HomeMy WebLinkAbout20040572.tiff Form No. OFFICE OF THE FATE ENGINEER
GWS-25 COLORADO DIVISION OF WATER RESOURCES
• 818 Centennial Bldg., 1313 Sherman St., Denver,Colorado 80203
(303)866-3581
LIC
WELL PERMIT NUMBER 59127 -F -
APPLICANT DIV. 1 WD2 DES. BASIN MD
APPROVED WELL LOCATION
WELD COUNTY
NE 1/4 NE 1/4 Section 19
RALPH E& BARBARA I MAY Township 1 N Range 65 W Sixth P.M.
2827 WCR 39 DISTANCES FROM SECTION LINES
BRIGHTON, CO 80603- 950 Ft. from North Section Line
165 Ft. from East Section Line
(303)536-4307 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.
3) Approved pursuant to CRS 37-90-137(4)and the findings of the State Engineer dated rJj /1�2, J 44: .
4) The use of ground water from this well is limited to Domestic,Commercial and Irrigation. OO
5) The maximum pumping rate of this well shall not exceed 30 GPM.
The average annual amount of ground water to be appropriated shall not exceed 2.5 acre-feet.
) Production is limited to the Laramie Fox-Hills aquifer which is located 780 feet below land surface and extends to a depth of 1060 feet. Plain
casing must be installed and grouted to prevent the withdrawal of ground water from other aquifers and the movement of ground water
between aquifers.
8) The depth to the top of the Laramle-Fox Hills aquifer is approximate. To ensure the exclusion of poor quality water from zones immediately
above the aquifer,plain casing and grout shall extend through the lowermost coal and/or carbonaceous shale that overlies the Laramie sand
portion of the aquifer.
9) The entire length of the hole shall be geophysically logged as required by Rule 9 of the Statewide Nontributary Ground Water Rules prior to
installing casing.
10) 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.
11) 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.
12) This well shall be constructed at least 600 feet from any existing well,completed in the same aquifer,that is not owned by the applicant.
13) This well shall be constructed not more than 200 feet from the location specified on this permit.
14) Pursuant to CRS 37-90-137(9)(b)and the Denver Basin Rules,no more than 98%of the nontributary ground water withdrawn annually shall
be consumed and the well owner shall demonstrate to the reasonable satisfaction of the State Engineer that no more than 98%of the water
withdrawn will be consumed.
15) This well is subject to administration by the Division Engineer in accordance with applicable decrees,statutes,rules,and regulations.
NOTE:The ability of this well to withdraw its authorized amount of water from this non-renewable aquifer may be less than the 100 years
upon which the amount of water in the aquifer is allocated,due to anticipated water level declines.
m27— ,2/'9103
APPROVED // 7� r � �2 /Z��
MTT lid Z /�!
State Engineer By
Receipt No.0504109 DATE ISSUED 02-18-2003 EXPIRATION DATE 02-18-2004
2004-0572
•
FINDINGS OF THE STATE ENGINEER
IN THE MATTER OF AN APPLICATION FOR A PERMIT TO CONSTRUCT A WELL IN WATER
DIVISION NO. 1, WELD COUNTY, COLORADO
APPLICANT : RALPH E. & BARBARA I. MAY
AQUIFER: LARAMIE-FOX HILLS
PERMIT NO.: 59127-F
In compliance with C.R.S. 37-90-137O) and the Statewide Nontributary Ground Water
Rules, RALPH E. & BARBARA I. MAY, (hereinafter "applicant") submitted an application for a
permit to construct a well. Based 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 February 13, 2003.
2. The applicant proposes to construct the well in the NE1/4 of the NE1/4 of Section 19,
Township 1 North, Range 65 West, 6th Principal Meridian.
3. The proposed well is located outside the boundaries of a designated ground water basin.
4. The applicant proposes to apply the water withdrawn from the well to the following beneficial
uses: Domestic, irrigation and commercial.
5. The proposed maximum pumping rate of the well is 30 gallons per minute, and the
requested average annual amount of ground water to be withdrawn is 2.5 acre-feet.
6. The applicant is the owner of the land on which the well will be constructed.
7. The proposed well would withdraw ground water from the Laramie-Fox Hills Aquifer
(hereinafter "aquifer"), which, according to the Denver Basin Rules, is located 780 feet to
1,060 feet below land surface at the location of the proposed well.
8. The location of the proposed well is more than 600 feet from any existing well completed
in the aquifer.
9. According to a sworn statement, the applicant owns, or has consent to withdraw ground
water underlying 10 acres of land as further described in said statement, which is attached
hereto as Exhibit A.
10. 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. 37-90-103O0.5).
Applicant: Ralph E. & barbara I. May Page 2
Aquifer: Laramie-Fox Hills
Permit no.: 59127-F
11. 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 aquifer's life of 100 years, C.R.S. 37-90-137(4)(b)(I).
12. The quantity of water in the aquifer, exclusive of artificial recharge, underlying the 10 acres
of land described in Exhibit A is 2.5 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 164 feet.
13. A review of the records in the State Engineer's office has not disclosed that there are any
existing wells or other water rights claiming or diverting 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 2.5 acre-feet (the quantity of water which is considered available
divided by the 100 year aquifer life).
b. The 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 logs 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 30 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. 37-90-137(9)(b) and the Denver Basin Rules, no more than 98% of
the nontributary ground water withdrawn annually shall be consumed and the applicant
shall demonstrate to the reasonable satisfaction of the State Engineer that no more than
98% of the water withdrawn will be consumed.
Applicant:. Ralph E. & barbara I. May Page 3
Aquifer:. Laramie-Fox Hills
Permit no.: 59127-F
h. The owner shall mark the well in a conspicuous place with appropriate well permit
numbers, name of the aquifer, and court case numbers. He shall take necessary means
and precautions to preserve these markings.
L
Dated this /9 day of �72 1,07 , 2003.
,ild et, . "
Hal D. Simpson
State Engineer
By: � • �.2�"L
Kevin G. Rein
Water Resource Engineer
Prepared by: MTT
Form:0546(o)
STATE OF COLORADO
OFFICE OF THE STATE ENGINEER woF coop
Division of Water Resources
e� c-roo Department of Natural Resources � �
1313 Sherman Street, Room 818 \*
--
Denver,Colorado 802(13
Phone(303)866-3581
FAX (3031866-3589
Bill Owens
www.waler stale.co.us Governor
February 4, 2003 Greg E.Walt 1,nr
Exe(olive Director
I lal I) Simpson,PE.
Slate Engineer
Ralph E. & Barbara I. May
2827 WCR 39
Brighton, CO 80603
RE: Permit application receipt no. 504109
Dear Applicant:
I am returning the enclosed well permit application to you for clarification and correction. The
enclosed well permit application is being returned to you for the following reason(s). In order to
properly complete the evaluation of your application, the following changes and/or clarification
must be made:
• Please complete the enclosed GWS-1 and GWS-43 forms. If you wish to reference the
description of your property for GWS-1 on a separate attachment please reference it as
the attached exhibit A on the form. The description you supply should completely
describe every boundary of the property. Instructions fro each form can be found on the
reverse side of each form.
• It appears that there is approximately 2.45 acre-feet of Laramie Fox-Hills aquifer water
available underlying your 10-acre parcel. Please reference this amount in item no. 7 for
the annual amount to be withdrawn.
Once your corrected original application is resubmitted to this office, it will be merged into the
applications currently being reviewed. This should expedite your application through the final
stages of review. If you have any other questions, please contact me at (303) 866-3581. When
inquiring on the status of your well permit application please reference this letter and the above
receipt number.
Thank you,
Mark Trivisonno
Engineer Technician
Division of Water Resources
Form No.
GWS-43
Rev. 9/96
OFFICE OF THE STATE ENGINEER
818 Centennial Bldg.
1313 Sherman St., Denver, Colorado 80203
(303) 866-3581
NONTRIBUTARY LANDOWNERSHIP OR CONSENT VERIFICATION OF NOTICE
I (We) fart E- / /t/ameAS. \'
/ (Name of Well Permit Appli ant)
claim and say that I (we) have given notice pursuant to CRS 37-90-137(4)(b.5) of the application for
a well permit by registered or certified mail, return receipt requested, no less than ten days prior to
making of the application for the permit, to every record owner of the overlying land and to every
person who has a lien or mortgage upon, or a deed of trust to, the overlying land recorded in the
county in which the overlying land is located.
The names of the persons given notice are listed below:
� Ce400,14.“ -OFig
Further, I (we) claim and say that I (we) have read the statements made herein; know the contents
hereof; and that the same are true to my (our) own knowledge.
Rare.. Z:/a--eff
nature) (Date)
(Signature) (Date)
INSTRUCTIONS
PLEASE TYPE OR PRINT NEATLY IN BLACK INK. THIS FORM MAY BE REPRODUCED BY
PHOTOCOPY OR WORD PROCESSING MEANS. SEE ADDITIONAL INSTRUCTIONS ON BACK.
GWS1
04/12/01
STATE OF COLORADO
OFFICE OF THE STATE ENGINEER
DIVISION OF WATER RESOURCES
1313 Sherman St. Room 821
Denver, CO 80203
(303) 866-3581 Fax (303) 866-3589
NONTRIBUTARY GROUND WATER LANDOWNERSHIP STATEMENT
I (We) /U --11t�y9lgas
/ (Name(s))
claim and say that I (we) am (are) the owner(s) of the following described property consisting of
/6 acres in the County of teratale
State of Colorado:
(Insert the property legal description)
sc
and, that the ground water sought to be withdrawn from the y
aquifer underlying the above-described land has not been conveyed to reserved to another, nor has
consent been given to its withdrawal by another.
Further, I (we) claim and say that I (we) have read the statements made herein; know the contents
hereof; and that the same are true to my (our) knowledge.
I.—re Si na _lam" D 3
9 Date
Signature l Date
INSTRUCTIONS:
^ Please type or print neatly in black ink. This form may be reproduced by photocopy or word
processing means. See additional information on the reverse side.
I:
Pam No.
STA. only
INS-ms�11 •OFF1 TE•EJGINEER +r..-Vi Po office U.e
ale"' .1513 Shim=St,Denver,Odaa&a
(mss)
PRIOR TO CO - INSTRUCTIONS ON $IbE
CHANGE 11`t /t/ADDRESS N tiECE(V tit;
'WELL PERMIT, on Maslot cowl:oc )* 0CT 91997
1. NEW OWNER
ME -S) � 9® -baara_.1.. May'
NA WA.i Oi HtsuuNccs
• STAT cora EEn
Mailing Address 921 WC R�j -Ip G x7.
city, st. zip-Brt 17e. ., Co S oloo)
Phone (303 ). '*i,fr.601
2. THIS CHANGE IS EILC P;HE FOLLOWING:
Ei WELL PEiMI +, 'r 15 'I I......
ElUVESTOCK wAv t+PmR numeER
EROSION COiS6004P1MBER ._... .,...:.,
•
3. WELL LOCATION: cot* C - ''' e I d OWNERS WELL DESIGNATION
2'321 \A/CP q Bri h1-on Co 20b01
(Lc)
SE 114 of a f V 10 E 114, Sec. l 7 Twp, I EN.a D.S., Range_W5, ❑E.« N W. !o P.M.
Distances from See�ction lines l o(p 0 Ft. from®N or❑t S Line, (.^w'�.,} /
Ft. fror�m�Ip(r�!�E.«❑W. Line
Subdivision A A,� Lot. ,e1*-y?g _''OC (a t-5 P 9 NnN.._.....). N
4. LIVESTOCK TANK OR Q$N C9NTROL DAM LOCATION , %UNTY
1/4, Sec. rtwp,.. [IN. or❑S., Ranges ❑E. «❑W. P.M.
5 The above listed owner(e) (s)that he (they) own the structure described herein.
The existing record is gripaniiiialor the following reason(s):
'�7{L aWr
i: ",tac-l'.,f
ILS Chenoe in name di oiar tat Change in mailing address. ❑ Correction of location.
6 I (we) have read the stat4ftteefs made herein, know the contents thereof,and state that they are true
to my (our) knowledge
(Pursuant to Section 24-4-'t (itt)a)C.R.S.,the making of false statements herein constitutes perjury In
the second degree and iiii ntsfjadle as a class I misdemeano'r.j
Name/Title (Please type Or gent) Signature -.12.,7 7atir, Dale '
Rai ph e a. Carlo aat_.I. May ea, ----)4410 - 21- 97
•FOR OFFIC USE ONLY
ACCEPTED AS A CHANGE IN OWNERSHIP
AND/OR MAILING ADDRESS.
/ r.
, r
DEC 081997
State Engineer Sy/ri Deur
Court Case No. Div.J Co. 6 -WD 'n MD Use
•
WRJaS-69.- STATE OF COLORADO DIVISION OF,WATER RESOURCES -�,C�j �( �
/ / A PERMIT TO USE GROUND WATER ^�_it— �' `, �
L A PERMIT TO CONSTRUCT A WELL Y` On. s+• '
APPLICATION FOR: 0 REPLACEMENT FOR NO.. WriN11 w_ ...at
/7 A PERMIT TO INSTALL A PUMP la W 00
/7 OTHER 011
PRINT OR TYPE LOCATION OF WELL
APPLICANT DiR,s M. /PE/A/Pot0 COUNTY NE L0
Street Address Ire . / — feX i0 c-i 't, iv g. i, sec. pif
City & State S is jiYo,tl (iota. :rho/ T. / 4 R. , lE P.M.
Street o
Use of ground water i Lot & Block
Owner of land on which well City or
is located Subdivision
Number of acres
to be irrigated Ground Water Basin
k Legal description of Water Management
irrigated land : `District
Other water rights on
this land LOCATE WELL ON THE BACK OF THIS SHEET
Owner of irrigated /
land Driller v/ .,4/ ouc%rx ^ No.�eJ
Aquifer(s) ground water is to be obtained Driller s �f1Y i ' )
from Address&Y07 //
���7'�/!� QOYIf/1!t_ �(1�sC Y[el,"�'LC
.— Storage capaci ty AF 4.-0-6-/4-,s, ,iy7 . LprQ�
Signs re of Applicant
THE FOLLOWING NO FIGURES ARE MAXIMUMS AND
CANNOT BE EXCEEDED IN FINAL USE. CONDITIONS OF APPROVAL
MAXIMUM PUMPING RATE eed GPM
AVERAGE ANNUAL AMOUNT OF GROUND WATER TO
BE APPROPRIATED Acre-Feet
ESTIMATED WELL DATA
Anticipated start of drilling 7,1-- 191?
Anticipated start of use l 19 f
Hole Diameter: / APPLICATION APPROVED:
7 i from _ �_ ft. to ` 75 ft VALID FOR ONE (1 ) YEAR AFTER DATE ISSUED
f in. from Go ft. to 75 ft. UNLESS EXTENDED FOR GOOD CAUSE SHOWN TO
THE ISSUING AGENCY
Casing: PERMIT NO. 37399 CONDITIONAL / /
Plain 46_ in. from 6 .. ft. to ?ji ft.
/,c' in. from RI ft. to Cc ft. DATE ISSSUUE'DD�APR 111969
Perf• 4— in. from 1D ft. to 7j' ft. `� '� •
in. from ft. to ___ ft. STATE ENGIN ER or -FIcATR1.-1AN GROUND
WATER COMMISSION
' ' ESTIMATED PUMP DATA By �n 9 r _ pe�ti Outlet
Type HP; `, Size
APPLICATION MUST BE COMPLETED SATISFACTORILY BEFORE ACCEPTANCE
(OVER)
-MAY 2 0 1969
wRJ•2s-68 - _ STATE OF C01ORADO
Index Na,_ DIVISION OF WATER RESOURCES �^red�" "—' --
IDWD ( OFFICE OF THE STATE ENGINEER :,g
Use 7 APR l a 1969
Registere. MAP AND STATEMENT FOR WATER WELL FILING gRQiiS"t wA
1114 SECIj
PERMIT NUMBER 373 77 __ jCOLORADO
STATE OF COLORADO ) WELL LOCALTa EPIC".
C�am-�� SS
COUNTY OF d'- ter, `` ) ���� ��� County
Know all men by these presents: That the undersigned ,th/ 7 oft/ sec. �/
�c� —re—;/l Jo�d T. //1 R. ‘ P.M.
claimant(s),_. 40_ 42,,c4_.
whose address is ,/
r� / INDICATE WELL LOCATION ON DIAGRAM
City/A L ket61O/ ,states: NORTH
I t I
Claimant(s) is (are) the"owner(s) of the well described hereon; I I I
i I
the total number of acres of land to be irrigated from this well —I I
i I
is__ ; work was comm ericed an this well by actual con- of I I 4 m u
L !� I —I m
struction_ 6 day of _,19 f I I I VII I_ _
the yield to be used from said well is 7°~ (gpm), for —+ I I
^��l; ' I
which claim is hereby made for 07?ZG¢rvrposes; I I
that the average annual ,amount_.of water to be diverted is SOUTH
—._ acre-feet; and that the aforementioned WELL SHALL BE LOCATED WITH REFERENCE
TO GOVERNMENT SURVEY CORNERS OR MON-
statements are made and this map and statement are filed in UMENTS, OR SECTION LINES BY DISTANCE
AND BEARING.
compliance with the laws;"..-
ft. from section line.
X (North or South)
Claimant(s) - ft. from - section line.
Subscribed before me on this _ day of (East or West)
-- — 19
Ground Water Basin
My commission expires -
Water Management ,
Notary Public - --- District
WELL_ DATA Domestic wells may be located by the following:
r
Date Completed li0 /�� 9 LOT BLOCK
Static Water Level s�b SUBDIVISION
Total Depth 72 FILING p
ACCEPTED FOR FILING IN THE OFFICE OF THE STATE ENGINEER OF COLORADO ON THIS
DAY OF , 19
State Engineer
:ORM TO BE MADE OUT IN QUADRUPLICATE: WHITE FORM MUST BE AN ORIGINAL COPY ON BOTH SIDES AND SIGNED.
'HITE copy & GREEN copy, must be filed with the State Engineer within 30 days after well is completed. PINK copy
for the Owner & YELLOWi-edpy is for the Driller.
I
WELL LOG WELL DATA .
From To Type of Material Water
Loc. Type Drilling '
3 AUynidJ HOLE DIAMETER:
3 qaqu ��� 7 in. from /0 ft. to 4.0 ft.
ao a 3/ ��� 1 C in. from G0 ft. to 73 ft.
a5 ,i3 in. from ft. to ft.
43 V5 ' ter;��' "d CASING RECORD
? /5'- S3—.° Cemented from X
6-sa Go O �� Plain Casing
ha Gs" „� ,e,, ,, Size(4. kind ,eli from O ft. to Yi ft.
eS ' 70 47,40,alh Sizes, kind((// from ? / ft. to 6l ft.
70 73 `%�y 0-in al Size_, kind from ft. to ft.
Perforated Casing
Sized—, kind 93c4„from ,/ ft. to 7.7 ft.
V
Size) kind from ft. to ft.
Size , kind from ft. to ft.
TEST DATA
Date Tested a— ey
Type of Pump
Length of Test
Constant Yield /3
Drawdown 1/4)
WELL DRILLERS STATEMENT
being duly sworn, deposes and says:
he is the driller of the well hereon
described; he has read the statement
made hereon; knows the content there-
of, and the same is true of his own
knowledge.
roxigif gYL-)
Use additional paper if necessary to complete log. X
License/ iffl
^Tate of Colorodo, County of ) ss
Subscribed and sworn to before me this day of_ , f9__
My Commission expires_ , 19 .
Notary Public
THE LOCATION OF THE PROPOSED WELL SHALL BE SHOWN ON THE DIAGRAM BELOW WITH
REFERENCE TO SECTION LINES OR GOVERNMENT SURVEY CQRNERS OR MONUMENTS.
feet from (North or South) section line
feet from (East or West) section line
IF WELL iS FOR IRRIGATION, THE AREA TO BE IRRIGATED MUST BE SHADED OR CROSS-HATCHED.
This diagram represents nine (9) sections. Use the CENTER SQUARE (one section)
to indicate the location of the well .
I
I , , , I
- + - + - + - + - + - + -
I I I I I I
- + - + - + - + - + - + -
I ! I t I I
- + - + - + - + -
N
I I I I I ly
2
- + - + - ilf
+ - +
I I - M i I -
- 4 - + - + - + - + - + -
I I I I I I
•
•
- + -I- - + - + - + - + -
I
I I I I I
•
THE SCALE OF THE DIAGRAM IS TWO INCHES EQUALS ONE-MILE
. 0 0
I"Isr:'4O6F' Tr,+i:)I'.,ID(.JAL.. SEWAGE DISPOSAt.. SYSTEM PERMIT NO.. G-@(:39090
oi- 4 .rk WELD COUNTY HEALTH DEPARTMENT - NEW PERMIT
c1.01-465 0V ' ENVIRONMENTAL HEALTH SERVICES
1,�� II.A ��,w..`` i 546 HOSPITAL ROAD .D , (;REELI::Y . CO 906313i
MA.. f ✓ - 35:i•••O635 :XT ..''.....'.5
.JwNEk. .MAY , RALPH 6, BARBARA BARA ADDRESS 2027 WOR 39 H : ::iii;" 3:;6... 7E
2731 • 00000
PROPOSED ,.,. . .y ...r 't
3f it".L-..�.:. [l I' SYSTEM"T t.i�i :.'..� �,,, ;F: ' 9 _
01000
...EGAI_. DESCRIPTION OF SITE : ?'-: : NE4 SEC 10 Tt4::. • t RNG. .,'
iU1BDIVISIflN : AF'i-'OI...LO L.tH 6 BLOCK r.:1 FILING 0 •
iWtii_. TYPE : RESIDENTIAL
.RVICE_S : PERSONS 2 BATHROOMS 100 LOT SIZE 9 ,60 ACRES
BEDROOMS a' BASEMENT PLUMBING OD ,,,i'.T(-:R rtUi'PL'Y i:°WEL..i..
•
Pi::.i_ICA'TI(:!N FEE $0 .o -
C::C ' D BY C:OJF(''EY . Dlr"NNE SIGNED BY RALPH MAY
Wi ': OS/24/08 DATE t;:�8 2
.. fir,
'E Il l_:.1_F:1 ! I i,i J RATE 0.0 I'I J-1'Q P E.R INCH EiMiTiG ti.U •t t.. i,'1 i•.'..._
...0/L F'i:: SUITABLE PERCENT GROUND SLOPE OX' DIRECTION
F::Q i_i;f l•S ENGINEER DESIGN NO
ROM THE APPLICATION INFORMATION SUF'I''I...:'iI:_D AND THE ON-SITE SOIL PERCOLATION *j. O,
It'll:: EOLLOWING M:I:ia!]:MUM INSTALLATION :P::..(:'I 3:CAT'•:lri:ti ARE:: Ri::•9!l.;:f'tF::i`, :
SEPTIC TANK 1000 GALLONS ,, ABSORPTION ..::NCH SQ. FT.. ..
CiR
EQ....BED 1000 �..T.,
,? )DIE fl:ON . THIS PERMIT :r. :;:;p jE_( '.j. TOii.ABSORPTIONFOLLO,,.JIi; r`1I)nI IONAt_ T'ERi'L AND
.:Ur; `.t: rTONS • ......._._._____._...___•_•____.._.__._._._......._.._... ..._.._..._... .._.._ __. ._.._.....____............._..__.�...._. ____.................................
'i-ITS PERMIT is GRANTET. TEMPORARILY TO CONSTRUCTION 1.,,
'1""r.: i F�AF.'1'I._'Y � ('J� . f'' ,''f; COMMENCE.i i7cNf".;;... 'T ,.:. PERMIT
...
lA'Y ICE REVOKED OR SUSPENDED BY THE WE?..r COUNTY YHEALTH ' ,:.r..:a REASONS,
(..NT' i1:... . .RT'i'�f:_r�IT FOR ,•. ..!�.,,(.1t•.Et' ,�:'::•;• .
ORTH IN THE WE:L.D COUNTY INDIVIDUAL SEWAGE DISPOSAL SYSTEM REGULATIONS INCLUDING
:'A1:Li.ii' E TO MEET ANY TERM OR CONDITION IMPOSED THEREON DURING TEMPORARY OR FINAL
1F'F'F'OVAL.. THE ISSUANCE: OF THIN PERMIT DOES NOT CONSTITUTE IiS.:;(.li°iPT3:(:TN n' THE
)r=:F'�''1r.TIIFt•:i•T' OR ITS EMPLOYEES ES OF LIABILITY FOR THE FAILURE i'1F? INADEQUACY OF THE
;'SWAGE DISPOSAL SYST'FM:. .
X STAFF 03/24/O0
ENVIRONMENTAL... SPECIALIST DATE:
HIS PERMIT IS. NOT TRANSFERABLE AND HAL_.I... BECOME: VOID IF SYSTEM CONSTRUCTION T'ION i'ir::,.y:
401 COMMENCED WITHIN ONE YEAR OF I'i. ISSUANCE . BEFORE ISSUING FINAL APPROVAL or
'HIS PERMIT THE WELD COUNTY HEALTH DEPARTMENT RESERVES THE RIGHT TO IMPOSE ADDT....
'T@NAL TERMS AND CONDITIONS REQUIRED TO MEET OUR REGULATIONS .1N A CONTINUING B,•a•...
ZIS. . FINAL PERMIT APPROVAL :i:S CON'T'INGENT U.11'UN THE FINAL TN;'F'L(:'TIOU OF THE C(':?M._
'LETED SYSTEM BY THE WELD COUNTY HEALTH DEPARTMENT.
'YS"('EM INSTALLER UNKNOWN ED.,!r::,;._ INSPECTION DATE 02/24/@3
YSTEM ENGINEER APPROVAL_ X STAFF
:YF'E OF SYSTEM INSTALLED TANK E:NVIFCONMENTAL.. SPECIraI....t.ST
:HE ISSUANCE: OI,• THIS PERMIT DOES NOT IMF:'i...Y COMPLIc-40CE WITH OTHER STATE . COUNTY
NVNSICAL REGULATORY OR W.;ILDINC'T REQUIREMENTS. NOR SHALL TT :=CT iiJ cI_:Ri':i:FY THAT
IPA =,'IJT:,.J(:(:;'i" SYSTEM WILL OPERATE IN COMPLIANCE WITH APPL...TC11T:si._E STATE , COUNTY idJ()
_O1:Al._ REGULATIONS ADOPTED F'f. RS(.Jr'1NT T 1. r` k T':i:(::I...I 10 , TITLE 25 . CRS 1973 . AS AN ENDED .
.
.:XCr:r r FOR THE PURPOSE_ OF rS A1:II...I HING FINAL APPROVAL OF AN INSTALLED L) SYSTEM M . :.iit
:SSIJAN(_:E OF i I...00AL.. OCCUPANCY PERMIT PUt::'NUANT TO CPS 4973 ;,5....i 0....:1 i 4 2:)
IRIGINA!...... „I':.1::•'1 1CA �,:
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I-ISP1 06P INDIVI / lAt... SEWAGE DISPOSAL... SYSTEM PERMIT NC). G-660307
WELD COUNTY HEALTH. DEPARTMENT • NEW PERMIT
oris o, l,I lva ENVIRONMENTAL HEALTH SERVICES
U1C`- 1w" 1 .516 HOSPITAL. ROAD . GRt ELEY , CO 80631
AN'_:(;: HAY , RALPH E. . BARBARA ADDRESS 2827 WC;R :39
BRIGHTON CO is 0; (s1
)DDRESS OF PROPOSED OSIE-I,' SYSTEM 2827 WCJ :39 •
BRIGHTON CO 60601
..I: r7i!_. DESCRIPTION OF SITE : NE4 SEC 19 TWI"-' 1 RNt:; 61
:UDD:I:VIS.i:ON : APOLLO LOT 6 BLOCK 0 FILING 0
JSE TYPE : RESIDENTIAL
ERV ICE:: : PERSONS 2 BATHROOMS :3 .0() LOT SIZE 20.00 ACRES
BEDROOMS 3 BASEMENT PLUMBING NO WATER SUPPLY PWE:L.L..
iF'PLICATION FEE $0.00
..:F C:: ' o BY X STAFF SIGNED BY RALPH E. MAY
DATE 3%07/f.e DATE 03/07/66
•ERC OLA :(ON RATE:: ?0.0 MIN PER INCH LIMITING .ONE: 0 FEET
•
'(7J:1... TYPE: SUITABLE ABI...E:: PERCENT GROUND SLOPE r. DIRECTION '
:EG'IJIRES ENGINEER DESIGN NO
'ROM "i"Ht. AF'F'I...ICAT•ION, TNF•URMAI J:UN SUPPLIED I) AND THE ON—SITE SOIL_ PERCOLATION DATA
'HE FOLLOWING MINIMUM INSTALLATION SPECIFICATIONS ARE:: REQUIRED :
SEPTIC TANK 900 GALLONS . ABSORPTION TRENCH SQ FT.
OR
ABSORPTION BED 630 SQ. FT.
i'1 " )DITI(:ti.l , THIE PERMIT IS SUBJECT TO THE FOLLOWING ADDITIONAL TERMS AND
ilti-umu.; : _____________________.__.._....._.__.._.____._._.........._._...__..__..._..._._._._._.._._
"iilS PERMIT IS GRANTED TEMPORARILY TO ALLOW CONSTRUCTION TO COMMENCE. THIS PERMIT
ittY BE REVOKED OR SUSPENDED BY T1-11:: WELD COUNTY HEALTH T H DEPARTMENT nor.. REASONS S1.1
•ORTIT IN THE:: WELD COUNTY INI):EVIDUAL_. .SEWAGE: DISPOSAL SYSTEM REGULATIONS INCLUDING
A::LURE: TO MEET ANY TERM OR CONDITION IMPOSED THEREON DURING TEMPORARY OR FINAL
,F'F'F 1)VAl_. . THE ISSUANCE: OF THIS PERMIT DOES NOT CONSTITUTE ASSUMPTION BY THE:
.(:IARTMENT OR ITS EMPLOYEES OF LIABILITY FOR THE FAILURE OR INADEQUACY OF THE
EWAGE DISPOSAL SYSTEM.
X STAFF 03/07/6£3
ENVIRONMENTAL_ SPECIALIST DATE
HIS PERMIT IS NOT TRANSFERABLE AND SHALL BECOME VOID IF SYSTEM CONSTRUCTION HAS
OT COMMENCED D WITHIN ONE: YEAR .OF ITS ISSUANCE. BEFORE ORE ISSUING FINAL APPROVAL OF
I-II.S PERMIT T"HE. WELD COUNTY HEALTH DEPARTMENT RESERVES THE RIGHT TO .DEPOSE. ADDI-
I9NAL 1ERMYi,, AND CONDITIONS REQUIRED TO MEET OUR REGULATIONS ON A CONTINUING BA-
TS. FINAL PERMIT AlF'RO'vAL IS CONTINGENT UPON THE. F":I:NAI... INSPECTION OF THE: (.:OM
LETED SYSTEM BY THE: WELD COUNTY HEALTH DEPARTMENT. •
'(STEM INSTALLER UNK1OWN FINAL INSPECTION DATE 03/07/68
YSTEM ENGINEER APPROVAL X STAFF
YPE. OF SYSTEM INSTALLLED TANK ENV:IRONMENTAL.. SPECIALIST
HE ISSUANCE OF THIS PERMIT DOES NOT IMPLY COMPLIANCE: WITH OTHER STATE . COUNTY
RALOCAI._ REGULATORY Or: 1till._I)]:N( REQUIREMENTS . NC'i SHALL IT ACT TO CERTIFY THAT
i UB._JECT SYSTEM Will OPERATE: IN COMPLIANCE WITH APPLICABLE STATE . COUNTY AND
OCI_. REGULATIONS ADOPTED PERSUANT TO ARTICLE 40 . TITLE 25 , CRS i973 . AS AMENDED .
XCE:PT FOR THE PURPOSE OF ESTABLISHING FINAL APPROVAL OF AN INSTALLED SYSTEM FOR
SS(—LANCE OF A LOCAL. OCCUPANCY PERMIT T PURSUANT TO CRS 1973 25-10-111 (2) .
• .•a..r'`AI.....Al::P1.., t r::r'td'T : r;Iip'r—j.irI-Io
.. I.I;., n....I' WS f•.'ti 400A
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