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'••1SP:!.()t?P INDIVIDUAL RX)T:,1TX)IJi L.. SEWAGE DISPOSAL SYSTEM PERMIT NO.,. G••••9 i>>G.
• WELD ( (• t..'!'•.UT'ir HEALTH DEPARTMENT REPAIR r�•L.FtiN]:`
!:::r••R..`!: I t+,!!�'1l:::I*!'-�i^,I HEALTH SERVICES
1517 16TH AVENUE (:::(:.t.JR:'..T GREELEY, CO 00631
353-0635 EXT.2225
OWNER (:;rlhil :#::•r•^t., FRANK ADDRESS :I.:I.I:).:::R. (,l£::R 1.;3 PH (303) 651•...t'.
LONGMONT CO 80504
ADDRESS OF PROPOSED SYSTEM 11621 W(::F: 13
LONGMONT CO 80504
LEGAL DESCRIPTION (:1F SITE: ::3W4 {aR:4 EEC :I. T(,JP 2 RN(: 60
SUBDIVISIONg L..C1• . () BLOCK () F:f:I...:#j.Ic. ()
t.J;:3E:: •T'Y1::'E::: RESIDENTIAL I••1(:1tJ£3I:::
>f;:.l":'J.I.C#::.C,:: PERSONS 5 .f.t(^IiF..(R•'>(.1c:,I?!',•:? .t'.. (:v,) LOT SIZE .:i..0t) s,c::F>I::.::?
BEDROOMS r`# BASEMENT PLUMBING NO WATER: SUPPLY R'W!:1...4... 'ROI
APPLICATION FEE $240.00
RE C: 'I) BY HOLLY DENNIS SIGNED BY AI YC3ON CANE PA
DATE 00/21/95 5 DATE:: 00/21/95
PERCOLATION RATE 1 .4 I''1:!:I••i PER INCH LIMITING ZONE 0 FEET
:n(:i:I:L. TYPE UNSUITABLE (:'I::I:;{ E::N T GROUND SLOPE :!.:'•:: DIRECTION I
I:;:E::{:I(J:I:kE::`>•.3 ENGINEER DESIGN 'r'1:::`,•:3 III :I.()() YEAR FLOOD PLAIN ZONE NO
FROM I'! THE APPLICATION:1:{:i#•.! .!'.!#::{:i!;:!r!r':t'T':t:(:ih! SUPPLIED (.11X> THE ON—SITE f3o]:f... PERMATION DATA
THE • rI,. 1 INSTALLATION SPECIFICATIONS
T'.••fE:: MINIMUM It.Jlrl fll:::l::: I:;:I:::(:'tl.J:l:I::I:::X?:;
`''E::!::•'T:I:(:.'• "1• F II{ :I.".,f.:,( GALLONS, ABSORPTION 1"F2!:::r•I(:;!! SO. FT.
OR
ABSORPTION BED :#.;'0.t' .:3(:1.. FT.
:I:I•> ?I)£'T':I:(:1l•!,. 7'R••I:!:f:i PERMIT :I:4:3 .'..Jru:TE::(:"T 1..(:l THE FOLLOWING ADDITIONAL T'I:F 1`'1`:3 AI•'tI)
C;(:)r,!I):I:T I(:)hlf:3:: ................................................................................_................_..__...........__. .............._.............................,............................._......_........................._..........._
THIS PERMIT IS GRANTED TEMPORARILY TO f'l!...R...COW CONSTRUCTION T(:1 COMMENCE.ENCE .. THIS PL:.F:ErI:I:
MAY BE REVOKED OR SUSPENDED T•' ( THE:: WELD COUNTY HEALTH! DEPARTMENT FOR REASONS .'-.3F.T
FORTH IN THE t•J!:R...I) COUNTY INDIVIDUAL"iL.. SEWAGE x::I:f3IP•(.1;:S1•ll... SYSTEM REGULATIONS INCLUDING
FAILURE TO MEET t"ti.,R•Y. TERM (:)F;: CONDITION IMPOSED£:Ef:3I:I) THEREON DURING 'T'E MPI:T.:AIRY OR FINAL
l!...
APPROVAL. THE ISSUANCE c r:' THIS PERMIT I)(:)E::{:3 NOT (:;(:)h1S1''. 1'IJTE:: %f:i'r:3(J#rlP'T:!:Cihi BY THE
DEPARTMENT ME:NT OR ITS EMPLOYEES c 1::• LIABILITY FOR THE FAILURE E:: OR :r I'W,frW.(:llJu c::•'r' (:)I:" THE
SEWAGE 1):E:f: (:1t:3 t!... SYSTEM.,A ST'I;:''.'E:: W:1:r•^('TRf.1WS!T 11/17/95
`' te � !i::r>,AI,{..!•IIrE i, rt.._. SPEi:£.,Tr,L...IST DATC.
T'!'.#:I:::3 F l:::F::1''!:F: T IS NOT TRANSFERABLE SF:I F:R:Alal...E:: AND f:i#••IA!...!... ;F'R:::(::(:)I`!!::: ''>1(:l:l:X) IF S:5Yc:;'TE::h'! (:;(:lh!`::+T'R LICT'T(:1N HAS
'If...T' COMMENCED WITHIN otu. YEAR OF ITS S ISSUANCE. BEFORE :1:::3S(.1:1:!'•!(::t FINN_ APPROVAL. OF?
TI'•I:!:S PERMIT TI•lE: WELD COUNTY I•1E::AI...T.H I)EPAR':T'IMIE1'•IT RESERVES THE RIGHT To IMPOSE:. ADDI-
TIONAL TERMS AI.II) CONDITIONS I:::':::(;lt-J:!.;;:E:'D '.r'(:: i :E r 0(.11::: F::E::(:if.►!...rl•T:R:(:1h1::5 ON A CONTINUING BA—
SIS. #::•:!:hlt^•I;... PERMIT APPROVAL. :t: CONTINGENT T UPON THE FINAL INSPECTION: O#•". THE COM—
PLETED SYSTEM 11<'( ..#1'4E:. (JI:l...:c) C'(:iL.II-U.r'( HEALTH I)E::l r''fl:,,..,.f.,i!:::!••#T•»
SYSTEM :1I'>I 3Trl...l...E:.1:' ........ ... .4:7-. S:•• •;•..1... I t:..
` � ................„.................FINAL :l:ra : h. I)r�?t'r..•. ..l(.�.3p
':- EN-I:::N E:;!'•I{:::I:HE::E::#::> icr 1__ .,!"44-.0.,!Male............... ...............f'1F'!..,!••'(:l' 'fiR_. Q{
TYPE OF: SYSTEM :I:I•>I :3T tl...!.......... ' i , E3:1.!:J:I:r•c:rhI!rlE::l•,#.IAL. SPECIALIST
... .. WITH
OTHER
STATE,
COUNTY.. .:. .......t.�t•tt tc.:.::. OF r• t :•i...:::• �" .:.!'til''1.%. . DOES I•I:.: . IN PLY I...;' COMPLIANCE L4.!...#.!..! i'tY'I..IR::.f'ti ..: t f�l S E:... 4;�.I(.JI'R f Y
Hi is;f:'.. #. i'?!:, I_ ,! REQUIREMENTS,
t..r. ,
' ::l:::(::t.J....i^;..( .. .'" ::1. T::..?:!::...I'r...!••II:::' !:.::.;: I..J.:. >r:.. I.::.l�•� '::?.. NOR ;:31••!r•s,...l IT ACT �T(:1 ... ,
TI. 3(JI':,:II:::C:"T •:::•''::;;�::1"t 4J:•......... ;.EF'1:=:!:;:::('. :... I 1 ;'•, ,r:l i
.l. .. !., t•• APPLICABLE STATE, COUNTY AND
R...(.1:.. ' REGULATIONS� t' ADOPTED i:'t:. :,I i"y' `'r:t ARTICLE..r.'1... :I '`.` !...i t...+ .::.-.. {":'. 1973, r i,.? AMENDED
1R...I Ii'L I'
(.. ::Cit.,1. A T.I.\• I'>I.. Ai.: ..... #: J 1 .. F: .. . . r. S...
EXCEPT•'f' FOR THE ! •I:,I;;.r rr• I .I.r.:, .I.I ,... s. ♦. . .. (VA . .. , SYSTEM
•-
ISSUANCE r 1L. . I :., I :...;..� ,L;, �tt..,i:: a' :1:. !.t> ... hlr. INSTALLED >.. f ... . ...., 1 FOR
,... (.., ......:t I .I .:.;�•.;: I:,' ., , e.t.. .T.r.i 197,7 2 .-..1.'.>-111
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2008-1854_ ...
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taiV DEPARTMENT OF HEAL
eggn tie ?HONE(303) 353-C
1518 HOSPITAL R!
GREELEY, COLORADO 30
Zl
'i
• O^ LOAN APPROVAL
Request No: 382-86
COLORADO Date Received: 10/3/86
Date Forwarded: 10/21/86
Fee Paid: 550.00 Date : 10/9/86
TO WHOM IT MAY CONCERN: Review and inspection report regarding water and the sewage dispc
system for an existing dwelling.
Send to : Frank Canepa — Mail it Phone 0 : 651-0584
INFORMATION: Address : 11621 WCR 13 - Longmont, 80501
Legal : Pt NE4 , Sec 01 , T 02 N, R 68 W, Age of house 1968
Subdivision , Lot , Elk , Filing
Property Owner: Frank 4Mmilipp Original Owner: Coors Cattle Co._
Tank Pumped 'on: 10/10/86 By : Bob's Sanitation '
•ARIMENTAL RECORD SEARCH: Permit Found: None found
Tank capacity 1250 gals . Field Size 300 sq. ft. Water Supply_ptrELL
Other
INSPECTION COMMENTS : Date of Inspection: October 22, 1986
Soil Conditions : Dry x Saturated Snow-covered
Residence : Occupied X Vacant
NDINGS : SEWAGE DISPOSAL SYSTEM: Satisfactory x-_ Other
BACTERIOLOGICAL WATER TEST: Acceptable x Other
COMMENTS:
DATE : October 22, 1986 SIGNATURE: u'�,ul R, Lb
Environmenta ealthecialist
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 in connection
with either its examination of the property or in the report.
This inspection was conducted solely for the purpose of detecting health hazards
Illiervalue at the time bf inspection , and does not constitute a warranty that the
ten is without flaw or that it will continue to function in the future . Inspection
requested during periods of snow cover and high soil saturation may be of questionable
value to potential buyers due to adverse conditions . Water sample reports reflect the
bacteriological quality of the water supply at the time the sample was taken.
02-04-09 11:00A11 FR Kale Div o ilkr Resources
+3036663599 x-606 P.002/002 F-529
Form No. OFFICE OF THE S ATE ENGINEER
GWS-26 CIOLOMDOtsDIVISIOymen NOnFaWAref ClESOURCES LIG
• (3D3)e66-3581 _
WELL PERMIT NUMBER 176688 -
DN. 1 WD 5
DES.BASIN MD
-PP,'e0VED WEr I I CCAT10N
WELD COUNTY
SE 114 NE 1/466 W Sixth P.M.
Township 2 N Range
A R HOLDINGS LLC 1STANCES FROM SECTION LINE$
11621 WCR 19 2006 FL from North Settlers Line
L0N0M0NT, CO 80504- 158 FL from East Section Line
ORDINATES( tars Zone:13 NAD83)
(303)675-9727 Eeatin� Northing:
P
ISSUANCE OF THIS PERMIT DOES T PRO ANL ER A WATER RIGHT
C0N
1) Thls well shall be used in such a way as o cause no material Injury to editing water rights. The Issuance of this permit
does not ensure that no inlury vAl occur to another vested wrist riots or preclude another owner of a vested water right from
seeking relief In a civil court action.
2) Construction
din compliantce withis ing well the Water Well Conve not structin on Rule'',2 OCR 402-2. The Issuance of this permit doesd to this office;thereiore.It is not known If the s nootn
relieve the well owner of responsibility or liability In the evert contamination of the groundwater source results from the
construction or use of this well,nor does the State Engineer mums any respanelbilty or liabllty should contamination
occur.
3) Approved pursuant to CRS 37-02.602(3)@)(0 and the polity of the State Engineer dated 4/8/88 for appropriation of ground
. water tributary to the South Platte Rigor system.
4) for e c use of
b�ess that Include)is s an snails reealden's. Wafer from this well shall
ited to drinking and sanitary facilities as not be used for lawn orut)(a),
landscape irrigation or for any other purpose outside the onmmercia&reeidentiel structure.
5) The pumping rata of his well shall not exceed 15 OPM.
6) The annual amount of ground water to be diverted by this well shall not exceed 1/3 acre-foot(108.800 gallons).
7) Approved as the only well on a tract of land of 3 acre(s)deserlbed As 11621 WCR 13,Longmont,CO,weld County,
reference attached exhibit W.
8) The edam low from the he water Is this well ust be through al returnedto the se nle strreami waste syste In which the well Is located. The mabmum
cer disposal system of the
onsumptive use of ground water shall not exceed 10 perosnL g workin order, Permanent records o1 all
0) A totalizing flow meter must be Installed on this well and maintained in good
diversions must be maintained by the was owner(recordsc et least annually)and submitted to the Division Engineer upon
request.
1 ) Permit no.278388 was previous&issued for this 380.
101) This wall shall be located not more than 200 feet from�the locationg well. rs npecifiedton this permit.by cancels permit no.278
Md G --
17 I '
APPROVED i.e mat.•.4.. . .
GMS TIOe aA
Revel No.3626 29
Gists an ATE ISSUED 02-mss s=
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