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Home My WebLink About20080390.tiff 5530 1st _ "APPLICATION•R INDIVIDUAL SEWAGE DIS•SAL SYSTEM No- / - WELD COUNTY HEALTH DEPARTMENT New A ENVIRONMENTAL HEALTH SERVICES 1516 Hospital Road, Greeley,CO 80631 Repair • i , p OWNER ./7/ ^` !)� - 353-0540 EXT. 270 f ADDRESS i'�S?2 0 :` ai- Priry V. I PHONE' H-'4- ADDRESS OF PROPOSED SYSTEM AtM4S x i -)4.r LEGAL DESCRIPTION OF SITE: PT Af)P S .29 ,T ,.•-•-' , R 6 2 SUBDIVISION \\ LOT , BLOCK , FILING Y USE TYPE: RESIDENTIAL ? 0l: al 11•-•./ IS as r?A INSTITUTION COMMERCIAL OTHER SERVICES: PERSONS BATHROOMS 2 LOT SIZE D/)6/ V` ,:::2 02) BEDROOMS BASEMENT PLUMBING WATER SUPPLY i'r,rfC-'t'(A2/9 TYPE OF SEWAGE DISPOSAL REQUESTED: C(0 n 1.)Ei\+ t i("yip- Applicant acknowledges that the completeness of this application is conditional upon further 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 proposedisystem 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 application or revocation of any permit granted based upon said app`ica ion and in legal action for perjury as provided by law. =2= i i' A licatio fee �,'� ':�rA �t f//''' 7 , l 'PP p � �,� `c.. 2 , ,Y a.1 f,a, A� d-3 Rec'd by ( _t r r Date -7-S-.- Owner/Agent Signature Date • * * * * • • • * •.• * * • * w- • * * * * • • • • • • * • * • • • • • * * • • • • • • • • * * •, • * * FOR DEPT. PERCOLATION RATE ?o IM/,h / i 4,..r4 WATER TABLE DEPTH C /%S • E ONLY SOIL TYPF C.: 2 J", rbl.. e S A--,.,-.0 PERCENT GROUND SLOPE / .n, ,.� (- REQUIRES ENGINEER DESIGN ( )YES-kf No * * * * * * * * * * * * * * * * * * * * * S ,* 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 /Orr .' GALLONS, ABSORPTION TRENCH j!y SQ. FT. Or ABSORPTION BED 12 5 SQ.FT. In addition, this Permit is subject to the following additional terms and conditions: This Permit is 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 app,m al. The:lssuance of this Permit does not constitute assumption by the Department or its employees of liability orft a failure t ad y of the sewage disposacsysterj,_ R ems! ( 2 C,,y e / Y`- Envlron ental Special St ,/ Da$a ' 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. SYSTEM CONTRACTOR FINAL INSPECTION yn SYSTEM ENGINEER / APPROVAL dT /_ AS`F/ '7' /7 -27-V Envir nmental Specialist Date 0 h Issuance of this Permit doe's 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, 1961 • 2008-0390 /9- 7q'_ /U - ,' . 0 . . • . 1 v ti i �, / /il'ii/ I i . If ''j) i . 4% I ,..... ' 1 X17 • • • ,, PERMIT Ft M I T. N , f;.,...C.. 0 0 0 E-l�E . .:4?�� INDIVIDUAL SEWAGE d114�.''C+.`AI_ SYSTEM '�i- c••. • WELD COUNTY HEALTH DEPARTMENT NEW PERMIT ENVIRONMENTAL HEALTH 5E: VICEO:' 1516 HOSPITAL ROAD, GRE L.! Y, CO 80631 5 270 OWNER `;a • ASSOCIATES ADDRESS 7388 S, HWY 66 PH ( 30:3) 535-461 LONGMONT CO B0501 ADDRESS OF PROPOSED SYSTEM ,i'sJ88 E. HWY 66 - . _ LONGMONT. CO. 80,501 LEGAL DESC,:I. , OF SITE : 2 EEC 29 TLP 3 RNG _ r SUBDIVISION : LOT 0 BLOCK 0 FILING 0 USE TYPE : OTHER DAIRY BhRN SERVICES ; PERSONS 10 BATHROOMS 1 ,00 LOT SIZE 600,00 ACRES BEDROOMS 0 BASEMENT PLUMBING Nt NO WATER SUPPLY CWCWD APPLICATION 1•IuN FEE: $150.00 REC ' I. BY RECEPTIONIST AID SIGNED BY PAM HEMENWAY DATE 04/02/85 .{ ATE. 04/0'4 95 . . PERCOLATION RATE 25,7 MIN PER INCH WATER TABLE DEPTH 73 FEET SOIL TYPE SUITABLE PERCENT T GROUND SLOPE 0% DIRECTION REQUIRES ENGINEER DES 1.1:N N HO FROM THE: APPLICATION INFORMATION SUPPLIED IE D AND THE ON-SITE SOIL PERCOLATION DATA THE FOLLOWING MINIMUM INSTALLATION .SPECIFICATIONS ARE REQUIRED : SEPTIC TANK 10'00 GALLONS, ABSORPTION. TRENCH 6}54 EQ. ET, 0 ORABSORPTION BED 850 SQ. . IN ADDITION, THIS PEfttiI1` IS %SuI,JE: C i TO THE FOLLOWING ADDITIONAL TERMS ANT) CONDITIONi . _._ ,._.___..___._.__.__.._...__.__._ _ ___................._.. _.._. _._._______......_._.__..._....__...__.._ ._..____ THIS PERMIT 1:S 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 SEWAGEE. DISPOSAL SYSTEM REGULATIONS INCLUDING FAILURE TO MEET ANY TERM Fitt OR CONDITION IMPOSED THEREON DURING TEMPORARY OR FINAL APPROVAL , THE ISSUANCE OF THIS PERMIT DOES NOT CONSTITUTE ASSUMPTION I,. THE DEPARTMENT OR ITS EMPLOYEES OF LIABILITY FOR THE FAILURE OR INADEQUACY UACY OF THE SEWAGE DISPOSAL_ SYSTEM , C Tr -/ Li - Ps- J FriI'':I:!uI._Ic.1"I, GL•.ORGE:. z')4/16/85 ENVIRONMENTAL SPECIAL.1: T DATES �+' 6 Liu eomp. S-V'J-&S mAI THIS I..ER.YI.. Hr.. �' AND ;' • •COME VOID ICONSTRUCTION , ! H1:z� r'r:..�t•i�. i .I::v i...1T TRANSFERABLE ,�Hf�L_L. ::'E.�.:....i_ �t.l�. IF SYSTEM HAS NOT COMMENCED ME=:NCEI? tall t•l' IN •(1?•JE YEAR OF ITS ISSUANC:IE, BEFORE ISSUING FINAL HAI_ APPROVAL F'F;OVEAL.. Ol- THIS PERMIT THE WELD COUNTY HEALTH DEPARTMENT RESERVES FRVE S THE RIGHT TO 1:MPOS'E ADDI-•-. TIONAL TERMS AND CONDITIONS REQUIRED TO MEET OUR REGULATIONS ON A CONTINUING BA- SIS, FINf1L.. PERMIT APPROVAL IS CONTINGENT UPON THE FINAL INSPECTION f ICON OF THE COM- PLETED SYSTEM BY THE WLL:LIa COUNTY Y `E•HEAL.TI•i DEPARTMENT. Y.`.,'T'E.F1 INSTALLER ___ .(.{.!!...._ . ..�......_._ _._...._....__FINAL I t a F:EEC' L3 f.� i`r•':,.T.F: fa ��."E'; ti:i'i LEitil( :I:;�1E:E_E: N �.__._._... ____ _.........___. �F'F-F;CIVAI_. ... _ ._.--_ _. TYPE OF t:'•:'E EM INSTALLED ENVIRONMENTAL AE... l.`L(:IAL_.1..J Ti. .:, S'UTANCE OFTI••1T5' E'EHMIt DOES NOT IMPLY COMPLIANCE WITH OTHER STATE, COUNTY OR ..IiCn L.. REGULATORY OR BUILDING REQUIREMENTS,, NOR SHALL IT ACT TO CERTIFY THAT THE. SUBJECT A> r .. Ti::! W1:L.l_. OPERATE III COMPLIANCE WITH AF'FE...1:C:AdrIE:. STATE, COUNTY AND LOCAL REGULATIONS J I F:'r } I'4.. r:` ! 'tea. �..`.� ... 1 {:1". .. AMENDED, r-t x,�7 LI C'L:. �:IJE� It.. ARTICLE . 10, TITLE ��' �`�4';;S E ?:A, AS EXCEPT ESTABLISHING FINAL APPOVAL OF A.: INSTALLED SYSTEM Ft..R ISSUANCE ' •E OCCUPANCY E C•PERMIT PURSUANT..t�:_ -: r. •••: .. .. _,.7 ,.tom i . � �� LOCAL•:�,:... � .:_-i•t.:�.�. ! !.1 �..I..:> �1 f.. :...... 'i I ...... ,. t. A/ TS n CistneN C!streN icA • ° fro() ru, to4k a 4 r 4 44' 7 tot Area= z X 201/2 'z- 90z Fe K 2 z rY Or Ato fa/ilk 11•h le t c ot ve - 3 S n to dALs boy = i 1p / J3 -i-t tam)? > Ilet coven = 18 ' • B f dint. k'oy 38Yz 1049k time ± coven to tomh owlet cov ; -7' 7Lk ai did coves fa dfa4t £a4::19� /130 1516 Hospital Road r r _`77K"' � 2 • Greeley, Colorado • PERMIT NO. r/'1OQ'/. /..J Ph. 353-0540 Application for permit to Install, Construct, on Individual Sewage Disposal System, ',Owner K\A Y ft Co The CO Address ) J tg eat-tat f. jtro GG Phone --i' j ' ?'c j o6 Zi.-v'rN.e Direction to site: Hwy Co G • Rd. . N_mi„ E_mi., S_mf., Wjmi, ��t • So,Ai k s , S e n' road Legal Description: Pin_ Sec. 29 , T3N, f 7W Subdiv. Lot Blk General Information Dept. Use Only • No. Bedrooms ICr No. Persons Pere, Role (Avg. of 31 /0ith 4 klthC .) No. Baths 16- Basement Plumbing N O Sod Type_ . geed, l • C la y Size of Lot- /GO C Ve, ! H1O Table Depth_ , HBO supply (if well give depth) AA , c eat — Lot Grade G -S6°/: New Home Mobile Home Modular Add'n Requires Engineer Design Yes ✓ No Type of sewage disposal requested:.___ If yes — reason \.1. • Septic tank_" _ Privy__Other ____.__ -- Comments: This is 'ho 2f fi tha+ -hesysicm Is NOT within goo' of Rbhe SealerXe —• • °S Inatallalion Instructions: (Minimum Requirements) 11 Septic Tank 7� Gals. Absorption Trenches • /6� Sq. Ft. Other or Seepage bed r� I s--T-- Sq. •Ft. Special Instructions This system will be constructed and installed in accordance with the above specifications and regulations re- garding individual sewage disposal systems in Weld County, Colorado This permit shall expire at the crime time as the building permit, or, if nn building permit is issued, the permit shall expire 120 days after its issuance if construction has not been commenced. , Date: t(1 1177 f77 . Owner: • AppI it n65. //�f.f AA41 t\7-t.' :-ri The plans and specifications os shown ore approved pen cling payment of permit fee. Date: .4" j �� Sanitarian 19 The above system, inspected andfound to comply with plan and descriplio . Systems Contractor: ..r��FX// Dale: /z/ Sanitarian: „`� , ..4,---"/..1.--/�^' • Engineer Review: 54 avlural motel Permit Fee: $ 5O ' Q2 , .-,I n f '7 Received by: -^ici.,,,-- h Ca `:'.C"n-^_ _ Date: : JI '� WELD•OUNTY HEALTH DEPASMENT '7CO3' 8 15th Street and 17th Avenue /� P. O. Box 1227 No. 5211-- Greeley, Colorado application for Permit to Install, Construct, Alter or Repair Individual Sewage Disposal System. Owner r Sponsor {/� Addre),ss �--� d Phone +,Z ,- c, `� i.. cL , .r.. �. r If 7 1� �r , 'l ii , Addrress of Site rr ≤ <t 4 t —4'7: C - --r ct '1 — J '1 d. '7 Mailing Address 1,.. l` :2, -"1 ate— , '' '`, �J General Information Septic Tank � 1. Living Units f 1. Liquid Capacity `'CO Ni i'AI 6alhons , 2. No. of Bedrooms --` 2. Dimensions W T D 3. No. of Baths / 3. Material 4. Basement Drain - r 4. Type Inlet 5. Automatic Dishwasher ,..,--e Type Outlet 6. Garbage Disposal a 7. Automatic Laundry : _, Secondary Treatment 8. Size of Lot /G '7r •* —._2-- _ � /� 9. Type of Soil _,� a .r-�y Field a. S S A-q Bed -leg S� ileh 10. Percolation Test 1i' Mt 3, u '1 11. Water Supply CID. ;P. Q 1. No. of distribution fines 12. Lot Grade 2. Trench: Width ` Le gth 13. Water Table Depth 3. Type Filler Material " !a 14. Other 4. Depth of Filler Material 5. Gravel Size /-- 2- - 6. Type Tile Y like y 7. Depth of Cover fri /L, t!n ieI- 8. Other 1(J ' The Permit is to remain in full force and effect for six (6) months from date, until revoked for non-compliance. This system will be constructed in accordance with the above specifications and regulations governing non- municipal sewage disposal systems, in accordance with Regulation No. 1 of the Weld County Health De- partment. Date: 012'^ 9— 70 Applicant: / 4C - L+ /d-./aJ��cyi� The plans and specifications as shown are approved, pending payment of pe 't fee. !/ Sanitarian: /r ' Date: - Z- -- 7 D — 7 I7a The above system inspected and found to comply with the plan and description. Installed by Date: Sanitarian: PERMIT FEE $ 4.2 y •eceived by '2? - - Date Please use reverse side for/Plot Plan or use separate sheet of paper. GREELEY .,-. h.. TRIBUNE " 3O1 93 APPLICATION•R INDIVIDUAL SEWAGE DISSAL SYSTEM No. ' t WELD COUNTY HEALTH DEPARTMENT New ENVIRONMENTAL HEALTH SERVICES 1516 Hospital Road, Greeley, CO 80631ID p Repair _, �:,.. �r ^�� 353-0540 EXT. 270 ✓�/ / /Gr'fC{ :fr/_ BP i, OWNE"rL�rtS_, _ S (C ADDRESS •75 2/ c . flu.--/. ,-r.•, PHONE �', >�. -7/.2, ADDRESS OF PROPOSED SYSTEM 7I re - 7/et G-6- v 6 LEGAL DESCRIPTION OF SITE: PT 7'' S 42 ? ,T -3. , R G> .2 SUBDIVISION I� LOT , BLOCK FILING , USE TYPE: RESIDENTIAL Y, /7,C�1r/e )7C'H7t.. 6.1J INSTITUTION COMMERCIAL OTHER SERVICES: PERSONS BATHROOMS Y LOT SIZE C= K 26, OK) ,_2 riles/JAG' ,, ,.r.- BEDROOMS a BASEMENT P,LUMBING WATER SUPPLY TYPE OF SEWAGE DISPOSAL REQUESTED: '7,17;c' In'' t .C Yi" �1"GY/t#p 7k P.P/4- Applicant acknowledges that the completeness of thi application is conditional upon further 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 application or revocation of any permit granted based upon said appplication and in legal action for perjury as provided by law. Application,ieer''—,- ' i ,, rb. - / , :7j'5 -> Y yob Recd by ,- . ��.- �� !� fcp Date�7�� ' 7 _Owner/Agent Signature Date * * * * * * * * * * * * • * • -4 • * * • * • * * * * * / * * * * * * * * * * * * * * • • * * * • * * * • FOR DEPT. PERCOLATION RATE `7r C, h-1 <-^- / " n---c-t!--r,_ WATER TABLE DEPTH "---,OE ONLY SOIL TYPE --.C- C E.,L--y 7.A.4., -"A' PERCENT GROUND SLOPF - REQUIRES ENGINEER DESIGN ( )YES,( TNo 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 TAN 7 �� GALLONS, ABSORPTION TRENCH j 7 0 / SQ. FT. Or ABSORPTION BED r°' (1 L SQ. FT. In addition,this Permit is subject to the following additional terms and conditions: This Permit is 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 by the Department or its employees of liability for the failure or inadequacy of the sewage disposal system. Environmental Specialist ' Dale "' 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. SYSTEM CONTRACTOR FINAL INSPECTION O/127 SYSTEM ENGINEER APPROVAL r� -2/-/,-11 Environmental Sp lalist he issue ce of this Permit doemply 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 /9— 7q_ /c s 3200 E-z, . Pc 1APPLICATION OR INDIVIDUAL SEWAGE DISISAL SYSTEM No. 22—i;v WELD COUNTY HEALTH DEPARTMENT New X ENVIRONMENTAL HEALTH SERVICES Repair 1510 Hospital Road, Greeley, CO 80031 i ///j 353-0540 ,EX/T 270/ ' BP OWNER FSF ! -O A DRESS&b 2- #ii /0 4,.77f PHONE3ri3-4173 O ADDRESS OF PROPOSED SYSTEM �.2 11' y "ter in 4 "ids LEGAL DESCRIPTION OF SITE: PL/ S ,T ,- , R__ i . SUBDIVISION _ . LOT ; , BLOCK , FILING USE TYPE: RESIDENTIAL y/7 //4 4_ INSTITUTION COMMERCIAL OTHER SERVICES: PERSONS / BATHROOMS /4 •_LOT.SIZE .-5O K 9' O // BEDROOMS CO BASEME PLUMBIN WATER SUPPLYI �(��Cf/r D TYPE OF SEWAGE DISPOSAL REQUESTED: Applicant acknowledges that the completeness of this application is conditional upon further 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, re stnte to be true and correct to the best of my knowl- edge and belief, and are designed to be relied on by the Weld Cou ty Health partmen n evaluatin the same for purposes of issuing the permit applied for herein. I further understand that a y faislfl n or ni p se tall may result in the denial of the applicationpr revocation of any permit granted based upon sa app I t n f perjury as provi by law. Apptrcatio ee D t 0 D�=p Sr Y/ Reed by L� l9 Date< . wner/ ant Slgnatur % Date ii DEPT. PERCOLATION RATE_ / /-) 3 /' 0 r '�- WATER TABLE DEPTH •5/ ONLY SOIL TYPE CC/7 d7 d7°r PERCENT GROUND SLOPE r 2 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 /9h O GALLONS, ABSORPTION TRENCH * SO.FT. Al nci.- e Y,o �0)1‘ or e2 cvo,lol-� e ABSORPTION BED (932) a r SQ. FT. c jJ4Cr`� In addition, this Permit Is subject tc the following additional terms and conditions: -Cur vI This Permit is 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 fl al approval. Th Issuance of this Permit does not constitute assumption by the Department or Its employees of liability for th ure or lrl0d cy of the sewage disposal system. tilled"( ('/‘- Environment peciallet 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. SYSTEM CONTRACTOR _ -- FINAL INSPECTION •TEM ENGINEER APPROVAL /p Envlr nmental Specialist Date The Issuance of this ennit g—/?—C7--- oes not I ply 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 • yf T _ r S '4:-''i7 J Y - - ! �c,7_ ^s. a, - t r { S a.s C14; ,( �yy/x ..r$3$,,-.:‘,--# — t TO _�4 a., °,•1 fff co!: a# ky a \ 1 ' le ,f, q lkb t e. APPLICATION OR INDIVIDUAL SEWAGE DIS•AL SYSTEM No. _ WELD COUNTY HEALTH DEPARTMENT New ENVIRONMENTAL HEALTH SERVICES Re�, �� 70 (p�O BPPalr — 1818 Hospital Road, Greeley. CO 80831 �i� 383.0640 EXT. 0 BP OWNER / SSOG A DRESS y ciPHONE 3-53-4 �y ADDRESS OF PROPOSED SYSTEM 71, _ �±c-- 7 �y 7617.7 ,Po u h a"S LEGAL DESCRIPTION OF SITE: PT/ SrL L,T _;R SUBDIVISION A LOT BLOCK___:__, FILING USE TYPE: - RESIDENTIAL ��/ de ��.�..� Cl INSTITUTION ' COMMERCIAL_ OTHER SERVICES: PERSONS BATHROOMS 4 _LOT SIZE cSU X 90 BEDROOMS (p BASE NT PLUMB k9 ' WATER SUPPLY K 1X/T) TYPE OF SEWAGE DISPOSAL REQUESTED: :et17 F .O n-et° 2 ' Applicant acknowledges that the completeness of this application Is conditional upon further 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 nabs 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'appllcant ire, or Will be, repr= e e• be true and correct to the best of my knowl- edge and belief, and are designed to be relied on by the Weld Coun Health D •artment evaluating the same for purposes of issuing the permit applied for herein. I further understand that a falslfIc 6 or in - •rise tat!• may result In the denial of the appllcatiolor revocation of any permlhgranted based upon sal. appil - ,n .n ,f/.'j�- ti•n f• perjury as provld law., Appttcatio ee d �/, � �'�fV Rso'd by. 1 DatagL ' ' ner/Ag t ignature ate DEPT. PERCOLATION RATE / //in WATER TABLE DEPTH • ONLY SOIL TYPE fon6/y C/"7 PERCENT GROUND SLOPE^'? ``' REQUIRES ENGINEER DESIGN ( )YESK 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 /75 GALLONS, ABSORPTION TRENCH SQ. FT. 4'4-nolr ehc,-,0h or area avG,\alit ABSORPTION BED �c' SQ. FT. ' brA-c'c' c`1J/9„5"--D 'r^J In addition, this Permit is subject tc the following additional terms and conditions: This Permit is 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, Inai approval. T Issuance of this Permit does not constitute assumption by the Department or Its employees of liability for th failure or y of the sewage disposal system. 024 11 Environmertlial 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. SYSTEM CONTRACTOR __FINAL INSPI=91�Z q STEM ENGINEERS APPROVAL i( y_/9(J Environmental Specialist Date The Issuance of this ermit does not II . ply 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). s;Original-Applicant; Copy-WCHD WCHD—EHS February, 1981 • (...., n (q CO • 0i . 2' - c > 3 it ir ao0aa APPLICATION INDIVIDUAL SEWAGE DIS•AL SYSTEM No. 2'-- " ELD COUNTY HEALTH DEPARTMENT New X' ENVIRONMENTAL HEALTH SERVICES Repair 1518 Hospital Road, Greeley, CO 80831 /� 353.0540 ,�yXT. 70 BP OWNER sc 11- 50&--/ ADDRESS,5X/ _ _= L __ PHONE ,353-4/?3(6 ADDRESS OF PROPOSED SYSTEM O Q r` 7/ / ? 7 ,f�/J/.7weiuA S LEGAL DESCRIPTION OF SITE: PT/Y �' S , T 13 _, R Call SUBDIVISION LOT ,.BLOCK , FILING USE TYPE: RESIDENTIA ��/f#J ar.,�• _ INSTITUTION COMMERCIAL OTHER // SERVICES: PERSONS BATHROOMS ? _LOT SIZE AO y 70 BEDROOMS 4 BASE NT PLUMBI G�-77- WATER SUPPLY rv(X(%/>>� TYPE OF SEWAGE DISPOSAL REQUESTED: (/47?.(i tir.te Applicant acknowledges that the completeness of this application is conditional upon further 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 statemen - made, information and reports submitted here- with and required to be submitted by the applicant are, or will be, repr_;anted be true and correct to the best of my knowl- edge and belief, and are designed to be relied on by the Weld Coun Health + ;•artment evaluatin! e same for purposes of issuing the permit applied for herein. I further understand that an, falslfi f#n or r;•i son atio• ay result in the denial of the applicatlogor revocation of any permit granted based upon sal. appll : y-If tl//'fo • duty as provided w Application es d ® i.u.✓� /X//ll� � >`/ItReo'd by Date 9 9.v--- wner/Ag t Signature ate • • • R # ♦ M b k * • M IllDEPT. PERCOLATION RATE / /in 3D /rid• WATER TABLE DEPTH 7 fl ONLY SOIL TYPE caslely Ch"cc PERCENT GROUND SLOPE /`�..?9b REQUIRES ENGINEER DESIGN ( )YES ((No a,zy 9 a INDIVIDUAL SEWAGE DISPOSAL✓ SYSTEM PERMIT 4( q7o a v�a�� From the application Information supplied and the on-site soil percolation data, the following minimum Installation specifi- cations are required: SEPTIC TANK /°Z5-0 GALLONS, ABSORPTION TRENCH A' SQ. FT. * `ntA, eho„ k or ,Ial�e ABSORPTION BED /9/ cb SO. FT. Q� ava In addition, this Permit is subject tc the following additional terms and conditions: r -0-ehek 'l-emi This Permit is 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 t al approval. The issuance of this Permit does not constitute assumption by the Department or its employees of liability for th t<llura or l Se. 'acy of the sewage disposal system. tnvironmen - 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. SYSTEM CONTRACTOR _ FINAL INSPECTIO /pp'�TEM ENGINEER APPBQV ,L33 -'� �d�-3 Envl onmentale cialist The issuance of this Permit does not imply Oompliana with other state, ounty or 145 I regulatory or'building req , 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 prro ! ! Q 5- 57,gi 3C _ 7/----(tifr tooQci ` d P 1 � 1 5/ 21 I M JIV',/'d ' APPLICATION OR INDIVIDUAL SEWAGE DISIIISAL SYSTEM No. 17-82 7Q/O S4 //wy 6,C WELD COUNTY HEALTH DEPARTMENT New X it !� n / ENVIRONMENTAL HEALTH SERVICES 1616 Hospital Road, Greeley, CO 80831 Repair OWNERSc 353.0640 EXT 27/0 ' [ / BP SOG ADDRESS 79S li&V ZoP 47- v PHONF.46— '173& ADDRESS OF PROPOSED SYSTEM 771-n ,6unil LEGAL DESCRIPTION OF SITE: PTa Ss2L, T _, R 10'Y SUBDIVISION LOT , BLOCK , FILING USE TYPE: RESIDENTIAL/ , J./74J79 ¢i7GP., Cam, INSTITUTION - COMMERCIAL OTHER SERVICES: PERSONS BATHROOMS Al _LOT SIZE 39 X 70 .P;" 4 wAU' 0,O`o BEDROOMS & BAS ENT PLUM LyG WATER SUPPLY 61A 0th TYPE OF SEWAGE DISPOSAL REQUESTED: (.-00V 2 Applicant acknowledges that the completeness of this application is conditional upon further 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 statem=. - ade, information and reports submitted here- with and required to be submitted by the applicant are, or will be, reps--'nted o be true and correct to the best of my knowl- edge and belief, and are designed to be relied on by the Weld County ealth •artme n evaluatin• the same for purposes of Issuing the permit applied for herein, I further understand that any alelflc �'tn or I-•rase tall•jmay result in the •enlal of the application or revocation of any permit granted based upon said ,ppll /- .a. c I❑s !-rjury as provl•=• • law. Application fee / O , ct /,�`� Rec'd byj DateaZ R22 Owner/A• -nt Signature ate A itDEPT. PERCOLATION RATE / /'1 3° mc"- WATER TABLE DEPTH 7 ' / ONLY SOIL TYPE S ''dy c /c y PERCENT GROUND SLOPE ^2 9' REQUIRES ENGINEER DESIGN ( )YES 03 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' • GALLONS, ABSORPTION TRENCH SO. FT. ,K h:} P„"1 L or Gr1145k a_,--fa ABSORPTION BED /9� SQ. FT. In addition, this Permit Is subject to the following additional terms and conditions: v-, (K"` {7' ry This Permit is 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 by the Department or its employees of liability for fh lure or In y of the sewage disposal system. ,24te Environment peclallat 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. Aurov9 6-pvkAch fl SYSTEM CONTRACTOR ' - Parr FINAL INSPECTION STEM ENGINEER APPROVAL f odes r - irZ.ci .S y,12 Environmental Spe 1st 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 25-10-111 (2). Original-Applicant; Copy-WCHD WCHD—EHS February, 1981 . .• , • • • ..^ ! "� .._::' ,. - .�•. . . . .•' • w. j.. C.0 ,. .. • -it C.ii .•. • ,r7t •. ?c E:' ' -s- •. •i.- •. _ ,• , '(�y�y�//�'w_r .t^�,© �Y •fit.. r'.`•; 9,! ty - & •C �r° _ r r. r • •:F7' • 7'7 • t l I . i t - • APPLICATION • INDIVIDUAL SEWAGE DISOSAL SYSTEM No. 18-82 2,0 1G N` `l 6 WELD COUNTY HEALTH DEPARTMENT New X ENVIRONMENTAL HEALTH SERVICES• Repair _ 1618 Hospital Road, Greeley, QO eoe31 l _ 363.0640 �EEyxxT. 2 / ,//�� )) 2 BP ! OWNER7%'A � `a-Sdei ADDRESS 7s (0 A /TG/PHONE 3sS 47$67 ADDRESS OF PROPOSED SYSTEM J_ R , /7/17 /-rh� LEGAL DESCRIPTION OF SITE: PT N S 49 ,T iJ _, SUBDIVISION 7 LOT , BLOCK , FILING USE TYPE: RESIDENTIAL Y / e mo, .2' INSTITUTION COMMERCIAL OTHER ,. SERVICES: PERSONS BATHROOMS _LOT SIZE. Q0 )6 YO of f,'n 1/4nclei BEDROOMS (a, BASES PLUG WATER SUPPLY ea-ie- �TJ TYPE OF SEWAGE DISPOSAL REQUESTED: �7q Applicant acknowledges that the completeness of this application is conditional upon further 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 statem)nt ade, Information and reports submitted here- with and required to be submitted by the applicant are, or will be, repr ented o be true and correct to the best of my knowl- edge and belief, and are designed to be relied on by the Weld Cou Heal epartme n evaluating a same for purpose° of issuing the permit applied for herein. I further understand that y falsi a on or I prase ation ay result In the denial of the applicationgr revocation of any permit granted based upon d a I act n for rjury as proved yaw. AppircattorAlee�^ & 00 9 Reed bye A/lO-N 2 Date al"7 `C-1 wnerl ant Signature ate asDEPT. PERCOLATION RATE I in O iN. WATER TABLE DEPTH 7 & ONLY SOIL TYPE C bn°Y CM+y PERCENT GROUND SLOPE ,2 LP, REQUIRES ENGINEER DESIGN ( )YES(ly'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 /75t GALLONS, ABSORPTION TRENCH SQ. FT. * no+ cv,uagl) ABSORPTION BED /q 4D or SQ. FT. aJa`'^�6 area In addition,this Permit is subject tc the following additional terms and conditions: for 4 re cl,' fyS. This Permit is 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 by the Department or its employees of liability for failure or Inds cy of the sewage disposal system. cG� • O7./6' E vironm I 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 byII the Health Department. SYSTEM CONTRACTOR-VC-Asia-4 'Reim Aurora ta CONTRACTOR-VC-Asia-4FINAL INSPECTION / +� •TEM ENGINEER APPROVAL I � .S•z( L Env ronmental S ist 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 25-10.111 (2). Original-Applicant; Copy-WCHD WCHD—EHS February, 1981 •• • : • • ..... .. .. ' , • : . . ...... • .... 0 . ... . . . . . . . . . .....:. . . .... .. .... .r . .. . . . .. . . . •• .. . • . ._ . . . .._....... .._ . .. ... _ . . . . . ...,..:„............_:„.. ji,......„.: . . ..... . • •. .. .. .... .. . • . • .... .. _ . . . :• . ... .. ... .. . • • • ..• _ ......_ ....... . . . . . _ . t . . .- ....ii. ,;.,,,..••• . _ ... . ..... 1 ..._____.. .r.-• . • -. . .. ... . ..... .... . . .. . , , . i_...........5,hdre. .,........1 . „.„, . . .:. . ., .,... .......• •, ..7 .. . • . ,o , r ski;44,-, . . •.__„.. ... „....i...t.:. .. . • .,; . :„ ... .. 6-. i r . C I,t,"GC.-,caf • ,o ,w,y -1 1 • . \ \ . - .i. ' * 481E " i I \ ,.. . _.. - . ... . 0 `Sid ODVI APPLICATION •R INDIVIDUAL SEWAGE DIS•SAL SYSTEM No. Jr- WELD COUNTY HEALTH DEPARTMENT New X ENVIRONMENTAL HEALTH SERVICES Repair 1515 Hospital Road, Greeley, CO 80031 • 353.0540 EXT. A / / // �I PHONE �3- 73i' OWNER - �� S� (Lcsoc . ADDRESS ,,�.. JrfclJy IOtO ADDRESS OF PROPOSED SYSTEM fd 72- !2� Tor .C 7frA-4-.1-' LEGAL DESCRIPTION OF SITE: PT � e7. ,T ,1 R 7 SUBDIVISION LOT , BLOCK , FILING USE TYPE: RESIDENTIAL...41in= INSTITUTION COMMERCIAL OTHER SERVICES: PERSONS BATHROOMS t/ (_LOT SIZE :3 o Y C�i BEDROOMS BASEMENT PLUM NAG ,- WATER SUPPLY 717(21ill) TYPE OF SEWAGE DISPOSAL REQUESTED: ( �C974�� '��' " ' Appllcant,aoknowledges'that the completeness of this application is conditional upon further mandatory and additional tests and reports`asmayibe 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 state a made, information and reports submitted here- with and required to be submitted by the applicant are, or will be, r silent to be tr a and correct to the best of my knowl- edge and belief, and are designed to be relied on by the Weld Co ty He `Depart e t in eval ting the same for purposes of issuing the permit applied for herein. I further understand that ny fal ation r , . pr se Ion may result in the-denial of the application or revocation of any permit granted based upon Id II t d n I al tl or perjury as provided �y . Application r e 0 ` 9/5 -27. Reed by • Date-?-y'2.2- Owner gent S gna ure / /Date DEPT. PERCOLATION RATE / i"n 3O inn! • WATER TABLE DEPTH 7 8\ ONLY SOIL TYPE s-b^`T'7 C/c47 PERCENT GROUND SLOPE 7'- 2 XV,. REQUIRES ENGINEER DESIGN ( )YES IKNo INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT From the application information supplied and the on•site soli percolation data, the following minimum installation specifi- cations are required: SEPTIC TAN GALLONS, ABSORPTION TRENCH *.` `4 San. or At ,nc-k einc_,-kyn ABSORPTION BED /95D SQ. FT. ava ‘o,blcIW In addition, this Permit is subject tc the following additional terms and conditions: ,p__Th,.4yz,-c L. kr�S This Permit Is 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 by the Department or Its employees of liability for th !lure or Ina eq c of the sewage disposal system. __fir a • /4 � nvironme cialist 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 bails. Final Permit approval is contingent upon the final in- spection of the completed system by the Weld County Health Department. SYSTEM CONTRACTOR FINAL INSPECTIO O��'7 *TEM ENGINEER APPROVAL -e, 2 0 7 ,�c�i; _�_ Env . mental e list Date The issuance of this Permit does ndTimpycompliance with other state county or I al eguietory or building requirements, nor shall It act to certify that the subject system will operate in compliance with applica a state, county and local regulations n adopted pursuant to Article 10, Title 25, CRS 1973, as amended, except for the purposes of establishing final approval of an ro) nstalled system for issuance of a I aLoocup ncy permit pursuant to CRS 1973 25.10.111 (2). riginal-Appiicant; Copy-WCHD WCHD—EHS February, 1981 A( 7 . i y ' gip, 3 5- eY' -CP/ 3 nub , ,,,t - ,, - • - . .p �: S9,b0/6 APPLICATION Fil INDIVIDUAL SEWAGE DIS•AL SYSTEM No. - WELD COUNTY HEALTH DEPARTMENT �I� New ENVIRONMENTAL HEALTH SERVICES !I r (o Repair • 1510 Hospital Road, Greeley, CO 00031 ll 11 OWNERS r 353.0540 EXT. 70 / �/�� BP f �s..SOC. ADD EyS 73f�d� %4 J/, /4 NAT/h�PHONE 1A3-4,/;:-:</c ADDRESS OF PROPOSED SYSTEM , 4" 7`— 72 / / 77>h, ,CJowg', `• LEGAL DESCRIPTION OF SITE: PT /y-= �,T _, R 471 SUBDIVISION LOT ,.BLOCK , FILING USE TYPE: RESIDENTIAL X 71/44;42 /412-9-1„/ 02 , INSTITUTION COMMERCIAL OTHER SERVICES: PERSONS BATHROOMS 4 _LOT SIZE 45® Xr 90 BEDROOMS 6 BASEMENT PLUMB NG WATER SUPPLY& 'e 07 TYPE OF SEWAGE DISPOSAL REQUESTED: PAW �Aa�Prl 1 P Applicant acknowledges that the completeness of this application Is conditional upon further 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 eta nts made, information and reports submitted here- with and required to be submitted by the applicant are, or will be, r rase d 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 H h Departme ,n evaluati the same for purposes of issuing the permit applied for herein, I further understand thjtn# fai ation or mi r resentat may result in the denial of the applloatio�or revocation of any permit granted based upon Id I t ac n r rjury as provided I w. Apprtcatlortfee /&` #0 94 Reed by.r ✓' h 85 Date..2:7' ga— Owner/ gent Signature pate WEPT. PERCOLATION RATE / /%n ��M/N , WATER TABLE DEPTH 7 c5 / NLY SOIL TYPE canary c/c/ PERCENT GROUND SLOPE c"-'?9J , REQUIRES ENGINEER DESIGN ( )YES pC) No I 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: } e �u SEPTIC TANK /75t GALLONS, ABSORPTION TRENCH * SO. FT. K rc 9 Or corn c„orlabl� ABSORPTION BED /94D SQ. FT. -Fur '-\rcv.eL&J In addition, this Permit Is subject to the following additional terms and conditions: This Permit is 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 by the Department or Its employees of liability forththe-failure or lnaid su the sewage disposal system.e-nezeofnvlronme tai 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- spectlon of the completed system by the Weld County Health Department. SYSTEM CONTRACTOR FINAL INSPE I �� EM ENGINEER APPROVAL 7 lC 1-4—K3 nviron ntal Specialist Date The issuance of this Permit does not Imply compliance with other s ate, 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 • • ii N -/ - • 7 .a'1 C O Sl'3s l5-t- SPI?•1_5-- . c _ ---O 7-,- /000 Epc z : (coo e, & O ,, 21235 E sDe -__5- 1 I , '30013 APPLICATIONOR INDIVIDUAL SEWAGE DIAISAL SYSTEM No. 15-:'''-' WELD COUNTY HEALTH DEPARTMENT New _ ENVIRONMENTAL HEALTH SERVICES 'b III ,, • 1618 Hospital Road, Greeley, CO 80631 ell' 1-0 Repair _ �a r 1 363.0640 EXT. /_ l� BP OWNER , 7/ S.S(1� , • ADDRESS/aget-� _ / IIG PHONE 35,3-4 3(6) . ADDRESS OF PROPOSED SYSTEM / o . ( ? aZ a 77.7,7 /(7,4 Air's LEGAL DESCRIPTION OF SITE: PT_ �S- , T_- __, R.4_7_ SUBDIVISION // LOT , BLOCK. , FILING USE TYPE: RESIDENTIAL X/ al/ -20b;1(.7 (z) INSTITUTION COMMERCIAL / OTHER � SERVICES: PERSONS BATHROOMS T _LOT SIZE . 577 X 90 BEDROOMS 4 BAS MENT PLUMBING WATER SUPPLY(�L1)ete. Z% TYPE OF SEWAGE DISPOSAL REQUESTED: (4--i tJ &7 J .— Applicant acknowledges that the completeness of this application is conditional upon.further-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„rep`ree ed 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 H Ith pep ent in aluating the same for pur ores of issuing the permit applied for herein. I further understand th t any fa icatl n rpierep ntation may result In th bbbdyyyenial of the application or revocation of any permit granted based upo said c I Ion for perjury as provid law. Appircatio ee 9 �"N' ' od J{/ -urr Reed by I Date,,, y S?.a,- Ow r/Agent Signature Date a SDEPT. PERCOLATION RATE__ /i in 9O h,/^v. WATER TABLE DEPTH >5 ONLY SOIL TYPE cond2i r/7 PERCENT GROUND SLOPE ^-o7 c7.- REQUIRES ENGINEER DESIGN ( )YES(J6No INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT From the application information supplied and the on-site soli percolation data, the following minimum installation specifi- cations are required: SEPTIC TANK /74-O GALLONS, ABSORPTION TRENCH SQ. FT. IQ-3c e "N'�or cvar G l£ -=-"" a ABSORPTION BED /F67) so. FT. 4c tr"`t.P, In addition, this Permit is subject to the following additional terms and conditions: This Permit is 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 by the Department or Its employees of liability to a Failure or Ma ""-ss f the sewage disposal system. — a�� ! 01 /6 -(-P - Environm otg(Specialiet 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. SYSTEM CONTRACTOR - i FINAL INSPE W)/',TEMENGINEER �� APPROVAL �-(/� nviro ntal Specialist e The issuance of this Permit does Irr(ply 1-62-f -c( with other st te, count 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; CopyWCHD WCHD—EHS February, 1981 tif 1 • 0 r 72- Id7 - 6 Ca-,..2 Wk.. art 6 I 6,-- C O W c 0 ( f / - 7`-1) d ? ' Sp7 3s � it- Sp/e3 s U- !S f-✓ i 6. Gi_l I d-ri 47 s tZ --)-v, s Ca mac) 2 f- - i /e,,1 C tbee s,,,p \ cT� I : ) 1 / ., • II i `/ 9 ' • .. gc900/ 1( ' APPLICATION •R INDIVIDUAL SEWAGE DISIIIISAL SYSTEM No. ��ai Cc:\o NQ.%� �Ep WELD COUNTY HEALTH DEPARTMENT New ENVIRONMENTAL HEALTH SERVICES 1518 Hospital Road, Greeley, CO 80831 Repair _ 353.0540 EXT. 270 ' /7 BP �. J `, `7�' ' (> 4 /, < '1 ;•,!1 ///?ll'.'GaIioNP" _ ' :, OWNER_ Ji ADDRESS _ % ,. ( - ADDRESS OF PROPOSED SYSTEM ?, LEGAL DESCRIPTION OF SITE: PT -'"a. S «? ? , T '2 _, R 7} 7 T` ' SUBDIVISION /� _ LOT BLOCK , FILING USE TYPE: RESIDENTIAL E> 42.0e2//9 (4r7.4aP(.Q)INSTITUTION COMMERCIAL OTHER SERVICES: PERSONS BATHROOMS 274 LOT SIZE * x 90 laity , CQL.b t.„.at; BEDROOMS (0 BASEMENT PLUMBING -- WATER SUPPLY es//le:0: /c1 TYPE OF SEWAGE DISPOSAL REQUESTED: / 1447//PA`'//cN M,/> Applicant acknowledges that the completeness of this application Is conditional upon further 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 end required to be submitted by the applicant are, or will be, represe},ted 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 He th Depa went in evaluating the same for purposes of issuing the permit applied for herein. I further understand that any fal jfication' r misre re$ration may result in the/denial of the application or revocation of any permit granted based upon'said,ap I betion. Dirt' I gdtibn for perjury as provided'by law. Application/7e �� Ol � ,�%• al�r .,, Reed by -, Al/4i/1e*/-'�7 Dates 0�-- 7 Own9tlA ent il Signature Date * M k * * M * M ♦ * •!a � DEPT. PERCOLATION RATE_ / " in 'o "2,-,,,,/ WATER TABLE DEPTH r E ONLY SOIL TYPE Sandi- d/qy PERCENT GROUND SLOPE ^, c 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 /7S0 GALLONS, ABSORPTION TRENCH >ke SO.FT. * No 1 -`' ' 5" Or <rea -' r` 4-Or 4n,.c .r, ABSORPTION BED /9 SQ. FT. ,. In addition, this Permit is subject to the following additional terms and conditions: This Permit is 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. Th issuance of this Permit does not constitute assumption by the Department or Its employees of Ilabllity,far the failure o Mad cy of the sewage disposal system. 1Y aJ,el Envi ro ,gtd(Speclal ist Date This Permit is not transferable 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. I SYSTEM CONTRACTOR i ‘ '' Ca- '"" cxc FINAL INSPECTION *STEM ENGINEER APPROVAL C Envir nmental Spearalist 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 25.10.111 (2). Original-Applicant; Copy-WCHD WCHD—EHS February, 1981 • • r ` • 1 A-. 1111 ��.._ �-_-•..__.._. ..._ I �`i t t fi .kov..� c- f`� .� N Ct 4 ti vv.,'r^ 3 j •Y9 4 • 1� .-....._ ---_- ...1 I IL i a—1 t13 vwLQ• q Y1j •* ms\��+ EAA.._ \1'r -(k4U ..---".......N. I� i • 6-1 1-. 1... • • , vim. 'N.') ._ - . � • �1 ` yam. _rTr ' y f I :�: T - \ I l 1 { { \ \ ry s \ . \ i ' \ ,1 : ,i ; ..,.J...._ 1 (. T • 1 w ��•` ...« �.___...._�...., l.�j.., `. ��•I — +-4-may • f. r_ 1.... i9;SF'ii•)6P INDIVi: L SEWAGE" DISPOSAL. SYSTEi`i RM].1 NO . i.,....;:{6c:;237 WELD COUNTY I•'II:::ALTH DEPARTMENT NEW PERMIT ENVIRONMENTAL HEALTH SERVICES 0 15. 6 HOSPITAL ROAD, GRE::E:LEY, CO ₹'0631 353-0635 EXT. 225 OWNER AURORA DAIRY FARMS ADDRESS 7388 STATE HIGHWAY 66 PH (303) 535-462 LONGMON•T , CO 130501 ADDRESS OF PR(:)F'OSEI) SYSTEM WCR 15 JOI-INETC)WN , CO 80534 • i...EGAL. DESCRIPTION OF SITE : SW4 SEC 32 TWP 4 RNG 67 SUBDIVISION : LOT 0 BLOCK 0 FILING 0 USE TYPE : COMMERCIAL DAIRY FARM SERVICES : PERSONS 15 BATHROOMS 1 .00 LOT SIZE 160.00 ACRES BEDROOMS 0 BASEMENT PLUMBING NO WATER SUPPLY LTHMP APPLICATION FEE $150.00 REC ' n BY RECEPTIONIST ( I D SIGNED BY GEORGE SMITH DATE 09/19/(:36 DATE 09/19/86 PERCOLATION RATE AZ MIN PER INCH LIM:I:TIN ZONE 4 FEETSOILT•'iF'F.: F. M T PER GROUND SLOPE „ , D.I:RI::.(.:•l-I ON 40- I:-QUIRE ENGINEER DESIGN .._yam 1;cuM THE Al LIC:A••(•J ON INFORMATION SUPPLIED AND THE ON-SITE SOIL I:L PERCOLATION ON DATA THE FOLLOWING MINIMUM INSTALLATION SPECIFICATIONS ARE::: REQUIRED : SEPTIC TANK ..: Am.._ GALLONS , ABSORPTION TRENCH 7'_—•• E Q . F T. OR ABSORPTION BED c7r96.. SQ . FT. i:N ADDITION, THIS PERMIT IS SUBJECT TO THE FOLLOWING ADDITIONAL TERMS AND CCOTIONS : ___--_____..._....._ .._:........_..........................-- ---- - ---_ __ -___ • —---------dbile.4".....al.p/i.,.e I...ye/arc/41O4 THIS PERMIT IE GRANTED TEMPORARILY TO ALLOW CONSTRUCTION TO COMMENCE. THIS PERMIT ..1AY BE REVOKED OR SUSPENDED BY THE WELD COUNTY HEALTH DEPARTMENT FOR REASONS a SET I:•(:iRIii IN THE Wi:::I...0 COUNTY INDIVIDUAL I:D(.JAI... SEWAGE DISPOSAL SYSTEM REGULATIONS INCLUDING A:i:i...OH- TO MEET ANY TERM OR CONDITION IMPOSED THEREON DURING TEMPORARY OR FINAL PPRO's Ai...:. THE .I:SSUAN(::I..: OF THIS PERMIT DOES NOT CONSTITUTE ASSUMPTION BY THE I:::I ARTMI NT OF: ITS EMPLOYEES UI LIABILITY FOR THE FAILURE Or, INADEQUACY OF THE SEWAGE DISPOSAL.. SYSTEM. kpis s?Vs.._4444;___ ::. VIRI•JNHil:::i Al... SPECIALIST DATE ,'HIS PERMIT 1.5 NOT TRANSFERABLE AND SI-HAL...l... BECOME VOID IF SYSTEM CONSTRUCTION HAS iCi•I COMMENCED WITHIN ONE 'iI:::AR OF 1:•1•S ISSUANCE. BEFORE ISSUING FINAL. APPROVAL OF THIS' PERMIT TI•lE WELT) COUNTY I-IEAl_.TI•'I DEPARTMENT RESERVES THE R:l:(;HT TO IMPOSE ADDI— •IONAL TERMS AND CONDITIONS REQUIRED TO MEET OUR REGULATIONS ON A CONTINUING BA— :;IS. IINAL... PERMIT APPROVAL IS CONTINGENT UPON •1.1••11": FINAJ_. INSPECTION OF THE COM— : i...F TFI) SYSTEM BY THE: WELD COUNTY HEALTH DEPARTMENT. 0/0111D . / 2 --i --V,' ??..1 _ T. C . 1-2 -/-4v 1: ,l::I:CINAL..••-APPLICANT, COPY-•WCIiD WCHD••-EI••IS MAY, 1984 y • • o,, rbF' INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT NO. G-940255 WELD COUNTY HEALTH DEPARTMENT NEW PERMIT • ENVIRONMENTAL HEALTH SERVICES 1517 16TH AVENUE COURT, GREELEY, CO 80631 353-0635 EXT.2225 OWNER AURORA DAIRY CORP ADDRESS 4311 HWY 66 PH (303) 535-055 LONGMONT CO 80504 ADDRESS OF PROPOSED SYSTEM 18430 WCR 15 JOHNSTOWN CO 80534 LEGAL DESCRIPTION OF SITE: SW4 SEC 32 TWP 4 RNG 67 SUBDIVISION: LOT 0 BLOCK 0 FILING 0 USE TYPE: RESIDENTIAL MOBILE HOME SERVICES: PERSONS 2 BATHROOMS 2.00 LOT SIZE 160.00 ACRES BEDROOMS 4 BASEMENT PLUMBING NO WATER SUPPLY LTHMP APPLICATION FEE $150.00 RECD BY CHAD YOUNG SIGNED BY BILL CRONIN DATE 05/24/94 DATE 05/24/94 PERCOLATION RATE 16. 1 MIN PER INCH LIMITING ZONE 8 FEET SOIL TYPE SUITABLE PERCENT GROUND SLOPE O% DIRECTION REQUIRES ENGINEER DESIGN NO IN 100 YEAR FLOOD PLAIN ZONE NO rROM THE APPLICATION INFORMATION SUPPLIED AND THE ON-SITE SOIL PERCOLATION DATA THE FOLLOWING MINIMUM INSTALLATION SPECIFICATIONS ARE REQUIRED: SEPTIC TANK 1250 GALLONS, ABSORPTION TRENCH 868 SQ. FT. OR ABSORPTION BED 1172 SQ. FT. I DDITION, THIS PERMIT IS SUBJECT TO THE FOLLOWING ADDITIONAL TERMS AND ITIONS: - • "HIS PERMIT IS GRANTED TEMPORARILY TO ALLOW CONSTRUCTION TO COMMENCE. THIS PERMIT AY BE REVOKED OR SUSPENDED BY THE WELD COUNTY HEALTH DEPARTMENT FOR REASONS SET =ORTH 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. PAM SMITH 2/94 ENVIRONMENTAL SPECIALIST DATE 6 - / 3 -99/ 'HIS PERMIT IS NOT TRANSFERABLE AND SHALL BECOME' VOID IF SYSTEM CONSTRUCTION HAS `:OT COMMENCED WITHIN ONE YEAR OF ITS ISSUANCE. BEFORE ISSUING FINAL APPROVAL OF 'HIS PERMIT THE WELD COUNTY HEALTH DEPARTMENT RESERVES THE RIGHT TO IMPOSE ADDI- ' IONAL TERMS AND CONDITIONS REQUIRED TO MEET OUR -REGULATIONS ON A CONTINUING BA- SIS. rINAL PERMIT APPROVAL IS CONTINGENT UPON .THE FINAL INSPECTION OF THE COM- 'LETED SYSTEM BY THE WELD COUNTY HEALTH DEPARTMENT. Z; SYSTEM INSTALLER ftov(. FINAL INSPECTIL 'j ^ E 'STEM ENGINEER �" APPROVAL ! YPE OF SYSTEM INSTALLED b ENVIRC: MEN SPECIALIST ' HE ISSUANCE OF THIS PERMIT DOES NOT IMPLY COMPLIANCE WITH OTHER STATE , COUNTY CAL REGULA1ORv OR BUILDING REQUIREMENTS, NOR SHALL IT ACT TO CERTIFY THAT UBJECT SYSTEM WILL OPERATE IN COMPLIANCE WITH APPLICABLE STATE. COUNTY AND -.:CA_ REGULATIONS ADOPTED PERSUANT TO ARTICLE 10, TITLE 25, CRS 1973, AS AMENDED . YCEF'T FOB' THE PURPOSE OF ESTABLISHING FINAL APPROVAL OF ANINSTALLED SY EN :JF : SSUANCE OF A LOCAL OCCUPANCY PERMIT PURSUANT TO CRS 1973 25-10-111 (2) . : "I6INAL-AP�'LICANT : COPY-WC'-:D r . _ • • • • IiNJ%1 RZ ~w �idec� b(� r I T 6' I ill /25-0 9� o anu m o Z4' (1.1I ■ 1Z, • 15 ' . II :v,, DOCUMENT: STATEMENT OF EXISTING ' DISKETTE: BPS2B STATEMENT OF EXISTING SEPTIC SYSTEM (Fill out in ink) OWNER OF RECORD: PBONE:A.A _room_ MAILING ADDRESS: SITE ADDRESS: • LEGAL DESCRIPTION: P1_iej... ..e. P2 Sec 32-- TWNSP. RNG (,7 West Subdivision: __ Lot: Block: Filing: Bedrooms i, _ Bathrooms 2 Water Supply * + 1e Thompson IIse type c residence Lot Size ___43___________--Acres _ and has i snn gals capacity SYSTEM SIZE: Tank is constructed of (material • ABSORPTION BED: p _ sq. Ft. Total . Date System Installed [ ¶ 13 • 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 description, and further states that' the system isi gd 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 g pndded te based y upon this information hereby submitted and in legal action for prejury as aw. Aurora Capital Group Ltd. 62, e.-"L By: ite-r June 3, 1988 Date Subscribed and sworn to before me this day of , 193E by 0 g . Pa 072te v Witness my hand and official seal. My commission expires l/31q1 4o - 3-st Notary Publi Date g3oo25 APPLICATION • INDIVIDUAL SEWAGE DISIOSAL SYSTEM No. t' WELD COUNTY HEALTH DEPARTMENT New ENVIRONMENTAL HEALTH SERVICES 1818 Hospital Road, Greeley, CO 80831 • - Repair _ 3630540 EXT. 270 BP OWNER J A/5 / J, Oe . ADDRESSS 54`,/if 47 G� PHONE-4-'5 6- 2,:- ADDRESS OF PROPOSED SYSTEM / -h,(0,/,S r� fir: LEGAL DESCRIPTION OF SITE: PTO S_�.�, T _, R l<i I SUBDIVISION - LOT , BLOCK______, FILING USE TYPE: RESIDENTIA Y -� 'I('_LSL- INSTITUTION COMMERCIAL OTHER SERVICES: PERSONS . 5 BATHROOMS _LOT SIZE r&(V' x c2Dt / 0. 7/ BEDROOMS B MENT PLUM ING WATER SUPPLY(/ ///I/) TYPE OF SEWAGE DISPOSAL REQUESTED: 2 1? 7.4"i sa(9 Applicant acknowledges that the completeness of this application le conditional upon further 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, Infotmation 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 id application and in legal action for perjury as provided by law. Application/Coe 00 , N, sL biz .( .`'; Recd by,L/' ,Jr2-"� ' .u..a' Dates 64" .3 \ Owner/AgentSignature Date « « « « « « « « « « « « p / e DEPT. PERCOLATION cRATE_ a� 1 117 C4 WATER TABLE DEPTH ?a U ONLY SOIL TYPE �if...r�// �-, PERCENT GROUND SLOPE in./4e_ h0 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 /a' GALLONS, ABSORPTION TRENCH d/ 7 SQ. FT. p. or ABSORPTION BED ?0 Z- SQ. FT. In addition, this Permit is subject to the following additional terms and conditions: This Permit is 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. T Issuance of this Permit does not constitute assumption the Department or its employees of liability for e /allure d cy of the sewage disposal system. Sat 83 c 4 Ala* sap..., ?3/0. — / A p 1—c -f3 Rot / ` nnviro en al S eci ist Date 7'�lOpZ re-7/4ove fC 're, -.-- This Pe It 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. SYSTEM CONTRACTOR - FINAL INSPECT «N / ,ep a� .TEM ENGINEER APPROVALt. f �0—j3 En ronmental Spool I Da (J The issuance of this Permit does not Imply compliance with other stet:, county or local r g story 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 50( 2 O iecie( ;5- r (-0,, -Fvd 1(7C �0� � .. I �Y T�. ao 0. O • WELD COUNTY DEPARTMEIDOF PUBLIC HEALTH &ENVIROST 1555 NORTH 17TH AVENUE, GREELEY, CO 80631 PHONE: (970) 304-6415 FAX: (970) 304-6411 WEBSITE: WWW.CO.WELD.CO.US •Copy Reprinted on 04-19-2007 at 13:54:50 APPLICATION/RECEIPT Initials: CS Permit Number. SP-0700068 Receipt Number: HAP-07069 04-19-2007 Amount: $470.00 Payment Method: Check Notation: 6716 Owner Name: AURORA DAIRY GROUP Applicant Name: AG PROFESSIONALS LLC Parcel Number: 120929200049 _ Location: 7228 HWY 66 PLATTEVILLE Account Code Description Amount 2560-41400-4221-4203 New Septic Permit $0.00 2560-41400-4221-4203 Repair Septic Permit —$470:00- 2560-41400-4221-4203 Vault Permit $0.00 2560-41400-4221-4203 Variance Request $0.00 Description: NEW OFFICE Commercial: (Y/N) Y Residential: (Y/N) N Acres: 92.61 Number of Persons: 15 Basement Plumbing: (Y/N) N •Number of Bedrooms: 0 Bathrooms: Full - 3 3/4: 0 1/2: 0 Water Public: (Y/N) Y Water Supply: LITTLE THOMPSON Water Private: (Y/N) N Cistern: (Y/N) N Well: (Y/N) N Well Permit Number: TERMS AND CONDITIONS A permit fee,as set by separate ordinance of the Board of Weld County Commissioners,shall be required of applicants for new Individual sewage disposal systems (ISDS),payable at time of application.Pemit fees are non-refundable:permit analcatlons are nmtransferable.If both a building permit and an ISDS are issued for the same property and consuucdon Is not commenced prior to the expiradon date of the building permit,the ISDS permit shall expire at the same time as the building permit. If an ISDS permit is issued for a property that does not require a building permit,the ISDS permit shall expire one year after its issuance if construction on the septic system has not commenced. My change in plans or specifications after the permit has been issued invalidates the permit unless approval is secured from the Health Officer or his/her designated agent. Expired permits can be renewed by payment of the permit fee only IF. A.There has been no change In the plans and specifications of the proposed system as set out In the original application or such change is reviewed and approved by a Division Representative. B. The surrounding land,its use or zoning has not changed so-as-to cause the original application not to be acceptable under these regulations. NOTICE The completeness of this application Is conditional upon further mandatory and additional tests and reports as may be required by the Weld County Department of Public Health and Environment(WCDPHE).The issuance of the permit is subject to such terms and conditions as deemed necessary to Insure compliance with Ma and regulations adopted under article I O dde 25,CRS as amended.The applican4i.fies that the proposed system will not be located wititin 4OO feet of a community sewage system.The undersigned certifies that all statements made, .,t• adon and report submitted herewith are,or will be,represented to be true and correct to the best of his/her knowledge and are designed to be relied on CDPHE for evaluation for purposes of issuing the permit applied for herein. Applicant further understands that falsification or misrepresentation y in the denial of the application or revocation of any permit granted,and In legal action of perj as . • ded by law. /� "l 0-7 Owner/A•'c: : Date Form:RT_HAPP • Jun 26 07 04: 17p Central Weld 9703535065 p.2 RECEIVED AUG 2 3 t988 • ASSIGNMENT 9742 FOR VALUE RECEIVED. I/we hereby sell. transfer and assign to Colorado Dairy Farms, Inc_ water taps in the CENTRAL WELD COUNTY WATER DISTRICT, on my/our property described as follows situate in Weld County. Colorado, to wit; SEE ATTACHED LEGAL DESCRIPTION: It is understood that these taps were purchased for the above described lands and may not be transferred to other land, without express, written consent, in addition to the below consent, of the CENTRAL WELD COUNTY WATER DISTRICT. 1/we further authorize the Secretary of said District to do any and all things necessary to effectuate this transfer on the books and records of said District. I/we hereby state that all water rates and charges and other monies owed to the District have been paid and if not. shall be held out at the closing of the sale of my premises. IN TESTIMONY WHEROF, I/we have set my/our signature this day • of July 19 88 P.S.F. Associates SEL LEI�,:1 BY: SELL,ER: Authorized Agent 1/we further agree to pay any and all charges hereinafter levied by said District for said taps and to abide by all regulations adopted by said District. ACCEPTED$ Colorado Dairy Tarns. inf. BUYER: BUY R: CONSENT TO ASSIGNMENT I . John W. Zadel, General Manager of the CENTRAL WELD COUNTY WATER DISTRICT. Hereby consent to the above assignment on behalf of said District. BY: DATE: .\, Jun 26 07 04: 17p Central Weld 9703535865 p. 3 • . • • • • Legal Description For: Tap No. 742 P.S.F. Associates • • EXHIBIT A M ' r .,ct of land located in the North one-half of Section 29, Township 3 North, Fnire' 61 West of the 6th.P.M. , Weld County, Colorado and briny snore part+cutarly, .,•sL ribad as follows: }1 I 1 � $r• ;inruing at the vest one-quarter corner of said Section 29, thence along the Nest 1 • Iic of the Northwest one-quarter North 00' 09' 33" East 1625.26 feet ; thence South 86 51' 19" East 325.70 feet; thence North 00' 27' 02" East 968.23 feet to a point r or tc,r South Right-of-way line of•5tate Highway Number 66; thence along sail Rights nt -way line and parallel with the North line of said Section 29, South 89' 16' 24" East 1345.02 feet; thence South 83' 33' 47" East 100.50 feet ; thence South 89' 16' i! 24" last 2811 .44 feet to a point on the centerline of the Saint Yrain Creek; thence .rlt,i" said centerline the following courses. 1 South 32' 02' 38" West 7~6.93 feet; 5, „th 58' 58' 54" west 467.97 feet: Si.0 t h 84' 39' 45" West 864.41 feet; - So6th 54' 56' 04" West 495.22 feet to a point on the South line of the Northeast one quarter of the Northwest one-quarter of said Section 29; thence leaving said center- liar horth 89' 19' 51" West 1214.89 feet to the Northwest one-sixteenth corner; tns-nee along the East line of the Southwest one-quarter of the Northwest ono-quarter I 'If said Section 29. South 00' 01 ' 35" west 781.80 feet to a point on the center- line of the Saint Vrain Creek; thence along said centerline the 'followinq courses , South 70' 04' 05" West 392.85 feet; Su.,tn 22' 45' 17" West 312.81 feet; South 07' 42' 17" West 107.98 feet to a point on the South tine of the" Nurih one- 1 halt of said Section 29; thence North 89' 23t I)" West 810. 53 feet to the puir't of I,ryinnin., containing 140.300 acres more or less. tt I " Jun 26 07 04:17p Central Weld 9703535965 p.4 RECEIVED AUG 2 3 1988 • ASSIGNMENT 11967 FOR VALUE RECEIVED. 1/we hereby sell, transfer and assign to Colorado Dairy Farms, Inc. 1_2" water taps in the CENTRAL WELD COUNTY WATER DISTRICT, on my/our property described as follows situate in Weld County, Colorado, to wit: SEE ATTACHED LEGAL DESCRIPTION: It is understood that these taps were purchased for the above described lands and may not be transferred to other land, without express, written consent, in addition to the below consent, of the CENTRAL WELD COUNTY WATER DISTRICT. I/we further authorize the Secretary of said District to do any and all things necessary tc effectuate this transfer on the books and records of said District, I/we hereby state that all water rates and charges and other monies owed to the District have been paid and if not, shall be held out at the closing of the sale of my premises. IN TESTIMONY WHEROF, 1/we have set my/our signature this 27 day of July , 19 88 P.S.F. Associates SELLER: BY: f, SELLER: Authorized Agent 1/we further agree to pay any and all charges hereinafter levied by said District for said taps and to abide by all regulations adopted by said District. ACCEPTED: Colorado Dairy Farms, Inc. BUYER: CC C BUYE : CONSENT TO ASSIGNMENT 1 , John W. Zadel, General Manager of the CENTRAL WELD COUNTY WATER DISTRICT, Hereby consent to the above assignment on behalf of said District, BY: 1'O i • DATE::// :OG Jun 26 07 04: 18p Central Weld 9703535865 p.5 • . 7-7 II , . • 44„:.,... ... , .: • : i J . , . . . . , . . • Legal Description For: Tap No. 967 • P.S.F. Associates LEGAL OESCftIPTiON 1. . cdct of land located in the North one-half of Section 29, Township 3 Ho' th, i P.)nur 61 west of the 6th P.M. . Weld lounty, Colorartr, and briny more ;,art,cularly ; described as follows: 1 Britinninq at the vest one-quarter corner of said Section 29, thence along the West f line of the Northwest one-quarter North 00' 09' 33" East 1629,26 feet : thence South 1 86 5/' 19" Erst 325. 70 leet; thence North 00' 27' 02" Last 968.7,3 feet to a point on the South Right-or-way line of State Highway Number 66; thence along sni,l Right,- of-way line and parallel with the North line of said SF'.tion 29. South 89' 16' 24" .l sass 1345.02 feet; thence South 83' 33' 47" East 100.50 feet ; thence South 89' 16' ' 21+" East 2811 .44 feet to a point on the centerline of the Saint train Creek; thence 1 alunq said centerline the following courses. 1 1 South 32' 02' 38" West 11+6.93 feet; • i S...uth 58' 58' 54" West 467.97 feet ; . • illt S,:. th 84' 39' 45" West 864.41 feet ; South 54. 56' 04" West 495. 22 feet to a point on the South line of the Northeast nne-i quarter of the Northwest anc-quarter of said Section 29: thence leaving said center- , line North 89' 19' 51" West 1214,89 feet to the Horthot•st one-sixteenth corner: thence along the East line of the Southwest one-quarter of the Northwest ono-quarter t , of said Section 29. South 00' 01 ' 35" West 181 .80 feet to a point on the center- . s - line of the Saint Vrain Creep; thence along said centerline the •fol1owinct courses . . • • ' i . South 70' 04' 05" West 392.85 feet; I South 22' 45' 17" West 312.81 feet ; 'j South 07' 42' 17" vest 107.98 feet to a point on the SI►citil line of tht' North one- ' half of said Section 29; thence North 89. 23' 17" West 810.53 feet to the puir'I of beginning, containing 140. 300 acres more or less. , i E` t . I ' it i , i , F. . : ; I r Y S . i j . ' i t • v.. mM.re,.r .. .Y..YIwY/.w..�w•1�YM/+•M.YMIwn.-r,. .. ....,..-._. .-.. ....___.... . ...-�.. ..� Hello