTION FIVBO l 1O THE LATERALS SHALL BE LINES OFUSING WELD COUNTY ISDS DESIGN GUIDELINES: 88 GPD 6 PLANERS ! 14S 4 35DGPPD .280 GPD OF 8 PLANT WORKER 4 OFFICE WORKERS 1 15 GPPD - 60 GPD TOTAL - 428 GPD x 1.5 PEAKING FACTOR - 642 GPD LOADING. UTILIZING THE PERCOLATION RATE AS TESTED BY THIS FIRM OP 23 MINUTES PER INCH: ABSORATALw IUEU ARmR A . lu► VI /3.Q r,� . 642 3 /3.5 879 SQUARE PEET AREA 1.3 BED (VS. TRENCH) DESIGN FACTOR -1X144 SQUARE PEET ABSORBTION BED 7. REQUIRED THE DESIGN SHORN ON OUR PLANS FOR THIS SITE. FILE 32-305-08 INDICATE AN EXISTING ABSORBTION FIELD OF 12 FEET BY 42 FEET OR 504 SQUARE FEET. TOGETHER WITH AN EXISTING 1250 GALLON SETICINPSIZETBYN AS INDICATED. THIS 642 SQUARE FEET WITH IAN ADDITIONAL BED SDS SYSTEM IS NSIZE OF G F]�SED 16 FEET BY 42 FEET TO MEET THE BED SIZE REQUIRED. ALL CONSTRUCTION IS TO BE ACCORDANCE WITH WELD COUNTY. COLORADO. HEALTH DEPARTMENT INDIVIDUAL SEWAGE DISPOSAL SYSTEM REGULATIONS. CERTIFICATION: 1 HEREBY CERTIFY THAT THE SEPTIC SYSTEM DESIGN SHOWN ON THIS PI AN WAS DONE BY ME OR UNDER MY DIRECT SUPERVISION AND IS ACCURATE TO BELIEF. THE REST OF MY KNOW SEPTIC. pRsvi xP• stohJ Foa; COLO,T I211 kl elZr • ,,,..... ��,�AWEL� CDu�T S p0�(ZPFO• R 41r ALPHA ENGINEERING 0 j 611 STN STREET-P.O. SOT 392 • fORT LU►TOM, ax.cm AOO aoe2i N��A-ZC-7/• METRO l3031513-546 • FORT UPTON 1303)eS7-2304 • %'r F • A L`'. • ' PREPARED FOR ' �C I TO . ' F REVISIONS eY DATE''" Ci,l �- — DRAWN RTK . SCALE ,,,,,,,�..,��:, ,,:. DATE 8 - (9- ' . fir_ 4008 ec TOwe► S- PAGE PILL mo. 32- 314 -OS 12330 Is 16 DEPARTMENT OF HEAL.'").HEAL.'").� >� a.M t5TOSPITAL ROnI \j GREELEY.COLORADO 0007 Ic... ADMINISTRATION(303)3570561 HEALTH PROTECTION OW)353ac3: tDMMUNITY HEALTH(303)35306]: �Lt COLORADO STAFF APPROVAL OF ENGINEER DESIGNED SYSTQI The engineer—decigned Individual Sevago Disposal System proposed far the property located ac 12 3 , ! 1 <<Z '-H and designed by ,9/pLi 6n/pinceet e4; is hereby approved subject co the following conditions: 7; Ic �rS1RYG/c.( 1422 En e, :Des,y.. / To Ad kezc 1-OAll to illy c J.St•ta I .S. :.s. Rego l44..e. rs / / ✓ • I, i1ARR4lal l&mrso. applicant for T.S.D.S. Permit No.�j q/47/85 under the provision of the Weld County Individual Sewage Disposal System F.egulatigns. do hereby understand and agree 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 Weld County Board of Health, but char 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 chat I nay be required by the Board to remove any or all of the system installed prior to Doard of Health consideration of my application. n ()idea 9-7 Director, Health Protection Applicant 9 --a4- 9i Date Date J HSP 106E AF'FLI,...t IoN FOR INDIVIDUAL SEWAGE DISr uSAL SYSTEM NO. 011,1$1 ! WELD COUNTY HEALTH DEPARTMENT REPAIR APPLICATIU: ENVIRONMENTAL IICALTII SERVICES 1517 JATH AVFNIIF COIIRT, GREELEY, CO 80631 353-0635 EXT.2225 OWNER JAMISON, JARRALD ADDRESS 15721 UCH 10 PH (303) 857-219 • FT LUPTON CO 00642 ADDRESS OF PROPOSED SYSTEM 12311 WCR 41 . HUDSON CO 80642 LEGAL DESCRIPTION OF SITE: NE4 SE4 SEC 32L UI 0 BLOCK 0 FILING 0 TWP RNG65 SUBDIVISION: USE TYPE: COMMERCIAL MAIN BLDG -- PERMIT CG -070003 SERVICES : PERSONS 17 RATHRAAMS 7.00 IRT SIZE 3.90 ACRES BEDROOMS 0 BASEMENT PLUMBING NO WATER SUPPLY F'WELL APPLICANT ACKNUWLEDIi.S 1HA1 IHE. CUMFLLIENL-SS OF THIS APPLICATION IS CONDITIONAL UPON rURTIICfc MANDATORY AND ADDITIONAL TESTS AND REPORTS AS MAY BE REQUIRED BY THE WELD COUNTY HEALTH DEPARTMENT TO BE MADE AND FURNISHED BY THE APPLICANT OR BY THE WELD COUNTY HEALTH DEPARTMENT FOR PURPOSES OF THE EVALUATION OF THE APPLICATION; AND THE ISSUANCE OF THE PERMIT IS SUBJECT TO SUCH TERMS AND CONDITIONS AS DEEMED NECESSARY TO INSURE COMF'ITANCF WITH RULES AND REGULATIONS ADOPTED LINDFR ARTICLE. 10. TITLE 25, CRS 1973, AS AMENDED. THE APPLICANT CERTIFIES THAT THE PROPOSED SYSTEM WILL NOT BE LOCATED WITHIN 400 FEET OF A COMMUNITY SEWAGE SYSTEM. THE UNDERSIGNED HEREBY CERIIFIES THAI ALL SIAIEMLNIS MADE, INFORMATION AND REPORTS SUBMITTED HEREWITH AND REQUIRED TO BE SUBMITTED BY THE APPLICANT ARE, OR WILL BE. REPRESENTED TO BE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND RELIEF. AND ARE DESIGNED -10 BE RELIED ON BY THE WELD COUNTY HEALTH DEPARTMENT IN EVALUATING THE SAME FOR PURPOSES OF ISSUING THE PERMIT APPLIED FOR HEREIN. I FURTHER UNDER IAND MHAI ANY FALSIFICATION OR MISREPRESENTATION MAY RESULT IN THE DENIAI OF THE APPLICATION OR REVOCATION OF ANY PERMIT GRANTED BASED UPON SAID APPLICATION AND IN I FG.A1. ACTION FOR PERJURY AS PROVIDED BY LAW. APPLICATION FEE $110.00 RICHARD J. VITO 08/22/91 REC'D BY 09/2I/9N,LORRAINE OWN NT SIGNATURE DATE DATE 09/22/91 • !:;Y:iNA!.-A,I''Y'l_ICANT. COY bJC!!➢ 41CUD CMS HAY . ' �.- . i H SI•''i 0 ,P :I:NDI:V:I:DUAI... SEWAGE: I):I:SF'OSAL.. SYSTEM PERMIT NO,. G-07000 . - WELD COUNTY HEALTH DEPARTMENT NE:W PERMIT F::NV:IRONMI:::N•IAI... HEALTH SERVICES VI:CI_.S 1516 HOSPITAL ROAD, GREELEY, CO 00631 353-0635 EXT.222ti OWNER •JAMISON, •JAIRAL.I) ADDRESS i 'a721 WCIL 10 PI-I (_^03) (:3x17••.2 FT LUF'rON CO 80621 ADDRESS OF PROPOSED SYSTEM 12311 WCR 41 HUDSON CO 80642 LEGAL DESCRIPTION OF SITE : NE::4 S'l-4 SEC :32 1"WI :3 RN(:Y 65 SUBDIVISION : I_.UI 0 BLOCK () FILING U USE: TYPE : COMME:RCIAI... MOBIL. 1--TOME. & OFFICE SERVICES : PERSONS 4 BATHROOMS 4 .00 LOT SIZE E. 40.00 ACRES BEDROOMS 2 BASEMENT PLUMBING NO WATER SUPPLY PWELL APPLICATION FEE `•Isi 50 .00 F;EC ' I) BY DOREEN SCOTT SIGNED BY JARRAl_.I) JAMI:SON DATE. 01 /06/87 DATE 01 /06/87 PERCOLATION RATE fly() M.LN PER INCH L..IM:I:T:I.N(.v ZONE (3 FEET SOIL TYPE ISU:I:•rAlif...T ! t PERCENT GROUND SLOPE 0/. DIRECTION REQUIRES ENGINEER t: :I:(:YN YES FROM THE APPLICATION INFORMATION SUPPLIED AND THE ON—SITE SOIL_ PERCOLATION DATA THE FOLLOWING MINIMUM INSTALLATION SPECIFICATIONS ARE REQUIRED : . . . ..SEPT C TAN‹.— -1250 -GALLONS, ABSORPTION TRENCH SQ. F T .. 71 - OR . ABSORPTION BED 493 SQ. FT .. 1!--, ; IN AD!,:L•r:lON.,_.Jrl-IJ:.S-_F'LRI~i-.i•,•r_•:I. UBJEi.:1:._T ) THE FOLLOWING ADDITIONAL TERM; AND CONDITIOilS : .J ' 1 i.i-i:i:S PERMIT IS GRANTED TE:MF'ORARII...Y TO IAL.LOW CONSTRUCTION TO COMMENCE . THIS FERMI: MAY BE I-'1:::V(:1Kk::')1' (W',SYJSI t DET? BY THE WELD (:;(:JUNTY IILtil._1•H DEPARTMENT FOR REASONS SET FORTH IN THE WELD COUNTY TNI):I\'':I:DUAL, SLk4AC.YI::: DISPOSAL SYSTEM REGULATIONS INCLUDING FAILURE ITO MEET ANY TERM '1R CONDITION gMPOSI•::D THEREON DURING TEMPORARY OR FINAL APPROVAL. THE ISSUANCE OFITII:I•S' PI:::kill1•tDOES NOT CONSTITUTE ASSUMP'T'ION BY THE 1)1.I(iRTMP'N•T' OR ITS EMPLOYEES OF I...iABIL:I::rY FOR THE FAILURE OR INADEQUACY OF 1-HE. S1:::4lAGE. I :I:SF'C1SAL.. SYSTEM. { . �.. To.. 5-4$7 i i %I .\ SCOTT PERKINS 03/24/87 t + WY ENVIRONMENTAL NVIRC)NMENTAI_. SPECIALIST DATE cony S'S tg7 i c' i THIS PERi•�1 1:I:T IS NOT TRANSFERABLE -ANIZ- S'I-I'ML'E.. BECOME` VOID IF §YSTpt CONSTRUCTION HAS: NOT CdMMENCE:I) WITHIN ONE Y'Lfik OF 'I :I:SSl?'ANC',E BEFORE ISSUING-FINAL APPROVAL OF THIS 1 E:l-11 ..r___I'HL.-WEI...D -COUNTY I-II FII...'I H1 I)F::I aTMli=r- -ZLtLF.VES . aF pl-ptiT O IMPOSE: ADDI- TIONAL r� II.ONAL TL''MS AND CONDITIONS RL:: ' UJ.RED TO MlI:::'rL[1UR \FiIIGI.JIIfi •1-t-4:S�111I-6ONTINUING DA •••• r J'7 I• I F,{N A I_. I N I'E:C T:l'O N O F THIS: COM- PLETED z;I. Fl:l•1A1.. PERMIT AF-'f�'F:(:iVA{... ��, CONTINGENT lJl='C�J, SYSTEM BY THE WELD COUNTY HEALTH DE:F'A{:7A i I .--I SYSTEM INSTALLER _.__.._. _r.I :B.4k V .._.........._..........__._.._..._FINAL. 6NSP T-1. Dj4Tf_: (�V SYSTEM ENGINEER --�._. ..._. - -- - •-••--• TYPE OF SYSTEM INSTALLED V:I:IR "NTAL SPECIALIST 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 W:I:I...I... OPERATE IN COMPLIANCE WITH APPLICABLE STATE, COUNTY AND I...00AI... RI:::GUI...A-llON. ADOPTED I'E.RSUANT TO ARTICLE 10, TI.1•I._E" 25, CRS .1973, AS AMENDEI. EXCEPT FOR THE PURPOSE OF ESTABLISHING FINAL... APPROVAL. OF AN INSTALLED SYSTEM FOF- ISSUANCE: (:11:.. A I...00AL.. OCCUPANCY F'ERM:I:•r PURSUANT TO CRS i973 73 25-10-111 (2) . i'1p'I'i-:. I.NIAI .._GIPPI Tr ANT :IT , ('j pv....I.Ii'`Uf ,,irs_li,_ rIA47• ;n\:- : :.,, ;. ' n rDo • 20 2s 1750 4105°43 VA%\11/ j Y ..J } Y 1 `_+ WELD COUNTY HEALTH;D'EPARTM_..T 1516 Hospital .Road ,/�J • Greeley Colorado c PERMIT NO. /47,/ ' Ph. 353-0540 Application for permit to Install, Construct, an Individual Sewage Disposal Sys m /h ' Owner.�Arr1 /SON/ CL ✓ra 11 A. Address'?90rAR i9Pe n� Phone°,7PV—O2 ? Direction to site: Hwy Rd. 07?-edi/ N mi., E_mi., S_mi., W—mi. 12311 WcR. 4 o5osiJ �Rde..7 Age, Stet Legal Description: Ptn A/1 d A ,S e 32 , TAN, RXSubdiv. -Lot Blk General Information Dept. Use Only /0".. 3 No. Bedro ss �At a No. Persons Perc. Rate (Avg. of 3) / /$n+. No. Bat s�5 !Basement Plumbing /1�0 Soil Type �+� Size of Lo �Q0 )C.3 O C� H20 Table Depth 7,5 1 H2O supply (if well give depth:7fil 2o9P^' Lot Grade G 3d�6 New Home Mobile Home ✓ Modular Add'n Requires Engineer Design_Yes..No Type of sewage d is osal requested: If yes — reason Septic tank v Privy Other Comments: ' - von% recant- — 7:. hrnisrrh 3.2q•46 -SI'0u / Installation' Instructions: (Minimum Requirements) Septic Tank A < dIn 0,als. Absorption Trenches Sq. Ft. 4 Other I,, or Seepage bed "Sq. Ft. 67 Special Instructions t Ali a\se Veva sthv bK 9 '77d` l tv►{•a -*Wi:s siskvrt .—p F:ec G 0 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 building permit is iss ed, the permit shall expire 120 days after its issuance, if construction has not beef commenced Date: %y7G.� /F -,97e Owner: KNAA4C AL,� vTAK.., 0 J ' o C 6.29- rljf' Applicant: The plans and specifications as shown are approved pending payment of permit fee. Date: /ZL 17 fr Sanitarian C,efi- , - The above system inspected and found to comply with plan and description. Systems Contractor: a 0r.-4)\ O , Date: 1129 he?) e Sanitarian: \. (rQ a, Engineer Review: (Dote) (Signature) Permit Fee: $4"2,-5 . of-6 Received by: St Date (0- /cr X. •iSP1 @6F' ]:NDr4 )UAL SEWAGE :DISPOSAL SYSTE1 r'I:RMIT NO. G-91018 r WELD COUNTY HEALTH APARTMENT PARTMENT REPAIR PERMIT ENVIRONMENTAL HEALTH SERVICES 1517 16TH AVENUE COURT, GRE ELEY, CO 80631 353-0635 EXT.222 5 OWNER JAM]:SON, JARRALI) ADDRESS 15721 WCR 10 PH (30 3) 857 FT I...UPTON CO 8064E ADDRESS OF PROPOSED SYSTEM 12311 WCR 41 HUDSON CO 80642 I...EGAI_. DESCRIPTION OF SITE : NE4 SE4 SEC 32 TWP 3 RNG 65 SUBDIVISION : LOT 0 BLOCK 0 FILING 0 USE TYPE:. : COMMERCIAL... MAIN BLDG .-. PERMIT tCr-870003 SERVICES : PERSONS 2 BATHROOMS 2.00 LOT SIZE 3. 9(•) ACRES BEDROOMS () BASEMENT PLUMBING NO WATER SUPPLY F'wr.:I._L_ APPLICATION FEE $110.00 R EC ' I) BY MORRISON, L..ORRA:I NE: SIGNED BY RICHARD J. VITO DATE 08/22/91 DATE 08/22/91 PERCOLATION RATE 2'3.0 MIN PER INCH L_IMI.1'TING ZONE 8 FEET `''OIL.. TYPE SUITABLE PERCENT GROUND Sl...01F 0/ DIRECTION REQUIRES ENGINEER DESIGN YES FROM THE APPLICATION INFORMATION SUPPLIED AND THIN ON-SITE SOIL_ PERCOLATION DATA THE FOLLOWING MINIMUM INSTALLATION SPECIFICATIONS AlIA. REQUIRED : SEPTIC TANK 1250 GALLONS, ABSORPTION TRENCH Sty. FT. OR ABSORPTION- BED 1144 SQ. FT. IN ADDITION, THIS PERMIT IS SUBJECT T'O 'TUE FOLLOWING ADD:I:TIONAI... TERMS AND CONDITIONS : THIS PERMIT IS GRANTED TEMPORARILY TO ALLOW CONSTRUCTION TO COMMENCE. THIS PERMI MAY DE REVOKED OR SUSPENDED BY THE WELD COUNTY HEALTH DEPARTMENT .FOR REASONS SET FORTH IN THE WELD COUNTY INDIVIDUAL SEWAGE DISPOSAL SYSTEM REGULATIONS INCLUDING FAILURE TO MEET ANY TERM OR CONDITION IMPOSED THE=REON DURING ILMI''(JRARY OR FINAL APPROVAL. THE ISSUANCE OF THIS PERMIT DOES NOT CONSTITUTE ASSUMPTION BY THE DEPARTMENT - OR ITS EMPLOYEES OF LIABILITY Y FOR THE FAILURE OR INADEQUACY OF THE SEWAGE DISPOSAL SYSTEM. T C j d/,,ri 10- a9 - 9/4P-3 JUDY SCHM:[DT 09/23/91 (2,0-,,I`4 ) ENVIRONMENTAL SPECIALIST DATE THIS PERMIT IS NOT TRANSFERABLE AND SI'IAL..I_. BECOME VOID IF S"r'STEM. CONSTRUCTION HAS NOT COMMENCED WITHIN ONE YEAR OF ITS ISSUANCE. BEFORE ISSUING FINAL._ APPROVAL OF THIS. ti: }:.I•:i` I THE WI:::I...L' COUNTY HEALTH DEPARTMENT RESERVES THE RIGHT TO IMPOSE ADDI• -i J:c NAI.... 1"ERi`1,a AND CONDITIONS REQUIRED TO MEET OUR REGULATIONS ON A CONTINUING BA-- "3:::. FINAL PERMIT AP'P'RO:OVf'II... IS CONTINGENT UPON 1111:: FINAL INSPECTION OF THE COM— PLETED SYSTEM BY THE WELD COUNTY HEALTH DEPARTMENT. ..T /0-6-C11_ __, SYSTEM INSTALLER ._._. _.._.._ ...._ _...__.. __....................--.......--- ---•-- F I N r'1 I_ I:N S , � I: :) DINE E: -- . .... Al F'ROVAL �i'.L_. . - _ SYSTEM ENGINEER _ a.__. ..n. .. __....._.__ . _.__.__ _ ._-.... -.�_a,.,r_�___._______.. TYPE OF SYSTEM TNST�fI...LE.D 1lLc .._._ • i:NV:I RON MENTAL ;..IF(:IA1._IST r~cE'R G' TOES _ r �-d� THE :I:SS(.lAr�!(:'k:. OF T�li]:“ F�'L:Rr4l:T 1Ok=,� � {]'r LMF='L_Y {.: ..MPLE WI:' I•I Ci•rHEF: S'rA'T'1:::, COUNTY (JR LOCAL REGULATORY OR BUILDING REQUIREMENTS, NOR SHALL IT ACT TO CERTIFY THAT T'I"II SUBJECT SYSTEM W.I:I...I... OPERATE IN COMPLIANCE -WITH APPLICABLE STATE, COUNTY AND LOCAL REGULATIONS ADOPTED IE::RS(JAN'I TO ARTICLE 10, T:I:TI._I 25 . CRS 1973, AS AMENDF..I. EXCEPT FOR THE P'URP'OSE:: OF ESTABLISHING FINAL AP'P'ROVAL OF AN INS'T'ALLED SYSTEM FOR ISSUANCE OF A LOCAL OCCUPANCY PERMIT PURSUANT TO CRS 1973 25-10-111 (2) . ORIGINAL-APPLICANT; COPY-WCIID WCHI)-EHS MAY, 1984 I :4 rm.12 I .. I _ 3 I i ;d CIA Nt_ lC �l �k ! �t • a 0 Kt/LPN-03 cl Hello