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Home My WebLink About20221312.tiffFarm No.+ GWS-25 APPLICANT OFFICE OF THE STATE ENGINEER COLORADO DIVISION OF WATER RESOURCES 818 Centennial Bldg., 1313 Sherman St., Denver, Colorado 80203 (303) 866-3581 ROBIN VALOIS 14950 WCR 18 FORT LUPTON, CO 80621- EXST WELL PERMIT NUMBER 277492 DIV. 1 WD DES. BASIN MD Lot: A Block: Filing: (303) 857-3927 ,CHANGE/EXPANSION OF USE OF AN EXISTING WELL Subdiv: RECORDED EXEMPTION 1309-28-1 RE -4751 APPROVED WELL LOCATION WELD COUNTY NE 1/4 NE 1/4 Section 28 Township 2 N Range 66 W Sixth P.M. DISTANCES FROM SECTION LINES 430 Ft. from North 240 Ft. from East Section Line Section Line UTM COORDINATES (Meters,Zone:13,NAD83) Easting: Northing: 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 in use of an existing well constructed under permit no. 269209. 4) Approved pursuant to CRS 37-92-602(3)(b)(I) and policy of the State Engineer under the following conditions for a 3 acre parcel known as Lot A of County Recorded Exemption no. 1369-28-1 RE4751, Weld County, more particularly described in the attached Exhibit A. 5} The use of ground water from this well is limited to ordinary household purposes inside one (1) single family dwelling, the watering of four (4) large non-commercial domestic animals, and the irrigation of not more than 5,000 square feet of home gardens and lawns. 6) Production from this well is restricted to the Laramie Fox Hills aquifer. 7)The pumping rate of this well shall not exceed 15 GPM. 8) The annual withdrawal of ground water from this well shall not exceed 0.6 acre-foot. 9) The issuance of this permit hereby cancels permit no. 269209. 10) The return flow from the use of this well must be through an individual waste water disposal system of the type so that not less than 2% of the total amount of water withdrawn is returned to the same stream system in which the well is located. 11) This well shall be constructed not more than 200 feet from the location specified on this permit. 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. NOTICE: This permit has been approved for a location other than applied for. You are hereby notified that you have the right to appeal the issuance of this permit, by filing a written request with this office within sixty (60) Sys .f the date of issuance, pursuant to the State Administrative Procedures Act. (See Section 24-4-104 through 10 .) !f Condition no. 5 and 8 of this permit are hereby amended to read as follows: ��"1 '-3-05 5) The use of ground water from this well is limited to ordinary houehold purposes in-ide[ T s le amily dwelling, the watering of four (4) large non-commercial domestic animals, and the irri ation not more than 7,000 square feet of home gardens and lawns. 8) The annual withdrawal of ground water from this well shall not exceed 0.7 acre-feet. JLM 4/22/ APPROVED JLV Receipt No. 3628637B State Engrneer WELD COUNTY DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT 1555 NORTH 17TH AVENUE, GREELEY, CO 80631 PHONE: (970) 304-6415 FAX: (970) 304-6411 WEBSITE: WWW.CO.WELD.CO.US Permit Number: SP -0600142 05-10-2006 Amount: $470.00 Payment Method: Check Owner Name: VALOIS ROB Applicant Name: COALSON JULIANA Parcel Number: 130928100056 Location: TBD WCR #18 FT LUPTON Account Code 2560-41400-4221-4203 2560-41400-4221-4203 2560-41.400-4221-4203 2560-41400-4221-4203 Description: MODULAR Commercial: (Y/19 N Number of Persons: 4 Number of Bedrooms: 3 Water Public: (Y/N) N Water Private: (Y/1). Y Description New Septic Permit Repair Septic Permit Vault Permit Variance Request Residential: (Y/N) Y Acres: Basement Plumbing: (Y/N) N Bathrooms: Full - 2 3/4: 0 Water Supply: Cistern: (Y/N) N 7.5 1/2: 0 Well: (Y/1) Y APPLICATION / RECEIPT Initials: SG Receipt Number: HAP -06146 Notation: 5131 Amount $470.00 $0.00 $0.00 $0.00 Well Permit Number: 250609 TERMS AND CONDITIONS A permit fee, as set by separate ordinance of the Board of Weld County Commissioners, shall be required of applicants for new individual sewage disposal systems (ISDS), payable at time of application, perrrrlt fees are nensafundable: permit apolicatlorfs are rtorkronsferalio. If both a building permit and an ISDS are issued for the same property and construction is not commenced prior to the expiration date of the building permit, the ISDS permit shall expire at the same time as the building permit. If an [SOS permit is issued for a property that does not require a building permit, the 1SDS permit shall expire one year after its issuance if construction on the septic system has not commenced. Any change in plans or specifications after the permit has been issued invalidates the permit unless approval is secured from the Health Officer or his/her designated agent. Expired permits can be renewed by payment of the permit fee only if: A. There has been no change in the plans and specifications of the proposed system as set out in the original application or such change is reviewed and approved by a Division Representative. H. The surrounding land, its use or zoning has not changed so -as -to cause the original application not to be acceptable under these regulations, heaLIE The completeness of this application is conditional upon further mandatory and additional tests and reports as may be required by the Weld County Department of Public Health and Environment (WCDPHE). The issuance of the permit is subject to such terms and conditions as deemed necessary to insure compliance with rules and regulations adopted under article t0 title 25, CRS as amended. The applicant certifies that the proposed system will not be located within 440 feet of a community sewage system. The undersigned certifies that all statements made, information and reports submitted herewith are, or will be, represented to be true and correct to the best ofhisther 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 legal action of perjury as provided by law. XC O ner/Applicant Form: #t11Pt' y ' 0_ Date WE�Yc COLORADO SEPTIC INFORMATION FORM Se.OLODOLI To obtain an I.S.D.S. permit, one must file an "Application for Individual Sewage Disposal System" at the Weld County Environmental Protection Services office, and pay the application fee. A "repair° fee shall be charged for the expansion, replacement, or repair of an existing system. The following information must be provided on the septic information form: PARCEL NO.: '7)09p%I 0Q� THIS CAN BE OBTAINED FROM THE ASSESSOR'S OFFICE AT} 353�-f3845 EXT 3650 PROPERTY OWNER 960 V 0LLO (5 MAILING ADDRESS Wi (pC) E K)5111' Or CITY .nder,D i ST Co ZIPS Noarto HOME PHONEV1 .%111- 91-f8:3 WORK PHONE (393) FAX ( Y APPLICANT NAME MAILING ADDRESS HOME PHONE ( 5-1?25 ilk3Ge. 59 CITY i�� — STLD ZIP?WM' WORK PHONE ( 1 45`i �� FAX ( 1_ N I� Nt V LEGAL DESCRIPTION PT °t' PT -T SEC 28 TWN c RNG ((45,63 ACRES - . 5 t� SUBDIVISION_ ke l413 LOT DESCRIPTION OF BUILDING (ex: House, Mobile Horn SITE/LOCATION ADDRESS -1.--€1)117- 1 L DIRECTIONS TO SITE I , }A 1:655 NEW PERMIT X REPAIR PERMIT s***Ior Hio .co BLOCK FILING Shop, Office) 0 (1 � � n -}o Co aco, VAULT PERMI 1;14ir $04 `1170(1° $150 Nleal IF OBTAINING A REPAIR PERMIT, PLEASE LIST PREVIOUS OWNERS OF THIS PROPERTY: 9(.4 � WC.te_ *al FLOOD PLAIN YES NO CENSUS TRACT COMMERCIAL YES r NO RESIDENTIAL .� NUMBER OF PERSONS y 4 BASEMENT PLUMBING YES / NUMBER OF BEDROOMS 3 BATHROOMS: FULL a 3/4 WATER SUPPLY: PUBLIC YES / O NAME 1/2 PRIVATE ES NO CISTERN _ YES NO WELL PERC HOLES MARKED FOR INSPECTION BY SPECIALIST NO WELL PERMIT # c 1 NO 04/28/2816 89.23 3836596443 1AEST1 DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT 15664 N. 1Y" Avenue Greeley, CO $0531 VVESSITE yrer*.cgfrek1 cow, ADMINISTRATION: (WO) 3044410 FAX: gym} 3044412 PuBuc HEALTH EDUCATION & HURISINCt 354-6420 • FAX: { 30476 ENVIRONMENTAL FE14LTH SERVICES: gernr}',104.641S FORK {670} 304-6411 AUTHORIZATION FORM RE:A5 PERMIT APPLICATION p is a.S. EvAuJATiow p SALE OF PROPERTY WATER SAMPLE I ay4 Lam? Y1 far ebc preperty (AsemdLEOAL DESCRIPTION: SEC TRIAi�IMO SUBDIVISION NAME: , _ -- - _ urr ► :,e:d ruvnr4coM at the 11031421g dune IIasr._� The property 'ANIMISM) be enetneted at the Mowing phonies 3 5(5,y..` `'27175% Part # Conesixoptleme =fled to (only one) AgexifApplkeant u emelt), Owner DAB r /04 nk- OWNER'S SYCNA7'IIRS v` PLEASE DRAW A MAP TO YOUR PROPERTY. N WOK [ S Oi i d1.4Ch rodd . zek A \ _ i 02Q5 r gT 09/14/2008 TRIT 08:25 PAI 303 857 9238 HIGH PLAINS ENGINEERING POALSON CONSTRUCTION iN "t ki WO; -j I .i�T-c�vf ised /7 = 73-1 T j"if 6 } V_ .)V-4;-- /VI Priv" r i—Zv r 3/ f gs- 17 V+, ! rt r• CV 1-9 f �7 --5- alNarlf 7 gow1S 1` Li„,,,) )rt iedli-L lotr w�Y'L..... . The general layout of the system agrees with this as -built drawing provided by the installer_ High Plains Engineering & Design, LLC 1 121002/002 p1 COALSON CONSTRUCTION IN .•gUttAxiai p,1 -7; ----- yo ' r y i re a -7-;-- � 75-6,� r�V� '/ V- 0--, .-.--- ld ' V-,..= /Y' V-?� zjf 1-3v_..7 3+ -gs� f,,,)X X �t. s ,,-t] --5:r9 1 r , I 14-t zoi r 6r q '20.45 _ /00J L v ham) )(1:041.16 9 5 P e660 �.- - -�-., _.., • - The general layout of the system agrees with this as -built drawing provided by the installer. High Plains Engineering 8c. Design, LLC q/fit° (-<T\r"---.1 HI H PLAINS ENGINEERING & DESIGN, LLC 735 DENVER AVENUE, FORT LIPTON, CO 80621 • PHONE: (303) 857-92$0 • FAX: (303) 857-9238 September 13, 2006 Rob Valois 8760 East 105th Court Henderson, CO 80640 RE: Observation of the drip irrigation engineered septic system for the home site located at RE -2913, A Part of the NE 'A Of Section 28, T2N, R66W of the 6th P.M., Weld County, CO. High Plains Engineering, Inc. Job # 06-5008 To Whom It May Concern: We made an observation on September 12, 2006 of the septic system at the above - described home site and found that it was constructed in an adequate manner. A 1500 -gallon septic tank and a 750 -gallon pump tank were installed. A'/s hp Zoeller model 267 pump was installed in the second tank. .4 inch schedule 40 PVC pipe was installed from the house to the tank. Two risers were provided to the surface from the septic tank. I-Egh water shut off and low water pump turn on indicators were installed. A weep hole was installed in the outlet pipe from the tank to the field. The field consisted of 7 sections with 4 — 2 inch lines spaced at 2 feet on center per section. The perforated pipe was installed properly with 'A" diameter holes at 8 inches on center. There are 7 valves in the distribution valve box with one valve turned off. The field is 100 feet long with a vent at the end of each section. The field is between 12" and 30" deep. Sincerely, Todd M. Schroeder, 09/14/2008 T'HU 08:28 FAX 303 857 9208 HIGH PLAINS ENGINEERING 0001/001 . • , - +vORLSON CONSTRUCTION ` IN ' P.1 goLio tl,1pr S 4-7; r `i No 1 1., = 7.re,, T'1= 6' W /a wx.r.iv' v-0.77 Li - 2,/ .7- 31 r yd Zi s• -d f 47. r7 -vs .. f c 00,.tdifT 1ov ` Lop.) —v,eli. tier The general layout of the system ages with this as -built drawing provided by the installer liigh plain; Engineering & Design, X.LC 01/14/d 09/13/2006 WED 09;31 FAI 303 857 9238 HI® PLAINS ENGINEERING � a002/002 735 DENVER AVENUE, FORT. LUPTQN, CO 80621 ■ PHONE(303) 857-9280 + FAX: (303) 857-9238 September 13, 2006 Rob Valois 8760 East 105th Cows Henderson, CO 80640 RE: Observation ofthe drip irrigation engineered septic system for the home site located at RE -2913, A Part of the NE % 0f Section 28, T2N, R56W of the 6th P.M., Weld County, CO. High Plains Engineering, TM, Job # 06-5008 To Whom It May Concern: We made an observation on September 12, 2006 of the septic system at the above - described home site and found that it was constn,uted in an adequate manner. A 1500 -gallon septic tank and a 750 -gallon pump tans were installed. A'A hg T,ocIler model 267 pump was installed in the second tank 4 inch schedule 40 PVC pipe was installed fi+om the house to the tank. Two risers were provided to the surface from the septic tank. High water shut off and low water pump turn on indicators were installed. A weep hole was installed in the outlet pipe from the tank to the field. The field consisted of 7 sections with 4 — 2 inch lines spaced at 2 feet on center per Election The perforated pipe was installed properly with IA" diameter holes at 8 inches on canter. There are 7 valves in the distribution valve box with one valve turned off. The field is 100 feet long with a vent at the end of each section. The field is between 12" and 30" deep. Do too ibPQo loz ^—' I c7) -3u w ,0`-7 )1 1ozy r p - O 1930 dr,,p &LI r Permit #: Owner: Applicant: Permit Type: Parcel #: Location: Legal De Installer: 'WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 1555 NORTH 17TH AVENUE GREELEY, CO 80631 PHONE (970) 304-6415 FAX (970) 304-6411 scup SP -0600142 VALOIS ROB COALS ON JULIANA RNEW C —Commercial, R=Residential + NEW, REPair, VauLT 1309-28-1-00-056 14950 CR 18 O0_7.7 t� Description: MODULAR Commercial: N Sec/Twn/Rng: 28-02-66 F_inaied Status: ISSUED Applied: 05/1012006 Issued: 05/12/2006 Finaled: q f ) 14 ) Q 4p Residential: Y Acres: 7.5 # of Persons: 4 Basement Plumbing: N # of Bedrooms: 3 Bathrooms - Full: 2 3/4: 0 1/2: 0 Water Public: N Water Source: Water Private: Y Cistern: N Well: Y Well Permit #: 250609 Percolation Rate: 145.8 Limiting Zone: Oft 0 in Description: CLAY % Ground Slope: 1 Dir: SW Soil Suitable: (Y/l) N Engineer Design Required: (Y/N) Y In 100 Year Flood Plain: (Y/N) N Minimum Installation Septic Tank: 1500 gallons Absorption Trench: 0 square feet ;or Absorption Bed: 5600 square feet Actual Installation b� Septic Tank: 1613] r - gallons Design Type: Absorption Trench: _ Absorption Bed: $ 5a) bL,Jf i 11l4a,A/rLe] Chamber Model square feet square feet Chambers 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 CRS 1973 25-10-111 (2), Thls 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. virotal Health Specialist Form: S FINAL Scanning Cover Sheet for Septic Permits Permit # SP -0600142 Permit Type: I lealth / Residential / New Situs Street Address Situs City, State, Zip 14950 CR 18 Sec/Town/Range: 28 -02N -65W Parcel # 112 digits) 130928100056-R1518802 Owner Full Name: Owner Address: VALOIS ROB 8760 E 105TH CT HENDERSON,CO 80640 Contact Name: COALSON JULIANA Contact Address: 35735 WCR 59 GILL,CO,80624 Application Status: Fina/ed Application Date: 05110/2006 Owner Phone #: 303-564-9483 Contact Phone# 970-454-5556 information above has been Verified in Accela by emr loyee noted below X Processed by: April 22, 2008 Date Report ID: EHS00024v003 Page 1 of 1 Print Date -Time: 4/22/2008 2:00:23PM FOR OFFICE USE ONLY ISDS APPLICATION FLOW SHEET Owner Va Lc- Tob Location:LED W� , Date By Permit # DO« Legal Description: F-D)--i_oLQ Comments Parcel Number Received 5((01,Q S Information Form Complete 101)(1 J Authorization Form Received L u i Map Drawing Received t ( �1 Flood Plain? Yes/No Sile Inspection Date I 3 _ Engineer Design? Yes/No _ Date Engineer Design Received Customer Notified? Yes/No Date Staff Approval Sent Date Staff Approval Rec'd Pero Data Entered in Computer 5- F Date of BOH Approval Eng Approval Letter Sent (Letter, Permit, BOH Review) Date of Final Inspection 11-Ita Eng Final Inspection Letter Rec'd r Variances Needed? Yes/No Sent Variance Staff Approval Recd Variance Staff Approval Variance BOH Approval t Variance BOH Approval Sent (Variance, BOH Review) Additional Comments; u lamred eeot+cnbwa n ee L 5X.,.yd 1, artebiL avokka t 17)0 -IQ/ N11- ., - Permit #: Owner: Applicant: Permit Type: Parcel #: Location: Legal Desc: WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 1555 NORTH 17TH AVENUE GREELEY, COLORADO 80631 PHONE (970) 304-6415 FAX (970) 304-6411 SP -0600142 Sec/Twn/Rng: 28-02-66 VALOIS ROB COALSON JULIANA RNEW C‹onnnercial, R=Residential + NEW, REPair, VauLT 1309-28-1-00-056 TBD WCR #18 FT LUPTON PERMIT Applied: 05/10/2006 Description: MODULAR Commercial: N # of Persons: # of Bedrooms: Water Public: N Residential: Y Basement Plumbing: N Bathrooms - Full: 2 3/4: 0 1/2: 0 Water Source: Cistern: N Well: Acres: 7.5 Water Private: Y Well Permit Number: 250609 Percolation Rate _ ' • ' Limiting Zone ft in Description % Ground Slope t .5" Direction 4A0 Soil Suitable (Y Engineer Design Required (Y/N) k.1 -C% In 100 Year Flood Plain (Y/N) ILO From the application Information supplied and the on -site soil percolation data the following minimum installation specifications are required: Septic Tank leo° gallons, Absorption Trench ~— sq ft or Absorption Bed tX) sq ft Chambers: Infiltrator or Hancor Standard or Hi -Capacity, EQ36 or BioDiffuser Trench Bed Infiltrator Quick4 Trench Bed Hancor Narrow (15in) Envirochamber Trench Bed In addition, this permit is subject to the following additional terms and conditions: Oke--011d' kti 1V4(1... diSip. '5LM-e-fh N -1. -Leh 0530 iromi-- afroTe,61-4O, NO'T'ICE 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 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 transferable 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 consent upon the final inspection of the completed system by the Weld County Department of Public Health and Environment. Form: S PERMITN D p1,9 Environmental Health Specialist ate Hello