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Home My WebLink About20221684.tiffACCOUNT NUMBER NORTH WELD COUNTY WATER DISTRICT P,O. BOX 55 32825 CR 39 LUCERNE, CO 80646 PHONE: (970) 356-3020 • FAX: (970) 396-0997 • E-MAIL: waterramlrc rd.org 3800004 NAME ANC SERVICE ADDRESS BRIAN A. & JODI R. WARREN 36401 CR 43 EATON, CO 80615 952 n r-, r� Sep- Oct Nov Dec ---Jan Feb liar Apr -flay Jtift--Jv-1- Aug - Sep 91LUN6 PERIOD 09/10/2021-09/21/2021 Water Class 70 % of 0.750 Acre Foot Transferred Water Allocation Adjustment Less YTD Usage Remaining Water Allocation Plant Investment Class 70 % of 0.750 Acre Foot Less YTD Usage Remaining PI Allocation w Previous Balance 09/2112021 Standard - 3/4 Current Amount Total Amount Due Prev. Read Curr. Read Usage Unit 5031 5086 55 kgal P (KSal) 171 0 0 55 118 171 55 116 Amount 0.00 213.40 213.40 213.40 DETACH HERE NORTH WELD COUNTY WATER DISTRICT P.O. BOX 56 LUCERNE, c0 80048 PHONE: (S70) 356.3020 • FAX: (970) 395.0997 • E-MAIL: water@nwcwd.org Any payment received after the 15th of the month may not straw on this billing. Please note that all accounts are due by the ISth of the month. Return this stub with your payment Thank you. ACCOUNT NUMBER SERVICE ADDRESS AMOUNT DUE BY:10l1512021 AMOUNT PAID 3800004 35401 CR 43 X213.48 AUTO'"SCH 5-D1GIT 80632 y �lrrlhlhll111�I1riPllllllhl�lllhlrl11111P�1lrlhllrl�lhl� BRIAN A. & JODI R. WARREN 36401 COUNTY ROAD 43 EATON CO 80615-9113 14 y 3227 Iglu,II'll�IIII111111111!'IIlIII!'!IIlIII.lrll.11lllllll...11[Il NORTH WELD COUNTY WATER DISTRICT P.O. BOX 778 Gretna, NE 60028-0778 003800004003800004000021340 DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 1555 N. 17th Avenue Greeley, CO 80631 www.weldhealth.org .L4i1 Public Health H4,01h AtlmlrrlsNrfien Public Health & Clinical Environmental Health Communlcalion, Emergency Preparedness Vital Records Services Services Eduoallon 8 Pisnning d Response Tele'' 970 304 5410 Tele: 970.304 8420 Tele: 970 304 6415 Tele: 970 304 8470 Tele: 970 304 8420 Fax'. 970 304 6412 Fax: 970 304 8418 Fax: 970 304 8411 Fax: 970 304 8452 Fsx: 970 304 5459 Our vision: Together with the communIfies we serve, we are working lo make Weld County the haalfhiesf piece to live, team, work endplay. Septic Permit - Final Application Number:SP-1500019 Owner Name:RATHBUN DAKOTA & KATIE Site Address: 36401 CR 43 EATON, CO 80615 App Type: HealthlResidentiallRepair OWTSISeptic LLOYD BALL BALL CONSTRUCTION INC 3029 42ND AVE GREELEY, CO 80634 Parcel#: 070933400074-R6783066 Legal Desc: PT E2 33-7-65 LOT A 2ND CORR REC EXEMPT RE -5032 Work Description: ADDITION TO EXISTING FIELD EHS SEPTIC GENERAL: Associated Building Permit Yes Associated Building Permit Number BCR15-00062 Associated Disaster Permit No Location Description 36401 CR 43 EATON CO Number of Bedrooms 5 Number of Persons 4 Parcel Acres 5 Public Water Supply Yes Public Water Supply Utility NWCWD Repair Reason Type Repair for Upgrade Waive Fees No EHS SEPTIC ACTUAL (FINAL): Septic Tank Size, gallons 1250 Absorption Trench, sqft 525 Chamber Model Qulck4 Standard or High Capacity Number of Chambers Installed 8 Design Type Chambers -Trench 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 stake, county and local regulations adopted persuanl 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 end con-reluniiabls. 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. Katie Sall August 04, 2015 Flnaled Application Status: Finaled Applied Date: 01/22/2015 Issued Date: 01/26/2015 Flnaled Date : 08/04/2015 Environmental Health Specialist Date Print Date Time: 8/4/2015 2:10:35PM Septic Permit - Final EHS033 Page 1 of 1 6 9'i /si IAY11I 19 4 t 36q01 4,44 Li? 1)44r14::: SPIC006 e' 9e, r_ - 1U°4 A. 05p_ ri+ak 87 No' c -�. #0, ATM 61- _ e J ,f„ Yl„{' 1114/3 4":, 3 Are 5 �- - FRONT RANGE SEPTIC 33431 WCR 53 • Gill, CO 80624 Phone: (970) 302-0457 + www.frontrangeseptic.com Customer Na t► c cl- A /AA„ r Ph°nP7v S2 P— 06/� Job Address s� �./ � ti...� Cell Date Pumped IF ,.... 2 Mailing Address Pumper E-mail Septic tank O Grease trap ❑ Vault O Other Tank size: ---"Q Compartments: O 1 l]- O Can't verify Gallons Pumped . Tank construction:..SELConcrete O Plastic/Fiberglass O Metal O Other Liquid level in tank over Inlet line?...14 No O Yes O Can't verify Leach field running badcrT�Alo ❑ Yes O Eadra heavy O Can't verify Tee a Concrete Baffle Inlet: O No ,Ares TConcrete Baffle Outlet: O No -11 -Yes Can't verity O Lids within 8" of surface: Inlet No O Yes Outlet: Je0 O Yes Outlet Filter: O No O Yes If yes - Filter should be cleared every year Contact Pumper Comments: r3e, 2 P x Signature Amount First 1000 Gallons Pumped S D 0 Additional Gallons Pumped _,.l 6 ei v Septic Enzyme t {(-1 Cie' Locate Fee Digging Fee Other BALANCE DUE </.�$` ioa DAMAGE WAIVER: The company assumes no responsibility for damages inside of curb of property One or where damage may occur. Wald Coun Envlronmentat Health Sen t3 to ent 1555 N. 17th Avenue Greeley, CO 80631 Phone: (970) 304-6415 Fax: (970) 304-6411 Web: weldhealth.org Septic Permit Repair Application Number: SP -1500019 Owner Name: RATHBUN DAKOTA & KATHIE Site Address: 36401 CR 43 EATON, CO 80615 App Type: HealthlResidentiallRepair OWTS1Septic LLOYD BALL BALL CONSTRUCTION INC 3029 42ND AVE GREELEY, CO 80634 Parcel Number: 070933400074-R6783066 Legal Desc: PT E2 33-7-65 LOT A 2ND CORR REC EXEMPT RE -5032 EHS Septic General: Location Description Application Status: Final Pending Applied Date: 01/22/2015 Intake Person: SCERRILLO Permit Expiration Date: Repair Reason Type Associated Disaster Permit Waive Fees Number of Persons Number of Bedrooms Public Water Supply Public Water Supply Utility Parcel Acres 36401 CR 43 EATON CO Repair for Upgrade No No 4 5 Yes NWCWD 5 Percolation Rate iT ce Limiting Zone 7 S? ft in Description l SO..1) % Ground Slope Direction Soil Suitable ON) �1 Engineering Design Required (Yi� _ In 100 Year Flood Plain (Yg j From the application information supplied and the amskte soi percolation data Ito following minimum installation apecircationa are requited. Septic Tank t gllons Absorption Trench 91.14) sq tt or Absorption Bed so fl Chambers: Standard BioDiffuser Infiltrator Quick4 Standard or Hi Capacity Biodiffuser Arc 36 Standard or Hi Capacity Infiltrator Quick4 EQ36 Infiltrator Quick4 Plus Standard Low Profile Trench Bed Trench Bed Trench Bed Trench Bed --- Trench Bed ------ All Weld County ISDS regulations apply, In addition, this permit is subject to the following additional terms and contlitil7ns: k�c .cam `E'9' r Report ID: EHS00028v009 Print Date - Time: 1/26/2015 3:00:54PM Page 1 of 2 Application Number: SP -1500019 Owner Name: RATHBUN DAKOTA & KATHIE Site Address: 36401 CR 43 EATON, CO 80615 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 Individual Sewage Disposal System Regulations including failure to meet any term or condition imposed !heron during temporary or final approval. The issuance of this permit does not constitute assumption byte department or its employees of liability for the failure or inadequacy of the sewage disposal system. Tl i uarrmit IS non.tranaferpple and Pon -refundable Before issuing final approval of this penult the Weld County Department of Public Health and Environment reserves the right to impose addltional 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. This vomit expires one veer from the paollcation data X Environmental Health Specialist Date Report ID: EHS0002Bv009 Page 2 of 2 Print Date - Time: 1/26/2015 3:00:64PM DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 1555 N. 17th Avenue Greeley, CO 80631 www.weldhealth.org Helen ndrnInlstndon EMI Recede Tele: 970 3048410 Fair. 970 304 6412 Public Ifceah a all,urel services Tale: 070.304.6420 Fax: 070304.6416 o� EnvIromnenrel Neagh Ethane Tele: 970.304 6415 Fax'. 976 3046411 Gemmun4eeen, Rhaetian a Planning Tele: 970.304.5470 Fla: 970504.8452 Our `ie al Together wlrh the communMfea we term, we ere working re make Weld County the beetle'''.New lie rive, teem, Nark Me pew Application Number: APP Type: Owner Name: Parcel #: Legal Desc: Work Description: Site Address: App Specific Info: Septic Permit Application SP -1500019 HealthlResidentiallRepair OWTS\Septic LLOYD BALL BALL CONSTRUCTION INC 3029 42ND AVE GREELEY, CO 80634 RATHBUN DAKOTA & KATHIE 070933400074-R6783066 PT E2 33-7-65 LOT A 2ND CORR REC EXEMPT RE -5032 ADDITION TO EXISTING FIELD 36401 CR 43 EATON, CO 80615 nab& Heattlh Prntnf Mfa ranee rr.errr Emergency Preparedness a. Response Tele: 970.304 6476 Fax: 976.364.459 Location Description 36401 CR 43 EATON CO Number of Bedrooms 5 Number of Persons 4 Parcel Acres 5 Public Water Supply Yes Public Water Supply Utility NWCWD TERMS AND CONDITIONS. A permit fee, es set by separate ordinance of the Board of Weld County Commissioners, shell be required of applicants for mate wastewater treetmere systems, payable at time of applicagon Parrett fees are non-refundsble; permit applications are naneranaferable. H both a building permit and en OWTS are issued for the same property and construction is not commenced prior to the expiration date of the building permit, the OWES permit shell expire at the same time es the building permit H an OWTS permit is issued for a properly that does not require a building permit, the OWTS permit shall expire one year after its Issuence H construction an the meiotic system hem not commenced Any change in plena or specifications after the permit has been issued invalidates the permif unless approval is secured from the Health Officer or Mettler designated agent Expired permits can be renewed by payment of the permit fee only if; A. There has been no change in the plena end specifications of the proposed system es set oul in the original application or such change la reviewed end approved by a Division Representlative. B, The surrounding land, 6s use or zoning has not changed sa-ss•lo cause the original application not to be acceptable under these regulations NOTICE The completeness of this epplicalion is conditional upon further mandetory and additional tests and reports es may be required by the Weld Caunly Deperimert of Public Health and Environment (WCOPHE), The issuance of the permit is subject 10 such terms and conditions as deemed necessary to insure compliance with rules and regulations adopted under article 1D title 25, CRS as amended. The applicanl ratifies lhel the proposed system will not be located Within 400 feet of a community sewage syelem. The undersigned certifies that ell statements made, information and reports submitted herewith are, or will be, reprememed to be true and correct to the best of hisfher knowledge and are designed to be relied on by the WCDPHE for evaluation for purposes of issuing the permit applied for herein Applicant further understands that falsification or misrepresentation may result in the denial of the application or revocation of any permit granted, and in legs! action or penury as provided by law. er/Ap pl'rcant Print Date Time: 1/22/2015 2:31:22PM Report ID: EHS00056v004 Page 1 of 1 I moil. RESIDENTIAL ON -SITE WASTEWATER TREATMENT SYSTEM (OWTS) INSTALLATION PERMIT (New or Repair) NEW OR REPAIR RESIDENTIAL OWTS PERMIT FEE: F750'00 • All payments are due at the time of application submittal; by cash, check or credit card • incomplete applications will not be accepted (Site and soils evaluation, site plan and design document must be included) PARCEL NO.: [) 70 9 3 3 4 0 ot3 ? (12 DIGIT NUMBER) LEGAL DESCRIPTION: SECTION .17.TOWNSHIP � RANGE CI, r ACRES S SUBDIVISION LOT 5. BLOCK FILING dz4. —4._4-R 7 INFORMATION CAN BE OBTAINED FROM THE ASSESSOR'S OFFICE AT (970) 353-3$45 EXT 3650, OR ON THE COUNTY WEBSITE UNDER PROPERTY INFORMATION. Link to property information: hup; 'titi.vo.% icu.3r-elct.co_us.1)eptirinittnts_As,te sor/PropertylnformationPortal/i-ndex.htntI SITE ADDRESS -> (c 40 43 Co c - o lQ +S. DETAILED DIRECTIONS TO SITE (ATTACH MAP) PROPERTY OWNER:—.'.n�,a MAILING ADDRESS: '36. y -O a ce_ jf' CITY 64 1-O�1 ST CJ ZIP Q'O(0,5 HOME PHONE: ( ► WORK PHONE (600) S.31- pr, 14 FAX ( EMAIL ADDRESS: APPLICANT NAME: 0_1-.4 r L MAILING ADDRESS: -309,1 42 .A dr CITY 6.r -ac, it 6 ST CO HOME PHONE. ( EMAIL ADDRESS: PROPOSED.LISE: WORK PHONE (TV ) 39(,-S4-s-cr FAX R_ RESIDENTIAL NUMBER OF PERSONS: f NUMBER OF BEDROOMS: TYPE OF STRUCTURE (Ex, house, mobile home) h GtJ 5 O AUXILIARY BUILDING (Residential use only) TYPE AND NUMBER OF FIXTURES (shower, sinks, toilet): NUMBER OF PERSONS: TYPE OF STRUCTURE (Ex. personal shop, pool house) _ WATER;5 URGE: CO PUBLIC WATER SUPPLY (NAME OF SUPPLY) _ O INDIVIDUAL WELL (PERMIT #) ZIP _ of Oa03Z O CISTERN (PERMIT #) °WARNING: Neither Weld County nor any of its affiliates shall be responsible for the use of any information submitted in relation to this OWTS installation permit. It is the responsibility of the user to determine under what circumstances the information is being applied, and ensure that the circumstances are suitable to the application of the information Neither Weld County nor its employees are liable for the failure or inadequacy of the on site waste water treatment system 7 DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 1555 North 17th Avenue Greeley, CO 80631 Public Health Web; aaww weldhealth,orq Health Administration Public Hearth 8 Clinical Environmental Health Communication, emergency preparedness Vital Records Services Services Education 6 PI inning b Response Tale: 970 394 6410 Tale: 970 304 6420 Tele: 970 3048415 7elg 970 3046470 Tale: 970 304 6420 Fax 970 304 6412 Fax, 970904Wt6 Fax: 9703046411 Fax: 970 304 6452 Fax: 9703446469 Our o spar Together with the communities we serve, we are wtirking to make Wed Counly the healthiest pteae to We, ream, work and play. AUTHORIZATION FORM RE:PERMIT APPLICATION n OWTS EVALUATION n SALE OF PROPERTY n WATER SAMPLE i_i_l. --co,c +'1 12.�khvgives permission to i! Cj,r1_ivuci,`0.--, l .i.,,C. for the property (property Oer) (Agent/Applicant) located at 3oi-i D, Loue,. 43 to apply for/requested services checked above. LEGAL DESCRIPTION: SEC ) 3 TWN 7 RNG S I A Qe��d �Yt0'"el— SUBDIVISION NAME: 1-4A A LOT BLK jz 6_ s v 32, Agent/Applicant can be contacted at the following phone #'s: Home Work 5-70_ 3`x'4 -std Sg _ Fax # h E-mail a6±1_0".A.,5-'{-6S) t5''t`lcsi CLYIA The property owner can be contacted at the following phone #'s Home 0 tot) -It Work cr1p-- 53`xCOI to Fax # E-mail: [�Cl�-tx<b� 1tt ,cx cif Correspondence mailed to (only one):] Agent/Applicant DATE I - a3 - 15 OWNER'S SIGNATURE- rr 1, operty Owner c4 kt) 8 Hello