HomeMy WebLinkAbout20233645.tiff r: ' WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
►' j1555 North 17th Avenue, Greeley, CO 80631 wGvw.weldhealth,org
Septic Permit New
Application Number: SP-2200190
Owner Name: ROOSTER LAND COMPANY LLC
Site Address: 17171 CR 22
WELD, CO
App Type: Health\Commercial\New OWTS\Septic Application Status:
ERIN KRESS In Review
THENGINEERING LLC Applied Date:
PO BOX 337748 06/28/2022
GREELEY, CO 80633 Intake Person:
SCERRILLO
Parcel Number: 130912000017-R5169886 Permit Expiration Date:
Legal Desc: PT SW4 12-2-66 LOT B REC EXEMPT RE-712 06/30/2023
Work Description: COMMERCIAL OFFICE
EHS SEPTIC GENERAL:
Application Date 06/28/2022
Associated Building Permit Yes
Associated Building Permit Number CMN22-0073
Associated Disaster Permit No
Basement Plumbing No
Manual Expiration Date Entry UNCHECKED
Number of Persons 6
Parcel Acres 134.61
Private Water Supply Well
Private Water Supply Permit Reference 74583-F, 74584-F
Public Water Supply No
Septic Permit Expiration Date 06/30/2023
EHS PERC TEST(SITE) :
% Ground Slope 1.5
BOH Variance Required No
Engineer Design Required Yes
Engineer Evaluation Received Yes
Engineer Letter Received No
In 100 Year Flood Plain No
Limiting Zone Feet 8
Limiting Zone Qualifier Greater Than
Long Term Acceptance Rate 0.2
Page 1 of 3
Health Administration Public Health& Environmental HeaNh Communication, Emergency Proparadness
Vllal Records Clinical Services Services Education 3 Planning ;Response
Tekr 470-M4-6410 Tele:970 304-64210 Tele:970-304-6415 Tele:970-304-6470 le;le:970-304-6470
Fox: 470-04-6412 Fax: 970-304-6416 Fax; 970.304.641 Z Fox 9m-344-6452 Fox: 970-304-6452
Public I3with
Profile Pits 2
Slope Direction East
Soil Description Sandy clay
Soil Type 4
Soil Type Suitable Yes
Treatment Level Level 1
Variance Required No
SEPTIC SIZING INFORMATION:
From the application information supplied and the on-site soil percolation data the following minimum installation
specifications are required according to the Engineer's evaluation:
Engineer's Specified Installation Recommendations:
Absorption Bed 600
Dosing Specified No
Engineer Design Absorption Area Specified 600
Engineer Design Chamber Specified Quick4 Plus Standard
Engineer Design Number of Chambers Specified 50
Engineer Septic System Design Type Specified Chambers-Bed
Lift Station Specified No
Pump Specified No
Septic Tank Size 1000
CONDITIONS:
Description: New Permit
Comment: Construct onsite wastewater treatment system according to Engineer design. Install the soil
treatment area within 50 feet of the soils test location. Septic tank must be at least 50 feet
from any well. Soil treatment area must be at least 100 feet from any well. Building sewer or
effluent lines must be 50 feet from any well unless the lines are encased. Keep vehicle
traffic off of onsite wastewater treatment system. Use solid core pipe only. Septic tank must
be at least 10 feet from any potable water line, unless water line is encased. Septic tank lids
must have risers to ground surface. Sewer line to septic tank must have at least 1/8inch/ft.
fall. Effluent line from septic tank to distribution box must have at least 1/8inch/ft. fall.
Distribution lines shall be installed into the top hole of the chambers used. Install inspection
ports at the ends of each trench or corners of each bed. An engineer approval letter
approving system as installed per engineer design is required. Engineer designed OWTS
must be inspected by the design Engineer prior to backfilling. All Weld County regulations
are applicable.
INSPECTION RESULT:
Site C4,4,ie.• A nnrnvnel to lee..
VLCILLAJ• •-•Comment:
NOTICE
This permit is granted temporarily to allow construction to commence.This permit may be revoked or suspended by the Weld County Department of
Public Health and Environment for reasons set forth in the Weld County Onsite Wastewater Treatment 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.This permit is non-transf.ble and non-
refundable.Before issuing final approval of this permit 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 is contingent upon the final inspection
of the completed system by the Weld County Department of Public Health and Environment.
Page 2 of 3
Wealth Administration Public Heallh d Environmental Health Communication, Emergency Preparedness
Vllol Records Clinical Soivices Services Edtacatton t Planning &Response
rein:970 2O4 6416 • TeIe:970-304-6W 5 Tele:970-304-6470 Ial 910-30-1-64/0
�nx; 97a-?04-6412 Fax. 970-:304-6451: fox: 970-304-6452 Fox. 970-30d-6452 Public Health
Bill Fritz June 30, 2022
Environmental Health Specialist Date
Page 3 of 3
Heollh AdminittraIian Public Health& Envirunmanfal Health Cammunicalion-
Qm ey Proparodno{{
Vital Ftecatti: Clinical Sereltei Services Education L Planning i R.spo�{pO11N
Tele:470.304-6420 l• f: .: ;- _'e Tole:470-304-6470
fax; 9't 1- ° '-• ":i '? -- c~ F; 470-_''_:•c 452 Public Health
DNR COLORADO
WELL PERMIT NUMBER 74584-F
CO / Division of Water Resources RECEIPT NUMBER 3646919
Department of Natural Resources
ORIGINAL PERMIT APPLICANT(S) APPROVED WELL LOCATION
COOK GEORGE TRENT Water Division: 1 Water District: 2
Designated Basin: N/A
Management District: N/A
County: WELD
Parcel Name: COUNTY EXEMPTION NO 1309-12-3 RE712
Lot: B Block: Filing:
Physical Address: N/A
SE 1/4 SW 1/4 Section 12 Township 2.0 N Range 66.0 W Sixth P.M.
UTM COORDINATES (Meters, Zone:13, NAD83)
Easting: 523004.6 Northing: 4444007.5
ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT
CONDITIONS OF APPROVAL
1) This well shall be used in such a way as to cause no material injury to existing water rights. The issuance of this permit does not
ensure that no injury will occur to another vested water right or preclude another owner of a vested water right from seeking
relief in a civil court action.
2) The construction of this well shall be in compliance with the Water Well Construction Rules 2 CCR 402-2, unless approval of a
variance has been granted by the State Board of Examiners of Water Well Construction and Pump Installation Contractors in
accordance with Rule 18.
3) Approved for the change/expansion of use of an existing well constructed under permit no. 117782. The issuance of this permit
hereby cancels permit no. 117782.
4) Approved pursuant to CRS 37-90-137(4) and (10) as an additional well to Well No. 74583-F.
5) The use of ground water from this well is limited to commercial and livestock.
6) Production is limited to the Laramie Fox Hills aquifer.
7) The pumping rate of this well shall not exceed 15 GPM.
8) The allowed average annual amount of ground water to be withdrawn by this well in combination with well no 74583-F shall not
exceed 32 acre-feet.
9) The entire length of the hole shall be geophysically logged as required by Rule 9 of the Statewide Nontributary Ground Water
Rules prior to installing casing.
10) The owner shall mark the well in a conspicuous place with well permit number(s), name of the aquifer, and court case number
(s) as appropriate. The owner shall take necessary means and precautions to preserve these markings.
11) A totalizing flow meter must be installed on this well and maintained in good working order. Permanent records of all diversions
must be maintained by the well owner (recorded at least annually) and submitted to the Division Engineer upon request.
12) This well shall be located at least 600 feet from any existing well, completed in the same aquifer, that is not owned by the
applicant.
13) This well shall be located no more than 200 feet from the location specified on this permit.
14) Pursuant to CRS 37-90-137(9)(b) and the Denver Basin Rules, no more than 98%of the nontributary ground water withdrawn
annually shall be consumed and the well owner shall demonstrate to the reasonable satisfaction of the State Engineer that no
more than 98%of the water withdrawn will be consumed.
15) This well is subject to administration by the Division Engineer in accordance with applicable decrees, statutes, rules, and
regulations.
NOTE: The ability of this well to withdraw its authorized amount of water from this non-renewable aquifer may be less than the
100 years upon which the amount of water in the aquifer is allocated, due to anticipated water level declines.
Printed 11-26-2018 For questions about this permit call 303.866.3581 or go to www.water.state.co.us Page 1 of 2
WELL PERMIT NUMBER 74584-F RECEIPT NUMBER 3646919
Date Issued: 11/3/2010
Expiration Date: N/A
Issued By
PERMIT HISTORY
08-31-2018 CHANGE IN OWNER NAME/MAILING ADDRESS. CHANGED TO DANIEL VANDER DUSSEN
08-31-2018 CHANGE IN OWNER NAME/MAILING ADDRESS. CHANGED TO SOPHIA VANDER DUSSEN
Printed 11-26-2018 For questions about this permit call 303.866.3581 or go to www.water.state.co.us Page 2 of 2
DNR COLORADO
WELL PERMIT NUMBER 74583-F
CO / Division of Water Resources RECEIPT NUMBER 3646920
Department of Natural Resources
ORIGINAL PERMIT APPLICANT(S) APPROVED WELL LOCATION
COOK GEORGE TRENT Water Division: 1 Water District: 2
Designated Basin: N/A
Management District: N/A
County: WELD
Parcel Name: COUNTY EXEMPTION NO 1309-12-3 RE712
Lot: B Block: Filing:
Physical Address: N/A
SE 1/4 SW 1/4 Section 12 Township 2.0 N Range 66.0 W Sixth P.M.
UTM COORDINATES (Meters, Zone:13, NAD83)
Easting: 522976.0 Northing: 4443992.0
ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT
CONDITIONS OF APPROVAL
1) This well shall be used in such a way as to cause no material injury to existing water rights. The issuance of this permit does not
ensure that no injury will occur to another vested water right or preclude another owner of a vested water right from seeking
relief in a civil court action.
2) The construction of this well shall be in compliance with the Water Well Construction Rules 2 CCR 402-2, unless approval of a
variance has been granted by the State Board of Examiners of Water Well Construction and Pump Installation Contractors in
accordance with Rule 18.
3) Approved for the change/expansion of use of an existing well constructed under permit no. 127485-A. The issuance of this
permit hereby cancels permit no. 127485-A.
4) Approved pursuant to CRS 37-90-137(4) and the findings of the State Engineer dated November 3, 2010.
5) The use of ground water from this well is limited to commercial and livestock.
6) Production is limited to the Laramie Fox Hills aquifer.
7) The pumping rate of this well shall not exceed 15 GPM.
8) The allowed average annual amount of ground water to be withdrawn by this well in combination with well no. 74584-F shall not
exceed 32 acre-feet.
9) The entire length of the hole shall be geophysically logged as required by Rule 9 of the Statewide Nontributary Ground Water
Rules prior to installing casing.
10) The owner shall mark the well in a conspicuous place with well permit number(s), name of the aquifer, and court case number
(s) as appropriate. The owner shall take necessary means and precautions to preserve these markings.
11) This well shall be located not more than 200 feet from the location specified on this permit.
12) A totalizing flow meter must be installed on this well and maintained in good working order. Permanent records of all diversions
must be maintained by the well owner (recorded at least annually) and submitted to the Division Engineer upon request.
13) This well shall be located at least 600 feet from any existing well, completed in the same aquifer, that is not owned by the
applicant.
14) Pursuant to CRS 37-90-137(9)(b) and the Denver Basin Rules, no more than 98%of the nontributary ground water withdrawn
annually shall be consumed and the well owner shall demonstrate to the reasonable satisfaction of the State Engineer that no
more than 98%of the water withdrawn will be consumed.
15) This well is subject to administration by the Division Engineer in accordance with applicable decrees, statutes, rules, and
regulations.
NOTE: The ability of this well to withdraw its authorized amount of water from this non-renewable aquifer may be less than the
100 years upon which the amount of water in the aquifer is allocated, due to anticipated water level declines.
Printed 11-26-2018 For questions about this permit call 303.866.3581 or go to www.water.state.co.us Page 1 of 2
WELL PERMIT NUMBER 74583-F RECEIPT NUMBER 3646920
Date Issued: 11/3/2010
Expiration Date: N/A
Issued By
PERMIT HISTORY
08-31-2018 CHANGE IN OWNER NAME/MAILING ADDRESS. CHANGED TO DANIEL VANDER DUSSEN
08-31-2018 CHANGE IN OWNER NAME/MAILING ADDRESS. CHANGED TO SOPHIA VANDER DUSSEN
Printed 11-26-2018 For questions about this permit call 303.866.3581 or go to www.water.state.co.us Page 2 of 2
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