HomeMy WebLinkAbout20051465.tiff ) -r LASE RETURN TOP PORTION WITH YOUR PAYMENT- )
ATTENTION-NEW RATES NEWSLETTER UPDATE-As required by State Statute,the
WILL BECOME EFFECTIVE District Board adapted new Director District boundaries
FEBRUARY 1,2004 January 15,2004 to ensure equitable representation of
voters. Please call or stop by our office for a free map and
legal description or other election Information
LEFT HAND WATER DISTRICT
P.O. BOX 210 N ' (�
NIWOT, CO. 80544-0210 f eJ V
(303) 530-4200 .4030
www.lefthandwater.dst.co.us
ACCOUNT NUMBER DATE BILL MAILED SERVICE SERVICE T NUMBER DUE DATE
FROM TO OF DAYS
2996.01 + 01/31/2004 12/29/2003 01/28/2004 30 02/21/2004
PREVIOUS READING PRESENT READING UNITS USED DESCRIPTION I AMOUNT UUF
2,541 2,546 5,000 Last payment received 01/12/20114 37.80 C
!f ,
.00
3 — — — — — -- WATER BASIC FEE 15.00
WATER USAGE 13.05
10000 ACTIVATION FEE ,00
0 —I n I y () „IL I I , FM I1 SHUTOFF CHARGE .00
Feb MN Apr May Jim Jul Aug Sep Od Nov Dec Jan MISCELLANEOUS .00
—, --
Water i1000 oal)
SERVICE ADDRESS ► 4652 PEAK VIEW ST TEAL AMOUNT 1 P8.05
Ix t.
Yuu, Mite, Usage Rate is.300 Please see Rate Table lkw. - -n
IMPORTANT INFORMATION
300 Residential
N 310 Commercia_I 320 Multiple Housing 330 Dual System
p 1st 4,000 2.45/th All Usage 3.70/th AN Usage 3.70/th 1st 4,000 2.45/th
Cin Next 16,000 3.25/th Next 8,000 3.251th
-II
Next 30,000 4.10/th Over 8,000 11.20Ith
Over 50,000 5.10/th
See Reverse Side for Important Information
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) -PLEASE RETURN TOP PORTION WITH YOUR PAYMENT-
LEFT HAND WATER DISTRICT
P.O. BOX 210
NIWOT, CO. 80544-0210
(303) 530-4200
www.lefthandwater.dst.co.us
ACCOUNT NUMBER DATE BILL MAILED SERVICE SERVICE NUMBER1 DUE DATE
_ACCOUNT
nn.y �{} FROOMQ TO I OF DAYS
PREVIOUS READING �REpp}NU � USEb DESCRIPTION AMOUNT DUE
1,878 1,882 14,000 Last payment received 05/17/20 147.84 CR
If your present reading is a 0,your account was estimated.
.00
WATER BASIC FEE 16.30
WATER USAGE 44.22
ACTIVATION FEE .00
SHUTOFF CHARGE .00 )
00 MISCELLANEOUS .00
SERVICE ADDRESS ► TOTAL AMOUNT
4702 PEAK VIEW ST DUE ► 60.52
our Water Usage Rate is: 300 See Tab1108618WANT INFORMATION
300 RESID NTIAL 330 DUAL SYSTEM Ste COMMERCIAL.
Mr 4,000 2.88 1st 4,000 288 3.70 ALL USAGE 4003
Next 16.000 3.35 Next 6,000 3.36
' Next 30,000 4.10 Over 12.000 5.60 320 MULTtpLE HOUSING --
—
Over5p,000 5.24moo
3.70 ALL USAGE Kw WATER HOW GAL)Over
Jun Mg Sep Oct 6ac Tar Feb Ilar� lIp WV
See Reverse Side for Important information
WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
1555 NORTH 17TH AVENUE
GREELEY, COLORADO 80631
PHONE (970) 304-6415 FAX (970) 304-6411
STATEMENT OF EXISTING SEPTIC PERMIT
Permit#: SE-0400095 Sec/Twn/Rng: 09 01 68 PERMIT
Owner: LAFFERTY MICHAEL E Applied: 07/21/2004
Applicant: LEASE CHAD
Parcel #: 1467-09-1-02-008
Location: 4702 PEAK VIEW, ERIE CO 80516
Legal Desc: SA-8 PT L8 SCOTTS AC RES DESC AS BEG NE C
OR SEC 9 1 68 W680'
Description: HOUSE
Commercial: N Residential: Y Acres: 3.53
#of Persons: 1 Basement Plumbing: N
#of Bedrooms: 2 Bathrooms - (Full): 1 (3/4): 0 (1/2): 0
/ater Public: Y Water Source: LEFT HAND WATER DISTRICT
Water Private: N Cistern: N Well: N Well Permit Number: N
Septic Tank: 500 Tank Material: CONCRETE
Absorption Trench: 0 sq. ft.
Absorption Bed: 1000 sq. R. Year Installed: 1970
NOTICE
The property owner/agent has certified by Notary Seal that the above described septic system is in fact installed as described,and
exists at this time on the parcel identified above by the parcel number and/or legal description,and further states that the system
IS/IS NOT in good working order and to the best of his/her knowledge IS/IS NOT failing to function properly.
The property owner/agent further understands that any falsification or misrepresentation may result in the revocation of any permit
granted based upon this information hereby submitted and in legal action for perjury as provided by law.
The Statement of Existing Record relies on information the property owner or his/her representative provides,under oath,indicating
current status of the system and representing to the best of his/her knowledge that the system IS/IS NOT failing to function properly.
Issuance of the Statement of Existing Permit for any system does not consti to assumption that the site was evaluated or inspected
during any phase of construction by this Department to meet regulations,
7-11-6
x i
environmental Health Specialist Date
Form:S_EXIST
WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
1555 NORTH 17TH AVENUE
GREELEY, COLORADO 80631
PHONE (970) 304-6415 FAX (970) 304-6411
STATEMENT OF EXISTING SEPTIC PERMIT
Permit#: SE-0400072 Sec/Twn/Rng: 09 01 68 PERMIT
Owner: LEASE CHAD Applied: 05/25/2004
Applicant: LEASE CHAD
Parcel#: 1467-09-1-02-007
Location: 4652 PEAK VIEW , ERIE I-25 SOUTH TO HWY
Legal Desc: SA-8A PT L8 SCOTTS A CRES DESC AS BEG NE
COR SEC 9 1 68 W680'
Description: HOUSE
Commercial: N Residential: Y Acres: 3.83
# of Persons: 3 Basement Plumbing: Y
#of Bedrooms: 3 Bathrooms - (Full): 2 (3/4): 0 (1/2): 0
Water Public: Y Water Source: LEFT HAND
^Vater Private: N Cistern: N Well: N Well Permit Number: N
Septic Tank: 500 Tank Material: CONCRETE
Absorption Trench: 0 sq. ft.
Absorption Bed: 250 sq. ft. Year Installed: 1968
NOTICE
The property owner/agent has certified by Notary Seal that the above described septic system is in fact installed as described,and
exists at this time on the parcel identified above by the parcel number and/or legal description,and further states that the system
IS/IS NOT in good working order and to the best of his/her knowledge IS/IS NOT failing to function properly.
The property owner/agent further understands that any falsification or misrepresentation may result in the revocation of any permit
granted based upon this information hereby submitted and in legal action for perjury as provided by law.
The Statement of Existing Record relies on information the property owner or his/her representative provides,under oath, indicating
current status of the system and representing to the best of his/her knowledge that the system IS/IS NOT failing to function properly.
Issuance of the Statement of Existing Permit for any system does not constitute assumption that the site was evaluated or inspected
during any phase of construction by this Department to meet regulations.
Environmental Health Specialist Date
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