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FT LLUPTON CD 80621
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WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
X 555 North 17th Avenue, Greeley. CC) $G631 w.vw.w4lcllieglth.pry
Application Number:
Owner Name:
Site Address:
App Type:
Septic Permit - Final
SP -2000098
ROCHA GAB RI EL & ROCHA MARICELA
O E LA►
15819 NANCY AVE
FORT LIPTON, CO
Health\Residential\New OWTS\Septic
3455 W SERVICE RD
EVAN S, CO
Parcel Number 130927110003-R5200386
Legal ileac: AR 14-6 L6 BLK14 ARISTOCRAT RANCHETTES INC
Work Description:
NEW CONSTRUCTION
EHS SEPTIC GENERAL
Application Date
Associated Building Permit
Associated Disaster Permit
Basement Plumbing
Manual Expiration Date Entry
Number of Bedrooms
Number of Persons
Parcel Acres
Private Water Supply
Public Water Supply
Septic Permit Expiration Date
EHS SEPTIC ACTUAL (FINAL)
Septic Tank Size, gallons
Absorption Trench, sgft
Chamber Model
Number of Chambers Installed
Design Type
Dosing
Lift Station
Pump Size
03/11/2020
No
No
No
4
4
0,99
Well
No
10/12/2022
1500
624
Quick4 ck4 Plus Standard
52
Chambers -Trench
No
No
No
NOTICE
Application Status:
Finaled
Applied Date:
3/11/2020
Issued Date:
3/13/2020
Finaled Date:
10/12/2021
This permit is granted temporarilyto allow construction to commence. This permit may be revoked cr suspended by the Weld County Department of Public
Hearth and
nd Environment for reasons set forth in the Weld County individual Sewage Disposal System Rogulations including failure to meet any term or
condition imposed thereon duringtemporary or final approval The issuance of this permit does not constitute assumption by the department, or its employees
Of liability for the failrue 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 Evnironrrient resorves the right to impose additional teirrns 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.
Alex ciemments October 12, 2021
Environmental Health Specialist
H eaItti Adm 'Ernst ration
Vital !fie c.o rd 5
Fax: )70 —?.044 t2
Public Health &
COnia. l $ervi ors
370-,301 -542.
r�
Fax: 57')-344-4 5
Environmental Health
Services
TeIe:97D-304.54 F.
Fax 37O-304-64,
Date
Communication,
Education & Planning
Tele 370.2.--31-ez4 i o
Fax 970-atulte2
Emergency Preparedness
& Response
Tele: i?C.3O4-e41
Fax; 9'G -2O4-51 2
Public Health
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