HomeMy WebLinkAbout20080698.tiff • •
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,{{ , DATE 4A'ING -READING
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2008-0698
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PETITION FOR INCLUSION
• STATE OF COLORADO )
)ss
COUNTY OF WELD )
CENTRAL WELD COUNTY WATER DISTRICT
TO: THE BOARD OF DIRECTORS OF THE CENTRAL WELD COUNTY WATER
DISTRICT
I/we,being all of the owners of the below described real property,which property is capable
of being served with the facilities of the aforesaid District hereby petition the Board of Directors of
said Central Weld County Water District to include the below described real property within the
boundaries of said District.
Assent to the inclusion of such property is hereby given by the below signers, which signers
constitute all of the fee owners of said below described property.
Lot A of Recorded Exemption No. 0961-33-1 RE-3880, recorded October 5, 2004 at
Reception No. 3224845, being a part of the NE '/, of Section 33, Township 5 North, Range
65 West of the 6th P.M., Weld County, Colorado.
• Dated this 3 ) day of h'1CA-t} ,20 bs .
e ccavt-- Tpit-twct_
B�Luster JoNne F. Luster
STATE OF COLORADO )
)ss
COUNTY OF WELD )
The foregoing Petition was acknowledged before me this 3/ day of
, 20 OSby , hiuoo ' i n ct .: )6,,,s_
Witness my hand and official seal, cf. ) )'
Not Public
My commission expires: c,e)1
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r WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
1555 NORTH 17TH AVENUE
GREELEY, COLORADO 80631
• PHONE (970) 304-6415 FAX (970) 304-6411
Permit #: SP-0500026 Sec/Twn/Rng: 33-05-65 PERMIT
Owner: LUSTER BRAD & JOLENE • Applied:01/27/2005
Applicant: LUSTER JOLENE
Permit Type: RNEW C=Commercial,R=Residential + NEW,.kEPair,VauLT JioIc — 38/-t'/19
Parcel #: 0961-33- - -
330 4957
Location: 24505 WCR 43
Legal Desc:
Description: HOUSE
Commercial: N Residential:Y Acres: 13
# of Persons: 4 Basement Plumbing: N
# of Bedrooms: 3 Bathrooms - Full: 2 3/4: 0 1/2: 1
Water Public: Y Water Source: CWCWD
Water Private: N Cistern: N Well: N Well Permit Number:
Percolation Rate ,, Limiting Zone ;, ft o in Description (,2o"yr)../A--z-e
% Ground Slope - Direction — Soil Suitable (Y/N) tJ
Engineer Design Required (Y/N) v In 100 Year Flood Plain (Y/N) N.J.
From the application Information supplied and the on-site soil percolation data the following minimum installation specifications are required:
Optic Tank ocx, gallons, Absorption Trench sq ft or Absorption Bed sq ft
Chambers: Infiltrator or Hancor Standard or Hi-Capacity, EQ36 or BioDiffuser Trench Bed 5>
Infiltrator Quick4 Trench Bed
Hancor Narrow (l5in) Envirochamber Trench Bed
In addition, this permit is subject to the following additional terms and conditions:
aor �A1(=ciYcL.,- Cood rnx-iirn
NOTICE
This permit is granted temporarily to allow construction to continence. This permit may be revoked or suspended by the Weld County
Department of Public Health and Environment for reasons set forth in the Weld County Individual Sewage Disposal System
Regulations including failure to meet any term or condition imposed thereon during temporary or final approval. The issuance of this
permit does not constitute assumption by the department or its employees of liability for the failure or inadequacy of the sewage
disposal system. This permit is non transferable and non refundable. Before issuing final approval of this permit the Weld County
Department of Public Health and Environment reserves the right to impose additional terms and conditions required to meet our
regulations on a continuing basis. Final permit approval is con-it em upon final son of the completed system by the Weld
l
Counry Department of Public Health and Environment. R 1 /�)J'fr-
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turn, i PERMITN 1`l Environmental l Health Specialist (—At 'Date
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