HomeMy WebLinkAbout20232367.tiffWELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
1555 North 17th Avenue, Greeley. CO 80631 www.weldhealth.org
Septic Permit - Final
Application Number: SP -1900295
Owner Name: MAAS STEVE
Site Address: 10286 CR 15
Health\Residential\Repair OWTS\Minor
App Type:
Steve Maas
10286 CR 15
Longmont, CO 80504
Parcel #: 131108302002-R5377286
Legal Desc: EH -11 L11 ENCHANTED HILLS
Work Description: Attach bathroom for personal use to existing septic system.
EHS SEPTIC GENERAL:
Application Date 08/22/2019
Associated Building Permit Yes
Full Bathrooms 1
Number of Persons 1
Parcel Acres 4.65
Public Water Supply Yes
Public Water Supply Utility CWCWD
Repair Reason Type Repair for Upgrade
EHS SEPTIC ACTUAL (FINAL):
Comments
Final Inspection Completed Today.
Application Status:
Finaled
Applied Date:
08/22/2019
Issued Date:
08/22/2019
Finaled Date :
08/29/2019
Connection from the shop bathroom to septic system approved.
NOTICE
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 persuant to Article 10, Title 25, CRS as amended,
except for the purpose of establishing final approval of installed system for issuance of a local occupancy permit persuant to 25-10-112(1)(b), C.R.S.
This permit is non -transferable and non-refundable. The Weld County Department of Public Health and Environment reserves the right to impose
additional terms and conditions required to meet our regulations on a continuing basis. Final permit approval was contingent upon the final inspection of the
completed system by the Weld County Department of Public Health and Environment.
Casey Vogt August 29, 2019
Environmental Health Specialist Date
Health Adminhhollon
Vital Record&
Public Health it
Clinical Service&
'U 1J4
Environmental Health
Service&
Public Health
Scanning Cover Sheet
for
Septic Permits
Permit #
Permit Type:
Situs Street Address
Situs City, State, Zip
619721956
Health / EHS History / EHS Conversion History
10286 CR 15
Sec/Town/Range: 08 -02N -67W
Parcel # (12 digits) 131108302002-R5377286
Owner Full Name:
Owner Address:
Contact Name:
Contact Address:
WERTENBERGER MONICA
10286 WCR 15
LONGMONT,CO 80504
Application Status: Finaled
Application Date: 03/11/1996
Owner Phone #: 303 8332832
Contact Phone#
Information above has been Verified in Accela by employee noted below
x
Cif-.- (_A
April 09, 2009
Processed by: Date
Report ID: EHS00024v003 Page 1 of 1
Print Date -Time: 4/9/2009 3:16:42PM
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HSF'106F'
INDIVIDUAL SE.:wAGE D:[SPOSr;L SYSTEM PERMJ:'T I\IO. G-721956
WELD COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH SERVICES
1517 1. tTH AVENUE CDI )RT. GREE.LEY. CO 80631
353-0635 635 EXT..2225
NEW PERMIT
OWNER WERTENBERGER, MONICA ADDRESS 10286 WCR 15 PH (301 833-2832
LONGMONT CO 80 504
ADDRESS OF PROPOSED SYSTEM 10'296 NCR 15
LONGMONT CD 80504
LEGAL_ DESCRIPTION OF SITE::: SEC S TWP 2 RNG 67
SUBDIVISION: ENCHANTED HILLS LOT 11 BLOCK C: FILING 0
USE TYPE: RESIDENTIAL LOAN 047-95
SERVICES: PERSONS 4 BATHROOMS 2.25 LOT SIZE 4:72 ACRES
BEDROOMS 5 BASEME-N.T PLUMBING NO WATER SUPPLY L. THMF'
APPLICATION FEE $0.00
RE.C'I) BY X STAFF
DATE 05/23/72
SIGNED BY DANNY KOE:HN
DATE 05/23/72
PERCOLATION RATE 8.0 MIN PER INCH LIMITING ZONE 0 FEET
SOIL TYPE: SUITABLE PERCENT GROUND SLOPE 0 DIRECTION
REQUIRES ENGINEER DESIGN NO 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 1000 GALLONS, ABSORPTION TRENCH SQ. FT.
OR
ABSORPTION BED 1.049 SQ. FT.
IN ADDITION, THIS PERMIT IS SUBJECT TO THE FOLLOWING ADDITIONAL TERMS AND
LLJNL)I LIONS: -
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 T D(JES NOT CONSTITUTE ASSUMPTION BY THE
DEPARTMENT OR ITS EMPLOYEES OF LIABILITY FOR THE: FAILURE (JR INADEQUACY OF THE
SEWAGE DISPOSAL SYSTEMI.
X STAFF 05/25/72
ENVIRONMENTAL SPECIALIST DATE
E
THIS PERMIT IS NOT TRANSFERABLE AND SHALL BECOME VOID IF SYSTEM CONSTRUCTION HAS
NOT COMMENCED WITHIN ONE YEAR OF ITS ISSL.:ANCE. BEFORE ISSUING FINAL. APPROVAL OF
THIS PERMIT THE WELD COUNTY HEALTH 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 UNKNOWN
SYSTEM ENGINEER
TYPE OF SYSTEM INSTALLED TANK
FINAL. INSPECTION DATE 08/08/72
APPROVAL. X STAFF
ENVIRONMENTAL SPECIALIST
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 NIL.'.,., OPERATE: IN COMPLIANCE. WITH APPLICABLE STATE A.... :. COUNTY AND
LOCAL REGULATIONS ADOPTED F'ERSUAN... ..TO ARTICLE 10, TITLE 25, CRS 1`?73, AS AMENDED,
EXCEPT FOR THE PURPOSE OF ESTABLISHING FINAL APPROVAL. OF AN INSTALLED SYSTEM FOR
ISSUANCE OF A LOCAL. OCCUPANCY PERMIT PURSUANT TO CRS 1.973 25 10--111 (2).
ORIGINAL-F`1PP1_..IC.ANT: COPY-• WCHI)
WCI...II,.--E::. AS MAY. 1984
Installed by
'A10 0 k J j
PERMIT FEE
is I T5(sa /Y -le
WELD COUNTY HEALTH DEPARTMENT
No. y ?S
tm
Application for Perm to Ins
Owner o S.onsor
Address of Site
Mailing Address
1555 17th Ave.
Gr ley, Colorado
struct, Alt r o
air I dividual Sewage Disposal System.
Phoil
1. Living Units
2. No. of Bedrooms
3. No. of Baths --
4. Basement Drain
5. Automatic Dishwasher /
6. Garbage Disposal i
7. Automatic Laundry /
8. Size of Lot `�—e....-Lfi—c-------
General Information
Septic Tank
1. Liquid Capacity /aer-)
2. Dimensions W_ L D
3. Material 4f Pk,' et
4. Type Inlet
Type Outlet
Gallons
9. Type of Soil - Field
10. Percolation Test � - "l t .
11. Water Supply _ "f
12. Lot Grade
13. Water Table Depth
14. Other
Secondary Treatment/61%LT A --, H,4424
o. of distributign ines
2. Trench: Width Lengt
8. Type Filler Material
4. Depth of Filler Material
5. Gravel Size
6. Type Tile
7. Depth of Cover
8. Other
Bed
,6 A41
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 conutructed 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:
/710
Applicant:)C
The plans and speck ations as shown are approved, pending payment o—permitOee. -
Sanitarian:
2
Date :
The above system ' , e y ed and found to comply with the plan and description. + J
Date: /i7
Received by
nitarian:
g
(
Please use reverse side for �
P Ian or use sepa ate sheet of
paper.
Date
LIMP e11uur mBunS
®°
•1
•r
A
1
1
WEL Cot r Y HEALTH DEPARTMENT
,ENVIRONTI(NTAL PROTECTION SERVICES
1S11'16tb Avenue Court
Greeley,.Colorado 80631
(303)353-0635
OWNER OF RECORD:
Weld County Health Department
SOE O 72/95 6
LOAN 95 -n tj -�
ISDS 1
REPAIR 0 _
PERMIT
STATEMENT OF EXISTING FOR SEPTIC SYSTEM
(PLEASE FILL OUT IN BLACK INK ONLY)
PHONE:
833-a?6
MAILING ADDRESS: /42X' /S ihclaa ed LG fJ D►5�
City State j1:4/
SITE ADDRESS:
ity State Zip
LEGAL DESCRIPTION: PT: PT: SECTION: c TOWNSHIP:c RANGE:,(p
SUBDIVISION:ct4f/B,ctrfb .GCS LOT: IL- BLOCK: FILING:
NUMBER 0 LE:_il___ BATHROOMS: (/
LOT SIZE: ,� r BEDROOMS:I S
r COMMERCIAL BASEMENT PLUMBING: Yes No WATER SUPPLY:( Z / G ''2
SYSTEM SIZE: Tank is constructed of( e.e. e- and has _/6 _ gallons capacity
(material)
FIELD: Bed /01'7 sq. ft. or Trench sq. ft. DATE SYSTEM INSTALLED: /97.2 —
Yon are required to draw a diagram of the system an the reverse side of this form in
black ink only and indicate location, 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 legal description and further states that the system is in good
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 granted based upon this formation hereby submitted and in legal action
for perjury ,'s provided by law.
Subscribed' and sworn i.o before me this
by L611
Owner
day of
, 199 4
Witness my, hand and official seal. My commission Tres:
Date
STATEMENT OF EXISTING REVIEWED BY:
iid-Ndu
,t4IL ips#1.4.
Notary Public
Environmental Protection Specialist
BLACK INK ONLY!
N
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L
6Th
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4s'
WiDc
COLORADO
LOAN APPROVAL
DEPARTMENT OF HEALTH
1517-16 AVENUE COURT
GREELEY, COLORADO 80631
ADMINISTRATION (303) 353-0586
HEALTH PROTECTION (303) 353-0635
COMMUNITY HEALTH (303) 353-0639
• FAX (303) 356-4966
CLOSING DATE: 04/27/95 REQUEST NO: 047-951545
FAX FEE ($2.00): N/A DATE RECEIVED: 04/07/95
NEW LOAN
FEE $90.00: 04/07/95
TO WHOM IT MAY CONCERN: Review and inspection report regarding water and the sewage
disposal system for an existing dwelling:
SEND TO: Schlagel Realty
11749 North 75th Street
PICK-UP: Hygiene, Colorado 80533
REALTOR NO.: 678-0797
OWNER NO.: 833-2832 (H)
OWNER NO.: (W)
INFORMATION: Address: 10286 WCR 15, Longmont, CO 80501 Age of Septic: 1977
Legal: PT: PT: SEC: 08 TWN: 02 N RNG: 67 W
Subdivision: Enchanted Hills LOT: 011 BLK: FLG:_
Property Owner: Wertenberger, Monica Original Owner: Koehn, Danny
Tank Pumped on: 04/01/95 By: AC Sewer Service Licensed: Yes
PERMIT ON RECORD: Name: Koehn, Danny Permit No.: G-721956 S.O.E.: No
Bathrooms: 2.25 Bedrooms: 5 Total Acres: 4.72 Date of Final Inspection: 06/08/77
Water Supply: Central Weld Well Permit No.: N/A
Tank Capacity: 1000 gallons Field Size: 1044 square feet
INSPECTION FINDINGS: Date of Inspection: 04/10/95
Soil Conditions: Dry Saturated
Residence: Occupied XXX Vacant
Sewage Disposal System: Satisfactory
Bacteriological Water Test: Acceptable XXX Other
Snow-covered XXX
Other See Comments
COMMENTS: The system is adequately sized for a three (3) bedroom home. For a five (5)
bedroom home the tank is‘undersized by 500 gallons. This Departmnet requires that a
repair permit be obtained and the tank capacity must be increased to 1,500 gallons.
Livestock traffic in the corral over the leachfield may pause accyl rated deterioration of
the field.
DATE: 04/12/95 SIGNATURE:
Environmental Protection Sp list
Neither the County of Weld, nor any of its agents or employees undertake or assume any
liability to the owner of the above property, to any purchaser of the above property or to
any lending agency making a loan on the above property in connection with either its
examination of the property or in the report.
This inspection was conducted solely for the purpose of detecting health hazards
observable at the time of inspection, and does not constitute a warranty that the system
is without flaw or that it will continue to function in the future. Inspections requested
during periods of snow cover and high soil saturation may be of questionable value to
potential buyers due to adverse conditions. Water sample reports reflect the
bacteriological quality of the water supply at the time the sample was taken. Evaluations
based on Statements of Existing (S.O.E.) relies on information the property owner
provides, under oath, indicating current status of.the system and representing to the best
of his/her knowledge the system is not failing to function properly.
LOAN APPROVAL
Weld County Health Department
NEED: iii
SPECIALIST INSTRUCTIONS:
CLOSING DATE: /,. J 7/95
FAX (MAIi) PICK-UP
FAX FEE ($2.00): 404
LOAN RE -FINANCE
TO WHOM IT MAY CONCERN: Review and inspection
disposal system for an existing dwelling:
SEND TO:rA(XQ I (2 r f Vic nl 7C1i{C�.
t s . •-r u
PICK-UP:
FAX TO:
report
~A r r,y, OWNER NO.: (W)
FAX NO:: WA
REQUEST NO:
DATE RECEIVED: 617176-719'`)-
RECEIVED—BYUJ.
FEE 0.00 • 105.00: el/NI/47/7'
regarding water and the. sewage
D
REALTOR NO.: 7?
OWNER NO.: ?- `] 2
ri
(H)
INFORMATION: Address: /' -L') // L2_ IS', �; n ,1 %e/ Age of Septic: 47O-
Legal: PT:. PT: SEC: (`)R' TWN: (o'L N RNG: /.p' 7 W
Subdivision Ei,,, (J.,0 .t ,Lpd iidA) LOT: // BLK: ` FLG:_
Property Owner: t).& -n ,.120,‘ cym )> f'y,, r'csOriginal Owner: Alp /-, k3 f 02,,14-1,54 r
Tank Pumped on: n &J'j i! BY: A� _ o A + S j' d 0 V I.P LicenseN
PERMIT ON RECORD: Name: Yt 1 a .L-) ( i_rs..ruj - Permit No.: 7,Z) / q c-6 S.O.E.: Y
Bathrooms:.2? -Bedrooms: Total Acreage: L). -W4 Date of Finial Inspection: 19 70:
Water Supply: ...(Le." t i(a-� 1,O,2..h1 Well Permit No.: NIAA
Tank Capacity: �D3 gallons Field Size:164i/ square feet
INSPECTION FINDINGS: Date of Inspection: 04//0/9_,5d
Soil Conditions: Dry
Residence: Occupied )(
Saturated
Vacant
Snow-covered X
Sewage Disposal System: Satisfactory Other
Bacteriological ctWater Test:Acceptable /] Other
(1
//`C SyJ ;J t"Gt 4j�J%!�? 4y a (46 -Pe t�e.e '')�/ iZ
CO OlENTS: �, ya.t ar r t:C .'n fl�o tf-rr a/ a 7'b ,." 0S,ehf .40(.0
G'fiusf c3CCPh+la1led Ik
rear
44 Cer�'arp 00 4e ....„,,,„,440j
` A it 94��,
DATE: 4/ -/0- 1/,iSIGNATURE: I i
Environmental Protection Specialist
Neither the County of Weld, nor any of its agents or employees undertake or assume any
liability to the owner of the above property, to any purchaser of the above property or to
any lending agency making a loan on the above property in connection with either its
examination of the property or in the report.
This inspection was conducted solely for the purpose of detecting health hazards
observable at the time of inspection, and does not constitute a warranty that the system
is without flaw or that it will continue to function in the future. Inspections requested
during periods of snow cover and high soil saturation may be of questionable value to
potential buyers due to adverse conditions. Water sample reports reflect the
bacteriological quality of the water supply at the time the sample was taken. Evaluations
based on Statements of Existing (S.O.E.) relies on information the property owner
provides, under oath, indicating current status of the system and representing to the best
of his/her knowledge the system is not failing to function properly.
CENTRAL WELD COUNTY WATER DISTRICT
November 2, 2022
Steve Maas
10286 County Rd 15
Longmont, CO 80645
RE: Add Serve
Dear Mr. Maas,
This letter is in response to a request for water service to serve the following property described as follows:
EH -11 L11 Enchanted Hills
Parcel: #131108302002
Water service is presently available to the above described property through tap 696 located on County Road
15 between Maple Street and Elm Street. Additional taps can be made available with new tap purchases
provided all requirements of Central Weld County Water District (CWCWD), Northern Colorado Water
Conservancy District (NCWCD) and the U. S. Bureau of Reclamation are satisfied. Please note that it is your
responsibility to contact Northern Colorado Water Conservancy District (NCWCD) at 800-369-7246 for
petitioning confirmation into that District. Per Rules and Regulations of NCWCD, Central Weld cannot
install a tap until all requirements are satisfied. CWCWD requires that a Water Study be completed prior to a
Tap Agreement or Water Main Extension Contract being issued. We understand that the landowner plans
to submit an application with Weld County Planning. This project may require a "contractual
guarantee" prior to approval by Weld County Planning, and if so will be required to complete a Water
Study, purchase and/or transfer raw water, and if applicable pay a deposit for any necessary
infrastructure upgrade costs prior to obtaining a contract. A water tap installation is for a specific
parcel of property and a customer will not be permitted to extend a service line from one parcel to
another parcel to provide additional water service.
Due to the rapid cost increase of raw water, existing tap fees may not apply for water service to this property.
A Water Study determines the cost for tap fees and infrastructure upgrades. If a landowner is negotiating an
annexation to a City or Town, the terms of this letter become null and void and water service shall be
obtained through the City or Town. If annexation is not being considered, this letter expires on February
14, 2023, unless extended in writing by the District.
Please contact the District with any questions or concerns.
Sincerely,
CENTRAL WELD COUNTY
Stan Li
SL/bg
, District Manager
ATER DISTRICT
2235 2nd Avenue • Greeley, Colorado 80631 • Phone (970) 352-1284 • Fax (970) 353-5865
Stan Linker, District Manager
Meter Readings
Read Dates
Account Number Description Previous Present Usage Read Code Previous Present
000696-01 1000 Gallons 2327 2337 10 Actual 09/20/2022 10/20/2022
Previous Balance
Payment — Check
Water Minimum Charge
Water Usage Charge
CBT Surcharge
$63.43
—$63.43
$19.27
$15.36
$0.00
Total Current Charges $34.63
Total Amount Due $34.63
Please write Account Number on all check payments. Auto Pay is
deducted the 15th of each month if setup at www.cwcwd.com. Water
Service Rates, Surcharges, and Tap Fees increasing Nov 1,2022.
Water
ONDJ F MAMJ J ASO
Central Weld County Water District
2235 2nd Avenue
Greeley, CO 80631 **INVOICE ENCLOSED**
Temp Return Service Requested
EBill Bill ID 0432 00004616
Customer
Steve Maas
Service Address
10286 County Rd 15
Billing Date
10/25/2022
Due Date
11/15/2022
Account Number
000696-01
Amount Due
$34.63
Annual Allocation
YTD Usage
**Surcharges apply if Allocation is exceeded**
300
157
Central Weld County Water District
2235 2nd Avenue
Greeley, CO 80631
970-352-1284
************"AUTO**SCH 5 -DIGIT 80503
II
STEVE MAAS 1 > 28
10286 COUNTY ROAD 15
LONGMONT CO 80504-9446
Presort
First Class
US Postage
PAID
Permit # 940
Albuquerque, NM
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