HomeMy WebLinkAbout20050908.tiff l ,Aiuliawe "`1Fc,'Jr Olct ./ /5 "w . 2
Form No. OFFICE OF THE STATE ENGINEER
U 3Nl`4
GWS-25 COLORADO DIVISION OF WATER RESOURCES /Z.
818 Centennial Bldg., 1313 Sherman St., Denver,Colorado 80203 /�1/ II-o Z
(303)866-3581 LIC
WELL PERMIT NUMBER 057300 - F -
APPLICANT DIV. 1 WD 2 DES. BASIN MD
APPROVED WELL LOCATION
WELD COUNTY
NE 1/4 SE 1/4 Section 30
STEPHAN BRANCUCCI Township 1 N Range 66 W Sixth P.M.
PO BOX 127 DISTANCES FROM SECTION LINES
HENDERSON, CO 80640- 1475 Ft. from South Section Line
200 Ft. from East Section Line
(303) 659-5261 UTM COORDINATES
PERMIT TO CONSTRUCT A WELL Northing: Easting.
ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT
CONDITIONS OF APPROVAL
1) This well shall be used in such a way as to cause no material injury to existing water rights. The issuance of this permit
does not assure the applicant that no injury will occur to another vested water right or preclude another owner of a vested
water right from seeking relief in a civil court action.
2) The construction of this well shall be in compliance with the Water Well Construction Rules 2 CCR 402-2, unless approval
of a variance has been granted by the State Board of Examiners of Water Well Construction and Pump Installation
Contractors in accordance with Rule 18.
^1 Approved pursuant to CRS 37-90-137(2)for the replacement of an existing unregistered well. Upon completion of the new
well, the old well must be plugged and abandoned in accordance with Rule 16 of the Water Well Construction Rules. A
Well Abandonment Report form must be submitted within sixty (60)days of abandonment of the old well.
4) Approval of this replacement well permit shall not result in an expanded use of ground water. The use of ground water
from this well is restricted to domestic uses in two dwellings, the watering of domestic animals and/or poultry,fire
protection, drinking and sanitary purposes inside a warehouse and 1/3 acre of lawn and garden irrigation.
5) The maximum pumping rate of this well shall not exceed 30 GPM. + � () ,p ; ,•,t/ ,
6) The average annual amount of ground water to be appropriated shall not exceed 1.5 acre-feet.
7) Production is limited to the alluvium. The depth of this well shall not exceed 40 feet or the depth at which sandstone or
shale is first encountered, whichever comes first.
8) The owner shall mark the well in a conspicuous place with well permit number(s), name of the aquifer, and court case
number(s) as appropriate. The owner shall take necessary means and precautions to preserve these markings.
9) A totalizing flow meter must be installed on this 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.
10) This replacement well shall not be constructed-any closer to any other existing well than the well it is replacing, if such
other well is within 600 feet of the replacement,is completed in the same aquifer, and is not owned by the applicant.
11) This well shall be constructed not more than 200 feet from the location specified on this-permit.
12) This well is subject to administration by the Division Engineer in accordance with applicable decrees, statutes, rules, and
regulations.
13) This well shall not be pumped unless included in a court approved plan for augmentation or a substitute water supply
plan approved by the State Engineer. This well is currently covered by GASP.
2005-0908
APPROVED
o
JMW
State Engineer ��ry By
Receipt No. 1 0490163 DATE ISSUED APR LUtAG EXPIRATION DATE APR 1 1 2Q03
APR-08-2002 10 59 DIU WATER RESOURCES 303 866 3583 P.02103
, COLORADO DIVISION OP WATER. SOURCES Office Use Only I Form GWS-45(1/2001)
DEPARTMENT OF NATURAL RESOURCES
1313 SHERMAN ST.,RM 818,DENVER,CO 80203
phone—info(303)888.3587 main:(303)866.3681
fax: (3031 8883589 htep://www.water.stete.co.ue
GENERAL PURPOSE
Water Well Permit Application
Review instructions on reverse side prior to oomp1etinp form.
The form must be completed in black Ink.
1, Applicant Information 8. Use Of Well (Chock applicable boxes).___________
. .. .
tiii;:or mice, Iw Attach a detailed description of usees appliedr,fo
St !L.ti. 2iaN COCCI
Mawne address - `" ---" in industrial CIOther(describe):"a 40)C /Z ni �`/r
env -4Ilie_. � 0 municipal
_.._. UtAtele5 .
a
p oitse il/ Gists YP"06 ❑irrigation
1..eiz, 'vo ,Commercial/R t5 1d(Jag-1m I
tiliphOnl I
1`303 I I y-S,7-G I 7. Weil Data (proposed)
Meramum pumping fns ' .ar.•.aal revel to be wither...en
2. Type 01 Application (check applicable boxes)
o Construct new well El Use existing well "}o]"dpgp ppm acre-feet
*Replace existing will 0 Change or Increase use tdn pnex 90 feat
O Change source (aquifer) O Reapplication(expired oermR) 8 Land On Which Ground Water Will Be Used
❑Other:
3. To (if a licable) A. Legal Description drew be wowed San emicrwsne:
Refer _PP..__.—e_
Well Carmt I - '..,_ —..,._--....___...
WIWI tN Court case p •...••_..._._._._.___..._,
.5(Fine 9s 5. A.
n.__--Dea' amp Basin gtomluilani —_.._._....__..-....__............____._.
I
4. LOCetion Of Proposed Well -Ilt veal for crop Irrigation,attach a scaled map that shown irrioatna area.)
—County B. a saes .�
C. Owner
J•nion TOwnsha Na y.•....•Ri411•_..._EdW_ . PtflCDI Madan
30 1 M❑ l &Co O IS CP PTO
0, um any emu wells or nos rpm*used on the law:
-04,Ines or well Von,NOUN Mae(whorl lines of typcaiy not sopertv lines) I'
14/75 ,, rt.from p If ca(R „2p0 l N.hart 410 W. 9. Pr posed)Web Driller License #(optional):
fo Cpocfrnwt IIIs only_Oi:NMe Intl o snort fro Ok;nil to naWVIIII
/ 10. Sl nature Of A lioant(s) Or Authoriized Agent
.Sara 4 , , direction -•' -'_ ._.;-_._
�?s teat @P. _ 9 . ... ....-
-a on _ - Tne make of false atawmsms horain 1 mititutss-per- jury in the cacond
Wei.bpaoon adoraas IN appncap:n - degree, wrlhieh is puniahabie as a cease 1 misdemeanor pursuant to
S13-erf. ad C.R,B, 24.4.104(13i le). I neve reed the statements herein,know the
Cimino: GPS wef'.location information as(cilium's:
Us: 'crewel GOntanta thereg rid Stets,jh�(, ere trye to m know led e.
Rebored tdttingr for UPS units are as fnLowp: Sign hero I ust Cr edging/*ignitors) l cue
ramp nwee as GTM _...._.,_._..�___....._.._.. `� ''
Zone rocs(or.a „"'V - P.ci/ei 7-i-OL
'. Northing • Prim rte NM
Urge/suit be Natari ,/* /
Datum muYMN4pg]ICONVn tasting ��Ps4AN J. /3/2.A NC!/ceee cwt.", •
vr„ism to er;TO out noun Office Otte Only
wow pan('*waged?Oyes O NC V60a mop nemn ...—__. �' OMR moo no. -"" Sodom O,r:.
5. Parcel On Which Well Will Be Looeted
A. Legal Description,may se provides as an apeehmtm;, Receipt area only -----
`� ll
jet /�7f
•
B. YOt ens in Oaoa .__. C. w
Up Of ephg_u &Ls MUCC, WR
0. Win Ow be the only well en runs POMP BYES ONO Of no-list other wigs; '• CWCB
TOPO
�~—»
---,��
E. Sate Parcel lot iootloro'I: —_ • MYIPR
Sig Div WO BA MD
3
eat ;7 Ante
WELD COUNTY BOARD OF HEALTH 42 7`j !t i f /Zl/ 17
ENGINEER DESIGNED SYSTEM REVIEW -
APPLICANT: Steve_ 3 ra n c kCf i NO: 'CY 9O005r
LEGAL DESCRIPTION: PT 5w 4 SEC a 9 TWN O) RNG 6 6
SUBDIVISION ' LOT
BLOCK FILING
SITE ADDRESS: jag, U)C- `77— I(�Ort441 kd •
FACILITY: atms,t-rn 0 0)d{n 1Jrm'c - c215 c ("pup G ACRES: 60
PERC RATE: I,O a0 SOIL: it r,(,Qkakoa • WATER SUPPLY: /2 RA-1/
SLOPE: LIMITING ZONE:
x nn ENGINEER DESIGN (3.5) EXPERIMENTAL DESIGN (3.14)
ENGINEER: ('�47_,..? l ��Bu/e
ADDRESS: (o /7 5 t PI) Sn 39°I, ej CU
ESTIMATED•FLOW: -1/6D G.P.D.
PRIMARY TREATMENT:7JSaQ ra- 4 1/4-ieutt. CAPACITY: /00C h� i _�yyvy
i 2OSAL METHOD: 4,�p y1-w�_Z .,.. .A,? SIZE: 564/ it .
REQUEST FOR VARIANCE: Q
STAFF COMMENTS: ali ni �f x..l-saas/ Atr-b-katti Sti yO
,.. Odirestiedecilier 92241 D.46. ticodhunt'
STAFF RECOMMENDATION:
/GZ� ENVIRONMENTAL PROTECTION SPECIALIS : 4--I, 7 REVIEWED BY BOARD: CIRO
B.O.H. DECISION: 4J APPROVED DENIED TABLED
Tom Cope, ( airman
Weld County Board of Health
4
ES24
Percolation rate of imported soil - 10 to 20 wln. / in. 1
bedroom home - 282 X 2 - `r ti4 Square tee'
Ise 12 ' x 47 ' absorptIon fed
2 bedroom home requires 1 . 000 gallon septic tank.
NOTE:
Construct according to Weld County • v,
Health regulations.
CERTIFICATION:
I hereby certify that the septic system
design shown on this plat was performed by me
and under my direct supervision and are accurate
to the estof my kknowl ge and belief .
Cecil R. Crowe, P. E. a L. S. 12330
P`‘"\"1" mipi;.,
Cq...':..
0
4` 23 . •
L.
•
SEPTIC SYSTEM DESIGN FOR GOLDEN WEST
AT 1281 W.C.R- , 27 WELD COUNTY, CO.
ALPHA ENGINEERING
617 5TH STREET-P.O. BOX 392 • FORT LUPTON, COLORADO 80621
METRO (303)573-5186 • FORT LUPTON (303) 657-2308
,
REVISIONS BY DATE PREPARED FOR
DRAWN BY [SCALE NOTED
BOOK DATE 4 - 3-90
PAGE FILE NO. 30 - IN6-- 2t
MfT4L
Bid9.
•
8idg.
AEXISTING
HOME
N ,5
�0 MOBLE
HOME
-'
,' 1000gal. SEPTIC TANK
ABSORPTION BED /.
v „ N
/55, 2' 6
C.
. ,
•
tDEPARTMENT OF HEALTH
' 1516 HUSH;AL
GREELEY, COLORADO 60631
ADMINISTRATION (303) 353-0586
HEALTH PROTECTION (303) 353-0635
C� COMMUNITY HEALTI4 (303) 353 0639
COLORADO
STAFF APPROVAL OF ENGINEER-DESIGNED SYSTEM
The engineer—designed Individual Sewage Disposal System proposed for the
property located at la '/ )G1' a---7
and designed by (.l42:to VLdi,vv is hereby
approved subject to the following conditions:
Cc/I . & 00 SS
I, SJleup je2A-Nc?ucu , applicant for I.S.D.S. Permit No.
under the provision of the Weld County Individual Sewage Disposal System
Regulations, 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 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 consideration of my application.
l�/ /It
�� GU CJ-�Grn
Director, ealth rotection - Applicant
Z/ l® -9e)
Date • Date 7
WELD COUNTY- HEALTH DEPARTMENT ENVIRONMENTAL UEAL'I•lI SERVICES ,
SITE EVALUATION Owner ,Cfc.w Rrancccc.e!
G— 90005-S
Ap{._ication No . Site (1.-( /cde a7 /3-resAyryi PT $&e/ S27T //
R_Co 6
Date 7/4430 Sub _Lot 4Block Filing
PERCOLATION TEST DATA: Start Time
9 # ,
Hole Hole HZO // '/e5 ( i'6S jo�:o6 /a•' /5 /�. a� min .
No . Depth Remain /O�+d„ 'om, ' /� inch
min. min . min ., min. min. min . min . min. min .
98 •7i0 ' /-7/1 720
I39n` 095 +t.'2C ff' 7 #" . 07,0
4n /�5 /7-1
• $.25 995- 1�0 17R
•
2 '7/0 +(3n 3. 3�
3c� I )s / �s / 70 S
1'34 5 9/ r-25-
6,9,-5
3 � C S 5 d •[.'O - 4;7.5
a 5 d .
34 icy.. . 1 .
9.30 si ' 'AS . c<
4 9"" ii. An t-45- .2 . 67
336ja 4n fss /s5 .
7sO %pc"- 7/Q 085
5 j !o/O w 5357 �/�U4le .2.1).
.332,, t 70 / 75 !c 4 3 io /212
sas 5�9 yti� •
,t- I n 1444/0 ÷1/7C)35 ' j 7 .5 ,Ss / 90. goot9.Xy
All measurements in .mm unless otherwise indicated. /5 -54
Total
* - Add 1120
Environmental Health Specialist 44 -eareAverage Rate of. 55
PLOT PLAN / SOIL PROFILE •
• :—..... ,Z'' I •_I9lI - C.tcy/5u,•,J w...
o ,. C7 O • P. 1111_2yrr . s•uad {.r,., ojw.'vc
ay /, 76 /
- cka�t
fp,t
iJf¼.L "' ,._••-mr•r•l...i. , .i.,mvir , %.t.,r i wi...rru
s•
T r.-. �.
• 1-ISP1 ()1rI:' APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL ,t'' O G-90005
WEI...D COUNTY '-n:AL.'n• DE: NEW
':1F�'T'i`�f::N'T'
ENVIRONMI-NTAL HIE HEALTH SERVICE.'
517 16TH AVENUE COURT, .GREI=LEY, Co B0631
353-0635 5 LXT. 2225
OWNER BRANUi";.'J. ::T EVE ADDRESS" 1261 WCR 27 PH (303) 659-526
BRIGHTON CO 08061
ADDRESS OF PROPOSED SYSTEM 1 :231 WcR 27
BRIGHTON CO 08061
,LEGAL DESCRIPTION>'(: R:I PT'ION OF SITE : S W4 EEC 29 414P i kNG r.',c'>
SUBDIVISION : L.(:l..1. :(al_,O1 K G FTI....I.NG O
.USE TYPE: : RESIDENTIAL.. MOBILE HOME
SERVICES : PERSONS 6 BATHROOMS 1 .00 LOT SIZE 60 , 00 ACRES
BEDROOMS 2 BASEMENT PLUMPING NO WATER SUPPLY ,::14E::L.L.
APPLICANT ACKNOWLEDGES THAT THE COMPLETENESS ENi:SS OF THIS APPLICATION IS CONDITIONAL.
UPON FURTHER 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 tPPL.I(:ATION,
AND THE ISSUANCE OF THE PERMIT .1V SUBJECT O SUCH TERMS AND CONDITIONS AS Dl::ENtL.:.
NECESSARY TO INSURE COMPLIANCE WITH RULES REGULATIONS �P UNDER L AND .(:►NS ADOPTED, U JDIr.�, ARTICLE
1 9 7.. AS 10, TTITLE ;�'.. , CRS Ai`•iiENDZD.. Ti-iM. APPLICANT (;ImR'T'1:FJ:Iw;., THAT� THE PROPOSED
r
SYSTEM WILL.. NOT BE LOCATED WITHIN 4 FEET 1 A COMMUNITY SEWAGE SYSTEM. THE
UNDERSIGNED HEREBY CERTIFIES THAT ALL STATEMENTS MADE, INFORMATION AND REPORTS
SU MITTED HEREWITH AND REQUIRED To BE SUBMITTED BY THE APPLICANT ARE, OR WILL. BE::,
RE „SENTED TO BE TRUE:: AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF, AND
ARL DESIGNED TO BE RELIED ON BY THE WELD COUNTY i-iEAL.'T!-! DEPARTMENT IN EVALUATING
TI-IE' SAME FOR PURPOSES OF ISSUING THE PERMIT APPLIED FC)R HEREIN. I FURTHER UNDsER--
STAND THAT ANY FALSIFICATION OR MISREPRESENTATION MAY RESULT IN THE DENIAL. OF 'T.in::
APPLICATION OR REVOCATION OF ANY PERMIT GRANTED BASED UPON .SAID APPLICATION AN
IN LEGAL ACTION FOR PERJURY AS PROVIDED BY LAW.
APPLICATION FEE $1 _•≥O.00 S'Tw•Vi_: BRANIJCCI
REC ' D BY RECEPTIONIST AID _.......,..". !de _......_..,....,._ __03/:'(3 90
DATE 03/28/90 • OWNER/AGENT SIGNATURE:: DATE
i .
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