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HomeMy WebLinkAbout20230740.tiffWELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 1555 North 17th Avenue, Greeley, CO 80631 wrww.weldhealth.org Septic Permit - Final Application Nurnber:SP-1700352 Owner Name:SANDBERG GEORGE L IRREVOCABLE TRUST Site Address: 17215 CR 46 LASALLE, CO 80845 App Type: HealthlCommerciallNew OWTS\Septic JIM CLARK CLARK ENTERPRISES COST CO 80 FACTORY ROAD EATON, CO 80615 Parcel #: 105712300009-R8948334 Legal Desc: PT SW4 12-4-66 LOT A REC EXEMPT RECX17-0013 Work Description: OFFICE/ WAREHOUSE EHS SEPTIC GENERAL: Associated Disaster Permit No Number of Persons 1 Parcel Acres 6.90 Public Water Supply Yes Public Water Supply Utility CWCWID EHS SEPTIC ACTUAL (FINAL): Septic Tank Size, gallons 750 Absorption Trench, sqft 84 Chamber Model Quick4 Plus Standard Number of Chambers installed 7 Design Type Chambers -Trench NOTICE The issuance of thispermit 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 operateIn cornprtartOewithppplicablestater, county and local regulations adopted persuant to Article ID, Title 25, CRS as amended, except for the purpose` of establishingapproval of Instelled-system for Issuance of a local occupancy permit petulant to 25-10-112(9)(b). This permit is nomliansfeEtkblikanst nonareflmdabig The Weld County Department of Public Health and Environment -reserves the right to impose additional.terms anti tcrediifons required to -meet our, regulations on a continuing basis. Final pemlit:approval was.contingent upon the final inspection of the completed system by the Weld County Department of Public Health and Environment Application Status: Finaled Applied Date: 10/18/2017 Issued Date: 1 D123/2017 Finaled Date : 01/11/2018 Alex Clemrnents January 11, 2018 Environmental Health Specialist Date trealirkAdrnirtisimtion tub&e14.ell r& 41Hesl ea.eeseda Car td.Sdawices_. Tel?: 971-X.1-6416 r_ie:976\.71 ,44Z l ax: v7C-W4-6412 .; 9;y.;aZa-y4F� Eriviranreetntatleolh Corrimardcotiem, Sesn elcein Edvee+fl al Fksnn2ng fele: 471-304-6415 Tee: 970-304-6470 Fax 970-2044411 Fox 47c -30i-6452 Ernalgenay Prepapirchema & R pons. Tula: 97G304-600 Fax: 970-304-6452 li ubncEleaft`h Account Number Description 003229-01 1000 Gallons Meter Readings Previous Present 134 135 Usage 1 Read Code Actual Read Dates Previous Present 10/21/2021 11/18/2021 Previous Balance Payment — Check Water Minimum Charge Water Usage Charge CBT Surcharge $22.23 —$22.23 $19.27 $0.00 $0.00 Total Current Charges $19.27 Total Amount Due $19.27 Please write Account Number on all check payments and on all correspondence. Please use the Bill ID to set up Auto Pay. Auto Pay is deducted the 15th of each month. You may pay your bill & setup AutoPay at www.cwcwd.com Water JASON NDJFMAMJ EBill Bill ID 0432 00007327 Customer Sandberg Irrevocable Trust Service Address 17215 County Rd 46 Billing Date 11/22/2021 Due Date 12/15/2021 Account Number 003229-01 Amount Due $19.27 Annual Allocation YTD Usage **Surcharges apply if Allocation is exceeded** 300 45 Central Weld County Water District 2235 2nd Avenue Greeley, CO 80631 970-352-1284 Hello