HomeMy WebLinkAbout20053584.tiff wan
II
wan 0
Left Hand Water District
June 6, 2005
Jim Sutton
5557 Aspen Ave
Re: 85 CR B2 L2
TO WHOM IT MAY CONCERN:
The property located at the above address or legal description is within the
"SERVICE AREA" of Left Hand Water District. The tap fee for the above
named property has been paid. This entitles one living unit to receive
water service at this location.
If you have further questions regarding this matter, you may contact me at
the District office.
Sincerely,
Kim Lane
Administrative Assistant
2005-3584
Left Hand Water District
PO. Box 210 Niwot, Co 80544-0210 ni Phone 101-510-4200 r, Fax 901-510-5252 www.lefthandwater.dst.co.us
- j a — ° [ elC)OO�c
' -- ll I4V
74/
DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
1555 N 17TH AVE
GREELELEY, CO 80631631 WEBSITE: www.co.weld.co.us
ADMINISTRATION (970) 304-6410
FAX (970) 304-6412
'IN ige. PUBLIC HEALTH EDUCATION AND NURSING (970) 304-6420
FAX (970) 304-6416
COLORADO ENVIRONMENTAL HEALTH SERVICES (970) 304-6415
FAX (970) 304-6411
January 24, 2001
Jim and Sherrie Brotzman
1143 Washington Street
Denver, Colorado 80203
RE: Jim and Sherrie Brotzman ISDS No.: 01-005
Permit No.: SE-010006
Dear Mr. and Mrs. Brotzman:
On January 9, 2001, an evaluation of the existing individual septic disposal system at 5557 Aspen
Avenue, Erie, Colorado; Section 5, Township I North, Range 68 West, was conducted by Pam Smith,
an environmental specialist of this department.
The existing individual septic disposal system is of sufficient size and capacity to adequately handle
the proposed load. This evaluation is based on a final treatment capacity for a 3 bedroom residence.
The direction of the absorption field is unknown. There were no visible signs of failure at the time of
inspection.
Be advised, neither the County of Weld nor any of its agents or employees undertake or assume any
liability to the owner of the above property, to any purchaser of the above property or to any lending
agency making a loan on the above property or in the report.
This inspection was conducted for the purpose of determining compliance with current regulations and
for detecting health hazards observable at the time of inspection. This does not constitute a warranty
that the system is without flaw or that it will continue to function in the future. Inspections requested
during periods of snow cover and high soil saturation may be of questionable value to potential buyers
due to adverse conditions. Evaluations based on Statements of Existing (S.O.E.) relies on information
the property owner provides, under oath, indicating current status of the system and representing to the
best of his/her knowledge the system is not failing to function properly.
If we can be of any further assistance, please contact our office at(970) 304-6415.
S'ncerely,
i
Environmental Health Specialist
f'S/rb-I402
Enclosure
cc: Weld County Department of Planning
WELD COUNTY DEPARTMENT OF PUBLIC SE# 0I UUU UW
, HEALTH AND ENVIRONMENT ORG PERMIT#
". i N. 17TM AVENUE REPAIR#
1 GREELEY, COLORADO 80631 LOAN#
IIIDc PHONE: (970) 304-6415 ISDS# o -00g
FAX: (970) 304-6411
JOLORADO STATEMENT OF EXISTING FOR SEPTIC SYSTEM
(PLEASE FILL OUT IN BLACK INK ONLY)
PARCEL# /y52:/D 200J
PROPERTY OWNE - 'n ,4 niu�L PHONE NO.C (�3) ���j r���
MAILING ADDRESS///t/3 6-16-a--4-4,t et --J.,--- J-1' # 1-- L' NJe1 Y 5-4:5)-O 3
G City State Zip
DESCRIPTION OF BUILDING (ex.6ouse7nobile/modular home,shop,office)
SITE/LOCATION ADDRESS ,5-5757 L (fzc 2 th SOfI s
City State Zip /
LEGAL DESCRIPTIOx PT PT SECTION S- TOWNSHIP / RANGE 6 o
SUBDIVISION C&'Lr cc4r.ri31t_J LOT 2- BLOCK .2— FILING
CENCUS TRACT 70 LOT SIZE/ACRES ze 1-
COMMERCIAL YES/NO RESIDENTIAL YES/NO
NUMBER OF PERSONS BASEMENT PLUMBING YES /NO
BEDROOMS) BATHROOMS FULL 9 3/4 in WATER SUPPLY PUBLIC YES NO UTILITY NAME I a //�'I/�
"`c`k4
PRIVATE YES/NO CISTE S/NO WELL YES/NO WELL PERMIT#
SYSTEM SIZE: Septic tank material is constructed of(116-i.,(°,,fQT/ and has 7/700 gallons capacity.
FIELD: Trench square feet or Bed ,JO )C.57) square feet YEAR INSTALLED 3 CZ Ad C y�
/%7/
You are required to draw a diagram of the system on the re side of this form in black ink only and indicate
location,length,width,and distance from the dwelling.
The undersigned property owner hereby certifies that the above described septic system is in fact installed, as
described, and exists at this time on the parcel of ground identified by the above legal d cription and further states
that the syste is no in good working order and to the best o ,er knowledge i is no ailing to function
properly. ..1.11.., .....46
I further understand that any falsification or misrepresentation may result in revocation of any permit granted based
upon this information hereby submitted and in le al action for perjury as pr vided by law.
/ 7o7
OWNE
5' 2-027
Subsc 'bed and swor3 to'b"ef.or�e me this day o t�
by ........n.,— bitc} pro—try
V
Witness my hand and official seal. M commiss�io� expires: /7/.71-00
/ 470 r ( /I. . '-
DATE NOTY PUBLIC
STATEMENT OF EXISTING REVIEWED BY
ENVIRONMENTAL HEALTH SPECIALIST
. N:...\\--....
;lc.
~ .Crcc.d.2_
--41 r..74- •
, .2. 1 .
WELD Cr-INTY DEPARTMENT OF PUBLIC ^ SE# L) DOOO(Q
CHEALTH . ..JO ENVIRONMENT ORG PERMIT#
1555 N. 17TM AVENUE REPAIR#
GREELEY, COLORADO 80631 LOAN#
PHONE: (970) 304-6415 ISDS# 61 OOr,FAX: (970) 304-6411
coLOEADO STATEMENT OF EXISTING FOR SEPTIC SYSTEM
(PLEASE FILL OUT IN BLACK INK ONLY)
ARCEL# i y pi/U 2.GO� t. _ 7/ROPERTY OWNER ��""..1-4,/k..-1.2 �/o�r f.4*-...._ PHONE NO. (�3) '- e' /�3
(AILING ADDRESS //1/3 (,v(c 4iStr # 2-- /s1 -i (v x'O)-O3
City ESCRIPTION OF BUILDING (ex.6ouse mobile/modular home,shop, office) State Zip
fTE/LOCATION ADDRESS 557-57 62, (ice C- 47 ev 1°j/‘
EGAL DESCRIPTIO PT % City State 51°1/4)
Zip /
PT SECTION ,S TOWNSHIP 7 RANGE 6r
SUBDIVISION aA-4,44.6 (5vt f LOT 7- BLOCK Z FILING
ENCUS TRACT 2c LOT SIZE/ACRES .o - -
OMMERCIAL YES/NO RESIDENTIAL YES/NO
UMBER OF PERSONS BASEMENT PLUMBING YES/NO
..DROOMS 3 BATHROOMS FULL 9 3/4 1/2
ATER SUPPLY PUBLIC YES NO UTILITY NAME �r Iw e..('U 9;1;476z.e.clield
2IVA YES /NO CISTE S /NO WELL YES/NO WELL PERMIT# /
'STEM SIZE: Septic tank material is constructe r
and has /ljCrQ gallons capacity.
ELD: Trench square feet or Be are AiR INSTALLED 30 e'Giy c
uu are required to draw a diagram of the system on the rev r isle s for in black ink only and indica7`7te
•ation, length, width, and distance from the dwelling. L
ie undersigned property owner hereby certifies that the above described septic system is in fact/nstalled,as
scribed, and exists at this time on the parcel of ground identified by the above legal description and further sta
it the syste is s not in good working order and to the best o hi her knowledge is failing to function
nperly. .41-**" �s no��
L-7 ate-7z
urther understand that any falsification or misrepresentation may result in revocation of any permit grant
on this information hereby submitted and in le al action for perjury as prided by law.
Li— /6/ " 4 .
.TE I OWNER
7edandnbthNmetb55 daytness my hand and official seal. M commissio expires: / ]/��(J
TEl �� o /
NOT Y PUBLIC /
/
%TEMENT OF EXISTING REVIEWED BY
ENVIRONMENTAL HEALTH SPECIAJ
Hello