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Home My WebLink About20081304.tiff 11I 13I ZUG/ LIWU PAGE 02/02 • • LITTLE THOMPISON WATER DISTRICT Directors; District Manager; • Alex Saner,Prcaideat Richard H.A.Whiffet Jim Cooper Kathy Ca111vnaCrial 035 E.Highway 56 Mac Amato aerthood,CO 80513 DAVE Loma. Richard Macomber P 970.532,2096 Gary Mon F 970.532-3734 wwa.LTWDare November 12,2007 To Whom it May Concern: Little Thompson Water District provides water service to Mile High.Dairy at; 15333 Weld County Road 5 Longmont, Colorado 80504 Tap#03211 —2"meter Any questions may be directed to me at the District office. Yours truly, • Richard H.H. 'net District Manager • EXHIBIT 2008-1304 APPLICATION • INDIVIDUAL SEWAGE DISMAL SYSTEM No. /a-g ,. WELD COUNTY HEALTH DEPARTMENT New X ENVIRONMENTAL HEALTH SERVICES Repair 1516 Hospital Road, Greeley, CO 80031 • 363.0640 EXT. 70 /..e)Wind BP OWNER /WC/ /6,/ P ADDRESS =2O • ,1/47720 ��• PHONE_72/215 ADDRESS OF PROPOSED SYSTEM X4333 20 c.e' ' 5�� p ✓zoNt- LEGAL DESCRIPTION OF SITE: PTf.2 F 2 S_�_, T 3 _, R,�?I-) SUBDIVISION LOT ,.BLOCK , FILING USE TYPE: RESIDENTIAL - _ INSTITUTION COMMERCIAL OTHER SERVICES: PERSONS 47- BATHROOMS / _LOT SIZE g4z ctu's'L) , ��" "" BEDROOMS BA EMENT PLU G NG � i SUPPLY.« TYPE OF SEWAGE DISPOSAL REQUESTED: ., n>C,ce4c. ) P „Q�* ia � j Applicant acknowledges that the completeness of t(�ls application is conditional upon fu r mandatory and additional tests and reports as may be required by the Weld County Health Department to be made and furnished by the applicant or by the Weld County Health Department for purposes of the evaluation of the application; and the issuance of the permit is subject to such terms and conditions as deemed necessary to insure compliance with rules and regulations adopted under Article 10, Title 25, CRS 1973, as amended. The applicant certifies that the proposed system will not be located within 400 feet of a com- munity sewage system. The undersigned hereby certifies that all statements made, information and reports submitted here- with and required to be submitted by the applicant are, or will be, represented to be true and correct to the best of my knowl- edge and belief, and are designed to be relied on by the Weld County Health Department in evaluating the same for purposes of issuing the permit applied for herein. I further understand that any falsification or misrepresentation may result in the denial of the applicatlor revocation of any permit granted based upon said application and In legal action for perjury ae provided by law. Application fee 73. d ,y� � � �I�R��O -' //� �'!Z a'/ /� sCLC//1/l r 4z(rr,VF U`� �r Reo'd by A/til �x/ Date /,-a-gi Owner/Agent Signet Date 1pDEPT. PERCOLATION RATE / �lF � WATER TABLE DEPTH Cr ' ONLY SOIL TYPE LO/977--2 PERCENT GROUND SLOPE L so PO REQUIRES ENGINEER DESIGN ( )YES( No INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT From the application information supplied and the on-site soil percolation data, the following minimum installation specifi- cations are required: - _ SEPTIC TANK /Do D GALLONS, ABSORPTION TRENCH 'tom SQ. FT. or ABSORPTION BED --..-570 SQ. FT. In addition, this Permit t lie subject tc the followin additional terms and conditions: /C-2.9 p er/ \1 i/�. 't/ !�?�lcL OD/rl�, .�fl�S�jQ®6/HttCJ JZ3 �/ \ J This Permit is granted temporarily to allow conetructloh to commence. This Permit may be revoked or suspended by the Weld County Health Department 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 as map flop by the Department or Its employees of liability or the failure or In dequacy of the sewage disposal system. Environmen al Specialist Date This Permit is not transferrable and shall become void if system construction has not commenced within one year of its issuance. Before issuing final approval of this Permit the Weld County Health Department reserves the right to impose additional terms and conditions required to meet our regulations on a continuing basis. Final Permit approval is contingent upon the final in- spection of the completed system by the Weld County Health Department. rC SYSTEM CONTRACTOR deepee (2/L F NA INSPECTION__-4 ` _ *TEM ENGINEER _APPROVAL 7'�'/ A /`-u Environmental Specialist Date The Issuance of this Permit does not imply compliance with other state, county or local regulatory or building requirements, nor shall it act to certify that the subject system will operate In compliance with applicable state, county and local regulations adopted pursuant to Article 10, Title 25, CRS 1973, as amended, except for the purposes of establishing final approval of an Installed system for issuance of a local occupancy permit pursuant to CRS 1973 2510.111 (2). Original•Applicant; Copy-WCHD WCHD—EHS February, 1981 a-: e. w ,-u2. _4 •"-r kA, Ia b 5` .,sit _ -25 y APPLICATION I INDIVIDUAL SEWAGE DISOSAL SYSTEM No. ��,7 fffFr WELD COUNTY HEALTH DEPARTMENT New ENVIRONMENTAL HEALTH SERVICES Repair 1518 Hospital Road, Greeley, CO 80031 / 353-0540 EXT. 270 X _ - BP OWNER it,ni)(1/ /fil , 7('; /74 ADDRESS � <`—.L._,-.4) , i r' Pt,:' PHONE;,,, = ADDRESS OF PROPOSED SYSTEM / .3.3'2 a1 .F /c i 6-,,,--i,,, ,r" i'-x,y t9, v%!, at ��/- /7"/U ay LEGAL DESCRIPTION OF SITE: PTS- L -, s /7 T `, _ R ,fP 4 ) j-r_3-2-434 SUBDIVISION l/� ; --Yy�v4` {f!,`. LOT ,.BLOCK , FILINGls, C USE TYPE: RESIDENTIAL X /7 (es-e l ymP 1 INSTITUTION n� COMMERCIAL y.)- 1 OTHER 1.)1SERVICES: PERSONS i R'` BATHROOMS ?LOT SIZE - /71,-",/ ' E`? BEDROOMS 1/111 BASEMENT PLUMBING S tQ WATER SUPPLY i/'% 0 s?/A+TYPE OF SEWAGE DISPOSAL REQUESTED: 7/ic T ?K c ,4, �ir' ><l gip,/O' Applicant acknowledges that the completeness of this application is conditional upon further mandatory and additional tests 6 and reports as may be required by the Weld County Health Department to be made and furnished by the applicant or by the Weld County Health Department for purposes of the evaluation of the application; and the Issuance of the permit is subjectQ to such terms and conditions as deemed necessary to Insure compliance with rules and regulations adopted under Article 10, i Title 25, CRS 1973, as amended. The applicant certifies that the proposed system will not be located within 400 feet of a corny. munity sewage system.The undersigned hereby certifies that all statements made, information and reports submitted here- with and required to be submitted by the applicant are, or will be, represented to be true and correct to the best of my knowl- edge and belief, and are designed to be relied on by the Weld County Health Department in evaluating the same for purposes of issuing the permit applied for herein. I further understand that any falsification or misrepresentation may result in the denial of the application or revocation of any permit granted based upon said application and in legal action for perjury as provided by law. Application fee / IC'c---'s �,(,/ i n / Reo'd by //(7� r, „_a_.x s* / Date/"/f 0/ ' I OwneriAbent Signaturee / Date ,r DEPT. PERCOLATION RATE 7- S 133.1--fir in-eft— WATER TABLE DEPTH (Fa' /{ U8E ONLY SOIL TYPE PERCENT GROUND SLOPE < ' 0 ' D REQUIRES ENGINEER DESIGN ( )YES( No INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT From the application Information supplied and the on-site soil percolation data, the following minimum installation specifi- cations are required: /S0 0 SEPTIC TANK /-t C uc GALLONS, ABSORPTION TRENCH 7 rso, FT. 2 3 o 9'67 or ABSORPTION BED / sa FT. In addition,this Permit is subject to the following additional terms and conditions: This Permit la granted temporarily to allow construction to commence. This Permit may be revoked or suspended by the Weld County Health Department 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 r by the Department or Its employees of liability for or Me qua sewage disposal system. sa 9t-1 Environmental Specialist Date This Permit le not transferrable and shall become void if system construction has not commenced within one year of its issuance. Before issuing final approval of this Permit the Weld County Health Department reserves the right to impose additional terms and conditions required to meet our regulations on a continuing basis. Final Permit approval is contingent upon the final in- spection of the completed system by the Weld County Health Department. SYSTEM CONTRACTOR _FINAL INSPECTION--2/q t( r TEM ENGINEER APPROVAL 7// A CiZCQ� /( `�/ Environmental Specialist D to The issuance of this Permit does not imply compliance with other state, county or local regulatory or building requirements, nor shall it act to certify that the subject system will operate In compliance with applicable state, county and local regulations adopted pursuant to Article 10, Title 25, CRS 1973, as amended, except for the purposes of establishing final approval of an Installed system for issuance of a local occupancy permit pursuant to CRS 1973 25.10-111 (2). Original-Applicant; Copy-WCHD WCHD—EHS February, 1981 • • • 4 - fib, _ 9-D (/ I� ( t t • it • 0 ! FI Sf:' i 06P IND:[V:I:D(JAL.. SEWAGE DISPOSAL SYSTEM PERMIT MJ j41) , G-0602 WELD COUNTY HEALTH DEPARTMENT NEW PERMIT • ENVIRONMENTAL. HEALTH SERVICE: : 1516 HOSPITAL ROAD, GREE.LE'r', CO 806.31 353-0635 I: x'T.222.5 , (-OWNER FIooc;-i...AND, BERNARD ADDRESS 15333 WCR 5 PI_I (303) 5. 35---4 1...(Ji''NGMONT CO 80501 ADDRESS COM.. PROPOSED SYSTEM 'i 5,x:3;3 WCI:< 5 • IY I...C1NGMONT CO 80501 ..EGAL.. DESCRIPTION OF SITE : NW 4 SEC 3 TWI::' 4 RNG 68 '(.JuD IV I :I:(:1i4 LOT t: BLOCK 0 FILING ..JSE TYPE : RESIDENT1:Al... DUPLEX SERVICES :: PERSONS 2 BATHROOMS 1 .00 I...01 SIZE 80.00 ACRES BEDROOMS 2 BASl:::rii_:i4T PLUMBING. NO WATER SUPPLY L.THiIP '•1P'F'i._f('ATICIN FEE $150.00 �I:.CC ' D BY WES POTTER SIGNED BY HE:NR:I.I::.T TA rlf UGI...ni•J:() DATE: 11 /05/86 DATE 11 /05/86 PERCOLATION RATE 30.0 MIN PER INCH LIMITING ZONE 0 FEET SOT.I... TYPE UNSUITABLE PERCENT GROUND SLOPE 0% DIRECTION I:WQU1: : ::,';' ENGINEER DESIGN NO ::I:<oM "1'I-II::: APPLICATION INFORMATION SUPPLIED AND THE ON-SITE SOIL. PERCOLATION :DATA THE FOLLOWING MINIMUM INc— __' - SPECIFICATIONS ARE: F:I:::C:!I..JIREI) : SEPTIC TANI 1000 GALLONS , ABSORPTION TRENCH }0') SQ. F: T, r --- OR ABSORPTION BUD 6!° 0 ;GI:. I'"'T IN IlkITION, THIS PERMIT :[.`v' SUBJECT TO THE FOLLOWING AI)D.. ..... .r--t... ERMS AND ::(: NDI'T:I ONS : _..................... ._..............._..._.............._.........................__.............................._...._...._..............................._._..._........ MIS PERMIT IS GRANTED TEMPORARILY TO ALLOW CONSTRUCTION TO COMMENCE , THIS PERM:I: i '•iAY BE REVOKED OR SUEPENDED BY THE WELD (:;(:111N'IY HEALTH DEPARTMENT Mi:NT FOR REASONS Ot);:> ,`,'I:::..I -'URTH IN THE WI:::I...V COUNTY Y INDIVIDUAL SEWAGE WAGE:: DISPOSAL SYSTEM M REGULATIONS INCLUDING "'ATI...(JI:<E: TO MEET ANY TERM OR CONDITION :[IMPOSED THEREON DURING TEMPORARY (:1R FINAL WF:'RC1Vr:iI_:. THE ISSUANCE (:11:: THIS PERMIT DOES NOT ('flj........(.J'1-F:: ASSUMPTION BY THE OEF'ARTME NT OR ITS' EMPLOYEES C11" LIABILITY FOR THE FAILURE OR INADEQUACY (:1l" THE SEWAGE DISPOSAL SYSTEM. nc .. IQ c'1_- . . 1 Ac._ i.4I:::.:. POTTER 11 /ci : 6 > > , I1 CEN:i:[RClNMENTAi... SPECIALIST DFA'TE. THIS PERMIT IS NOT TRANSF:'ERABI...E:. AND SHALL.. BECOME VOID IF SYSTEM CONSTRUCTION HAS 10T COMMENCED WITHIN ONE: YEAR OF ITS ISSUANCE . BEFORE ORE ISSUING FINAL PF'1U:JVAL OF THIS PERMIT M:I:T THE WELD COUNTY HEALTH DEPARTMENT RESERVES THE RIGHT TO Ii'iP(:1 i::: ADDI— TIONAL TERM AND CONDITIONS REQUIRED TO MEET OUR REGULATIONS ON F'i (:;UN'( IN(.JJ:i ii i:.A S:I:S. FINAL PERMIT APPROVAL IS CONTINGENT I_I-IIN THE FINAL INSPECTION OF THE i:`;::1i:. '''I...I: TED SYSTEM BY THE WELD COUNTY HEALTH DEPARTMENT., SYSTEM [N J'.T'A I...l...E R lAajzal frk•:1t d ..__...0C''?S......FEW ...r- ... .. (:1 i J:) „,5A,578,-,-,7 SYSTEM ENGINEER .. .. A1..F Ot!jr'' TYPE OF SYSTEM INSTALLED ANO ENV_RO .MENTAL SPELTALTT... THE: ISSUANCE OF THIS PERMIT DOES NOT IMPLY COMPLIANCE 14:I:...H OTHER FEIN: STATE , COUNTY of ::AL. REGULATORY (:1R I:t(J:[L.... :I:NG REi:(a!(J:I:REME;:N'T,S, NOR ' F-iAi...1... IT AC TO CEI.:.I IF Y THE ..UBJ1:::CT SYSTEM W1:L1... OPERATE :!:N C(:1MPi._IANCI::: WITH APPLICABLE STATE, COUNTY r i•?0 I...00AI_. REGULATIONS ADOPTED F'E::R;SI.Jni•lT TO ARTICLE 10, TITLE (::RS i r;: , AS AMENDED , EXCEPT FOR THE PURPOSE OF ESTABLISHING FINAL APPR(:1Viii... OF AN INSTALLED SYSTEM FOR ISSUANCE OCCUPANCY PERMIT PURSUANT T(:1 (:::r�:; 1973 ;5 10.._1 i 1 is 2).�.;�,y1.1i-tiN(:;i::: OF A i._(�1(::r'r1... ,(:;l..i . ;:'� .,:. :. 11 I I f�' 7 "'"i . I 5 '_61 ,�a 4 ' 5 v /-7 --It sy s, • • • • it r, I r I 1 • 7c 8 r i .I I • • • iD ,„-i) II l �� toc � h LI S Hello