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HomeMy WebLinkAbout20252865.tiff'O }. . I-ISPiOtfF'' INDIVIDUAL. SEWAGE DISPOSAL SYSTEM PERMIT NO. G -••94047:L WELD COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH SERVICES 1517 16TH AVENUE COURT, GREELEY, CO 80631 353-0635 EXT.2225 NEW PERMIT OWNER BORYS, DAN ADDRESS 4890 N 119TH ST PH (303) 665-5339 'T-+(131 ERIE CO 80516 ADDRESS OF PROPOSED SYSTEM WCR 3 LONGMONT CO 80501 LEGAL DESCRIPTION OF SITE: SE4 NE4 SEC 31 TWP 3 RHO 68 SUBDIVISION: LOT 0 BLOCK 0 FILING 0 USE TYPE;: RESIDENTIAL MOBILE HOME SERVICES: PERSONS 4 BATHROOMS 2.50 LOT SIZE 19.56 ACRES BEDROOMS 4 BASEMENT PLUMBING YES WATER SUPPLY L_NGPK APPLICATION FEE $:1.50.00 REC'I) BY CHAD YOUNG DATE 09/30/94 SIGNED BY DAN BORYS DATE 09/30/94 PERCOLATION RATE 19.0 MINI PER INCH LIMITING ZONE: 6 FEET SOIL.. TYPE UNSUITABLE PERCENT GROUND SLOPE 6% DIRECTION N REQUIRES ENGINEER DESIGN YES IN 100 YEAR FLOOD PLAIN ZONE':: NO FROM THE APPLICATION INFORMATION SUPPLIED AND THE ON -SITE SOIL PERCOLATION DATA THE FOLLOWING MINIMUM INSTALLATION SPECIFICATIONS ARE REQUIRED: SEPTIC TANK 1250 GAL.LONS, ABSORPTION TRENCH SQ.. FT. OR ABSORPTION BED 1764 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 FOR'T'H IN THE WELD COUNTY IND:I:V:I:DUAI... 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 EMPLOYEE:S OF LIABILITY FOR THE FAILURE OR INADEQUACY OF THE SEWAGE D1 spg AL.. SYSTEM. /%(‘)i�j 'ENVIRONMENTAL -SPECIALIST SPECIALIS'T' - - DA'T'E 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 HEAI...'T'I-I DEPARTMENT RESERVES THE RIGHT TO IMPOSE ADDI- TIONAL TERMS AND CONDITIONS REQUIRED TO MEET OUR REGULATIONS ON A CONTINUING BA— SIS. FINAL PERMIT APPROVAL.. IS CONTINGENT UPON THE: FINAL... INSPECTION OF THE COM— PLETED SYSTEM BY THE WELD COUNTY HEALTH DEPARTMENT. SYSTEM INSTALLER __,__�_,�- , Zzgmc FINAL IN; SYSTEM ENGINEER .."Aelr�� _..._._ �7R�ige./ '.....-..-..--'APPROVAL TYPE OF SYSTEM INSTALLED ._.22Ge, , e PAM SMITH 10/26/94 E:C'Yi� DATE ENVIRONMENTAL_. SPEC:1:AL1S'T THE ISSUANCE OF THIS PERMIT DOES NOT IMPLY COMPLIANCE WITH OTHER STATE-„ COUNTY OR LOCAL REGULATORY OR BUILDING REQUIREMENTS, NOR SHAI...L IT ACT TO CERTIFY THAT THE SUBJECT SYSTEM WILL OPERATE IN COMPLIANCE: WITH APPLICABLE STATE::;, COUNTY AND LOCAL REGULATIONS ADOPTED PERSUANT TO ARTICLE 10, TITLE 25, CF;S 1973, AS AMENDED, EXCEPT FOR THE PURPOSE 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 WCI-ID--EHS MAY, 1984 C. O O/4-00 74/ 3 O, LONGS PEAK WATER DISTRICT 1 • • • • • • • • • • • • • • • • • • • • • • • • 1 • O87{ Vermillinn Road • I.nngmnnt,( () A0504 • (101) 176-1847 • IpwdMrq PARAGON SERVICE DOGS (CAROL HEIDE N) 14737 CR 3 LONGMONT CO 80504 TO PAY ONLINE OR RECEIVE BILLS VIA EMAIL PLEASE VISIT LPWD.ORG. AC'iJJh" NUMBER 1600 02 23 PREVIOUS READING 1476263 DATE Bill MAILED 03/31/2025 PRESENT READING 1520834 TIER 1 20000 @ $4.65 = 95.00 TIER 2 22000 @ $4.85 = 112.20 14.91 TIER 3 2571 @ $5.25 = TIER 4 @ $6.00 SE; VICE cROM 02/21/2025 GALLONS USED 44571 Monthly Base Fee For Standard Residential Taps is $25.501 Month 14737 COUNTY RD 3 SERVICE ADDRESS ACC3LNT r .W3cR LONGS PEAK [I TRICT WA•T•E•R DIS, , , , , 9875 Vermillion Road Longmuot,C'O 80504 (303) 776.3047 BILLING ADDRESS 160032.02 PARAGON SERVICE DOGS (CAROL HEIDEN) 14737 CR 3 LONGMONT CO 80504 [-,4 03/24/2025 ri5FG SF ,.E TO 03/24/2025 1 31 DE SCRIP- rh WATER PREVIOUS BALANCE PAYMENTS ADJUSTMENTS EN> 04/15/2025 247 B', 242 36 2426CP c0 5 DAYS AF'ER :iE ATE , :LE :ATE 252.61 I CLE DATE 247.31 04/15/2025 160032 22 3 JAYS S :A:e_3',2LE.A7E 5 AFER E.JJ 25261 247.31 SERy+CE ADDRESS 14737 COUNTY RD 3 - " co cv JO 28 N i0 13i Jo ,_ ,6 ,ti, i' Imeimoulk Hello