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Home My WebLink About20060074.tiff r;..i .;.I.h r-i l.......i.a! I"L..r.l.. !.:l.!i.., .... H:; — 1 0—Eh,: i i:7..i,, i 1 2006-0074 ..., P106F' INI):I:V:I:DUAL.. SEWAGE DIS1P'OSAI... SYSTEM PERMIT NO.. G-899057 WELD COUNTY I--IEAL-TI•I DEPARTMENT NEW PERMIT ENVIRONMENTAL HEALTH I SERVICES 1 '516 HOSPITAL ROAD, GREELEY, CO ,30631 353-0635 I:::x•r. :.7•-7•-7,:; OWNER RASMUSSEN, MARYANNE B. ADDRESS 2400 ,JASPER ROAD F'£-I (:` 03 ) 443-59 BOULDER CO £30304 ADDRESS OF PROPOSED SYSTEM 7019 WCR 5 ERIE: CO 80516 LEGAL. DESCRIPTION OF SITE : 52 SE4 SEC 29 T•WP 2 RNC; 68 SUBDIVISION : I...(:31 (•) BLOCK 0 FILING 0 USE TYPE : RESIDENTIAL LOAN APPROVAL 0£30---£39 SERVICES : PERSONS 2 BATHROOMS 1 . 00 LOT SIZE 1 .09 ACRES BEDROOMS 2 BASEMENT PLUMBING NO WATER SUPPLY LFTiu) APPLICATION FEE *0.00 RE:( ' D BY RECEPTIONIST AID SIGNED BY MARYANNE B. RASMUSSEN DATE 05/30/89 DATE 05/30/89 PERCOLATION RATE 0. 0 MIN PER INCH I...:I:M:I:T:I:NG ZONE 0 FEET SOIL. TYPE:: SUITABLE PERCENT GROUND SLOPE 0""/ DIRECTION REQUIRES ENGINEER DESIGN NO FROM THE APPLICATION INFORMATION SUPPLIED AND THE ON-SITE E 'O:I:I... PERCOLATION DATA T)"'* FOLLOWING MINIMUM INSTALLATION SPECIFICATIONS IONS AlE::: REQUIRED : SEPTIC TANK ,:300 GALLONS, ADSORPTION TRENCH EQ . FT. OR ADSORPTION BED SQ. FT. IN ADDITION, THIS PERMIT IS SL.IB..1ECT• TO THEE FOI...I...OW:I:NG ADD:I:T:CONAL.. TERMS AND CONDITIONS : ___.............................................. _....._.._.__...__......_......_._......_._.._ THIS PERM:I:T IS GRANTED TEMPORARILY TO AL..I_.C)W CONSTRUCTION TO COMMENCE:. •rl••I:I:S PERMIT MAY BE REVOKED OR SUSPENDED DY THE: WELD COUNTY HEALTH DEPARTMENT FOR REASONS SET FORTH IN THIN WELD COUNTY 1:NDIVIDUAI... 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 (:)r THE SEWAGE DISPOSAL SYSTEM. X STAFF 05/30/09 ENVIRONMENTAL SPECIALIST :DATE THIS PERMIT IS NOT TRANSFERABLE ANI) SI-IAL.1... BECOME VC)ID IF SYSTEM CONSTRUCTION HAS NOT COMMENCED WITHIN ONE YEAR OF ITS ISSUANCE. DE FORE ISSUING FINAL_ AP'P'ROVAL. OF THIS PERMIT T•1* WELD COUNTY HEALTH DEPARTMENT RESERVES THE RIGHT TO IMPOSE ADDI- TIONAL TERMS AND CONDITIONS REQUIRED I0 MI:::I:_1• (:1118 REGULATIONS ON A CONTINUING BA- SIS , FINAL. PERMIT APPROVAL.. IS CONTINGENT UPON THE: FINAL INSPECTION OF •T•HE. COM- PLETED SYSTEM BY THE WELD COUNTY HEALTH DEPARTMENT. SYSTEM INSTALLER UNKNOWN FINAL INSPECTION DATE 05/30/89 STEM ENGINEER APPROVAL.. X STAFF 1 - OF SYSTE:M INSTALLED TANK 1:::Nv:r.F;DNME:.NTn1... s'I='!:=C:l:Fti...:i'"'T. THE ISSUANCE OF THIS PERMIT DOES NOT IMPLY COMPLIANCE. WITH OTHER STATE, COUNTY OR LOCAL REGULATORY OR BUILDING REQUIREMENTS, NOR SHAI_.L.. IT ACT TO CERTIFY THAT THE SUBJECT SYSTEM WIL..L.. OPERATE IN COMPLIANCE W:I: Ill APPLICABLE STATE, COUNTY AND I...00AI... REGULATIONS ADOPTED F'E:RSUAN1• TO ARTICLE 10, TITLE 25, CRS 1973, A:: AMENDED, EXCEPT'' •T• FOR THE: P'URP'OSE (:11 ESTABLISHING FINAL 1... Al F OVAL OF AN I:N`'TAi...I...1:::I) EYETEM FOR /7 CI, ;�� a-97067 Ccon oro-8 STATEMENT OF EXISTING SEPTIC SYSTEM (PLEASE FILL OUT IN INK) OWNER OF RECORD: MARYANNE B. RASMUSSEN Phone: RES: 443-5924 MAILING ADDRESS: 2400 JASPER ROAD BOULDER, ODIARADO 80304 City State Zip SITE ADDRESS:7019 WELD COUNTY ROAD #5 ERIE, CDIARADO 80516 City State Zip LEGAL DESCRIPTION: PT sk PT SE 4 Section 29 • Township 2 Range 68 Legal attached SUBDIVISION No 'tubdivision LOT BLOCK FILING NUMBER OF PEOPLE: 2 Bedrooms: 2 Bathrooms:. 1 Water Supply Left hand RESIDENTIAL OR COMMERCIAL: Residential Lot Size: 1.9+ - Acres SYSTEM SIZE: Tank is Constructed of Cement and has two tanks of 4UUga1 Parhgals capacity (material). ----This is a older home and we are. not the origins owners. To the best of my knowledge the FIdoted i formation is accurate. We have not had any problems. ELD:;Bed see diag. or Trench see diag. sq. ft. Date System Installed: ndt known 1, You, are required to draw a diagram of the system on the reverse side of this form and indicate position, 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 description and further states that the system is in good working order and to the best of his/her knowledge is not failing to function properly. • I further understand that any falsification or misrepresentation may result in revocation of any permit granted based upon this information hereby submitted and in legal action for perjury as provided by law. - This home consists of approximately 885 square feet. There are two bedrooms and 1 bath there is no dishwasher and no garbage disposal. The property is hooked up for a washer. R t/ AO). /9S 9 � n , £e_r May 30, 01989 Date Maryanne ssen Owner Subscribed and sworn to before me this -C ' day of 1.\\.%--)5, , 19V1 by \-\1C3-, Witness my hand and official seal. My. commission expires 2,(D — S Date/ Notary Pu lic y - II :-1‘ , i I IA Z. r Ic:. vk 1 a\te:i ..\ N � i \j i ' !st 1 1 a \ \ \• \ ‘\ 1 \\ \ \ 1 V 1 ; \ \ vv i / 1. / i ` i1 i r ; i Y - 7 ^. r. .4::,,P-1O.!'..,v- INDIVIDUAL A SEWAGE DISPOSAL .,.r. SYSTEM - N' O-'..'.:,,..021.,:, .{.I,1:.),I. ,. .l..(.r,.J.'{i... .:?1.�.(i-JI•il:Jl::. .lJ.}..:71''(.1 ' ..:�Y :? (I::.}} i'''s::.!".!.,1.!...I. ;..! • WELD c(:iuN.J Y HEALTH H DEPARTMENT.i ME'' ' REPAIR !::'L•::R1-•'I:.'f :::I`.;v.l:I:;:cw.II`•IE::NTAE... HEALTH SERVICES 1517 16TH AVi:.NI.JE COURT, 3p:::E::l...;:,•'.. CO 80631 .353-0635 ..X.... 2225 OWNER BODE. EL...WJOOD ADDE•',i::.SS 70:1.9 Wct: PH (3c.', ' : . .. ' ... ERIE 5 CO 80516 ADDRESS f.:S S (:1}::. PROPOSED SYSTEM 7019 W(::I;; ERIE CO EJ()5:L6 • LEGAL DESCRIPTION OF• SITE:: S2 `:3i:::'d £:31:::(:' 29 •T•WI::. 2 RN ; 6i:J ::'(.JY<I>:I:V:J:;:3 I(:)f-,}:: N/A 1...(:JT• () :B1...(:i(:::K 0 FILING () 'J`:+1::: TYPE:: RESIDENTIAL HOUSE SERVICES:: PERSONS (:J BATHROOMS 3.00 LOT SIZE 2000 B1::.I)E':(:J(:J1M'i;:S 5 BASEMENT !::•L..i..JM'iS:;:I:I••1(:; hi(1 WATER l': SUPPLY 1..1. 1I II) . i...:::C:(' i..}'(:N FEE $125.00 :.,.'! ; '::) B'r JOANNA•I!•.lNA (:.lrll...I...E::(:)(:J::3 . SIGNED BY I:::l...IAJ(:1(:OJ) J. BODE DATE ')7/19/93 DATE f::. /.':1.','/fJ,,.3 !::'I:::I:;:G(:il...y•T:1:(:11•,i 1:;I"ITf::: :L3..6 IYi:I:INR 1::'E::I:: :J:1••E(:;I••I i...:rri:I:•r•:EltlG :f(.i1nE: 5 1: E::I::: I SOIL TYPE SUITABLE PERCENT GROUND SLOPE DIRECTION IAi REQUIRES E:::I•u.:u:I:I•.}I:::EE;: DESIGN !',1(:) IN :L:)() YEAR FLOOD iP'i...r"):I:IwI : .(:i;il: AO I-F:OV! THE A1::'}:'E...:I:(::AT•:I:(:JN INFORMATION SUPPLIED AND THE ON-SITE S(:i:l:I... I::'I:::I;:(::(:J}...AT :1:(.Jh•: I:)A':1::•i THE::: FOLLOWING MINIMUM INSTALLATION SPECIFICATIONS r•^IRE:: R1:::(:11..J:I:E;:E::I)t: SEPTIC TANK 1500 GALLONS, ABSORPTION TRENCH '•;i:E.5 SO. F T.. OR ABSORPTION BED :}.::;0{) SO. E::'T„ :r!'^I)f):I:T•:I:(:J;'i.. THIS PERMIT T IS :; JI:<<:E:(: '•;• TO THE FOLLOWING ADDITIONAL •r•1-:1:;:lYl',•3 AND rHIS PERMIT IS GRANTED TEMPORARILY 1..(:l r.,l...l...(:117,1 C(:)NSTR1.JCT:rr)NI TO COMMENCE. THIS E'F:P!'i]. NAY BE REVOKED OR SUSPENDED BY TI•ii: Wt:::1...I) COUNTY L•}EfII...•TI••I DEPARTMENT 1:'t:)F;: REASONS ::51:::.f r:..!:iI•iii I:I''! THE (:Ji:::l...::o COUNTY. :I:III):1:VIDUAI... SEWAGE DISPOSAL SYSTEM REGULATIONS :E:NCI...I.iIIIN FAILURE TO MEET E I ii1'IY TE.:F{1`'! OR CONDITION :I:1'11'(:1(..I:::I:) -Tl-11:::1:;1::(:il••I DURING TEMPORARY (:)!': !::•::'.-I:11... 1-y!:'PI:::(7Vi:ll..... THE ISSUANCE (:11::• THIS PERMIT DOES NOT CONSTITUTE ASSUMPTION BY THE. D!::.P(ll•; •!'/IE::y¢ OR :I:ITS EMPLOYEES (3I LIABILITY FOR THE FAILURE (:R INADEQUACY O !!•1i:: ::+EkIr ;::. :li){/ ::iE,CL`•�ii l... SYSTEM. {f� STEVE W:I:F`,•TI:;(:)c;i<:1: 0.7/2 /Y.:, .: ENVIRONMENTAL '::3}:-'1:::c I:t?d...:E:sl I)ih•1�-!::. • I'I.! '::: I`I::.1:1''!:!:'•i• IS. NOT TRANSFERABLE AND :_;H(='{i...l... }•:<I:::(:;(.Jli1::: VOID 3:I:: '::'r•Y':::3'T-E::M t.A.)I'.I':a•TRI.i'::-T :!:+.: :•i LAS '::' :••}I:)T COMMENCED W:I:•T•I••I:I:hI ONE:: YEAR (.11:'• ITS ISSUANCE. BEFORE ISSUING F"!:NA}... AI::'I:.!.;;'c:, i::;l. ' THIS IIS I:.I.I:;I`'i:i...(. .T.I..Ii: WELD (:::(3ti:'.I.T..Y HEALTH DEPARTMENT RF:,;:1E:.1:.'VE::.'::S -1--1..11::: E;:I:(:i1••I.T. TO J:!'il':'(:i•:;SI::. i°{'::•:I:`:[ •I:(:)Ni`•11... TE':I:;:IYI::3 AND CONDITIONS I:tl:::(:11.J:1:1:;:E:::O TO I"IE::E:'T' (:iI.JE;: REGULATIONS ON i~i c::c:LiT:1:N•1(.i:J:l`G Y: ^I.. '::' S J:.:f.l•'I(:pI... 1:P'E::F,:!i:E:T APPROVAL IS CONTINGENT t•JI:'(:JI•'l •r•I..II::: F::•:I:NAl... INSPECTION h f: TI•F.:: (:i(.:IIY!' .'..E TE::I:) SYSTEM i:':i-I I:+`:` THE WELD (:;(:11.J14I•TY HEALTH{I...'i'I"I DEPARTMENT. 'I !:::1'' J:PEA:S'T'i^i1..1...f:::l: .......... ":!:I�lr^If... INS DATE 4 �` : Sithl r'I I i I II :I:h'}c:;-T i::ci I...I I:' 1 Al................................................ __ __&.(.1V I1::: 1.`::`:;::,i..J;';J (::J:: (:i}!:. ..i.i..l:l:s PERMIT i::1(:il:::,:: i;(:ur :FMI::'i...Y (:roMPL.:I:AI•,i(:;E.: I.II.T1-•I, OTHER STATE, :(: .J;••i i •'l:• LOCAL F.'1:::i:SLJ;...rIT(:JEtY (:JI:': BUILDING I:•:E::(;il..J:l:1:::1:::!'!!::'I'I..E'•::;, i•'d(:JI:; SHALL. 'I...T. i:i(::.Y. .1..('.r CE.I.,.l. I,.....ri .11.-W.H. T. SUBJECT SYSTEM (AJ:1:1...I... (:1E:'E::1:;'13IE:: IN COMPLIANGE LIJI:f!"1 iil::'i::'1...:!:(:;AI{f...E:: STATE, (:.:(:1f.!N :.N :. !::k.,A1... REGULATIONS:C(.11•''!!::S DOI:'TE::D PI:::E•:c:3IJi!;1•I.T. ..I..l.::r i.?{E.,,..I.:I:(::.1...;::: 10, 25, PURPOSE...\.•I... OF ESTABLISHING I::•:J:1••I(•^II... APPROVAL OF AN INSTALLED r•{•{1•ICE:. 1.31: A LOCAL OCCUPANCY PE:.Rl't:I.T PURSUANT 3u:1I''I.1.. .)..Ci (::i::!:..: :1.?7.2, :,3-...:1.0....:1.:1.:1. (2) , .. .; I..i.Yrii•li. .:i::.. .. .L C In'i••1 i .. C:I...1!:: Y %A{!,•! l.I l.':;•!I'. ..i:: Iv,•: .S :.}:'�'. d S.ek cf aixtvts ihkiyp - Mso WkactuLcf 4/1 zy *Zqg /y - �r G t-ibz)) 11d1 „etc 4545C. 1 --- ---......" la••••• Left Hand Water District June 30,2005 Deborah Lowry 7019 WCR 5 Acct# 3157.01 Re: 90 52 8 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,, t,), i Kim Lane Administrative Assistant Left Hand Water District P.O. Box 210 - Niwot, CO 80544-0210 - Phone 303-530-4200 ti Fax 303-530-5252 -www.lefthandwater.dst.co.us Hello