HomeMy WebLinkAbout20222648.tiffScanning Cover Sheet
for
Septic Permits
Permit #
SP -0000395
Permit Type: Health / Residential f New
Situs Street Address 15282 HIGGINS INS AV
Situs City, State, Zip
Sec/Town/Range: 27432N -66W
Parcel # (12 €digits) 130927305008-85232186
Owner Full Name: RETANA ENRIQUE
Owner Address: 15282 HIGGINS AV
FT LUPTON,CO 80621
Contact Name:
Contact Address:
RETANA ENRIQUE
907 STAGE DRIVE
FORT LUPT N,CO, 80621
1
Application Status: Fina/ed
Application Date: 04/25/2008
Owner Phone #:
Contact Phone# 303-857-4843
Information above has been Verified in Accela by employee noted below
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Processed by:
,(z)it
June 09, 2008
Date
Report ID: EHS00O24v003
Print Date -Time: 6/9/2008 9:32:18AM
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WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
1555 NORTH 17TH AVENUE
GREELEY, CO 80631
PHONE (97Q) 3fl4-6415 FAX (970) 304-6411
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Permit #: SP -0000395
Owner: RETANA ENRIQUE
Applicant: RETANA ENRIQUE
Permit Type: RNEW C=Commerciat, R=Residential + NEW, REPair, VauLT
Parcel #:
Location: 15282 HIGGINS AVENUE FT LUPTON 26,27-2-6
Legal Description:
Installer:
ec/Twn/Rng: 26-2-66
4
Status: 1)&10(
= &' u
Applied: 06/22/2000
Issued: 06/27/2000
Finaled: /0/020(do
Description: M oB ILEHDME
Commercial: N
# of Persons:
# of Bedrooms:
Residential: Y
2 Basement Pluinbing: N
3 Bathrooms t Full: 2 3/4: 0 1/2: 0
Acres: I
Water Public: Y Water Source: ARISTOCRAT
Water Private: N Cistern: N Well: N Well Permit #: N/A
Percolation Rate: 18.8 Limiting Zone: 7 ft 0 in Description GROUND WATER
% Ground Slope: I Dir: S Soil Suitable: (YIN) Y
Engineer Design Required: (YIN) N In 100 Year Flood Plain: (YIN) N
Minimum Installation
.Septic Tank: 1000 gallons Absorption Trench: 651
or Absorption Bed: 879
square feet
square feet
Actual Installation
Septic Tate: /000 gallons Absorption Trench: square feet
Absorption Bed: 9C6 square feet
Design Type: 67.A
Chambers
NOTICE
The issuince 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).
Jbis t ermit is ijut transfer ►ble, 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.
0 tdr--)
iron l Health Specialist Date
Form: S_$INAL
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WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
1555 NORTH 17TH AVENUE
GREELEY, COLORADO 80631
PHONE (970) 304-6415 FAX (97Q) 304-6411
Permit
Owner:
Applicant:
Permit Type:
Parcel #t:
Location:
Legal Desc:
SP -0000395 See/T a/Rag:26-2-66
RETANA ENRIQIJE
RETANA ENRIQUE
RNEW -=Commercial. R=Residential + NEW, REPair, VauLT
15282 HIGGINS AVENUE FT LUPTON 26,27-2-6
PERMIT
Applied: 06/22/2000
Expires: 06/17/2001
Description: MOBILEFIOME
Commercial: N
ft of Persons:
ti of Bedrooms:
Residential: Y Acres:
2 Basement Plumbing: N
3 Bathrooms - Full: 2 3/4: 0 1/2: 0
Water Public: Y Water Source: ARISTOCRAT
Water Private: N Cistern: N Well: N Welt Permit Number: N/A
Percolation Rate / s, Limiting Zone Re ft o in Description 7 -r, ‘4
Ground Slope 1 Direction S Soil Suitable (YIN) ' 1f
Engineer Design Required (YIN) NA In 100 Year Flood Plain (YIN)
From the application information supplied and the on -site son. percolation data the following minimum installation specifications are
required:
Chambers
Septic Tank lbw gallons, Absorption Trench 4,pds1 square feet
or
Absorption Bed Ste' - `square feet
In addition, this permit is subject to the following additional terms and conditions:
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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 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 not transferable, 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. Thispermit expires one year from the application date.
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High Plaints Engineering
735 Denver Avenue • Fort Lupton CO 80621
Phone 3C28579280 • Fax 303-957-9238
PROPERTY ADDRcSS /51282 Ear- ? FON Co _
PROPERTY OWNER:
NAME ENIRI(?ETAI'JA
-1i-. . .. . .tii.rle7
ADDRESS _i°7 5/A6E ORuE, F2i in�pray , CO 5oCi21
PHONE _303-X57- 4843... -
SATURATION AND SWELLING
F � SURFACES ,� yw w �1� � 'w'
Mi..f'1REZ 1.�U • ACES 1 EITI VE:: 1 S + -
r �
SAND OR GRAVEL ADDRD -YES___•
DATE AND TIME PRESOAK WAT"'"
61/4100 I;o
AMOUNT OF PRESOAK WATER ADDED CGAISON>:
1 0. 6 MS Oto!
DATE AND TIME PERCOLATION ION TEST IS rrAR T`ED:
:4° OA
waSilaPaatsesS
DID WATER R iAIN IN HDLG AF F E.R TWE VERat
NIGHT SWELLING P ICC:
HOLE
YES C
HOLE 2 - YES
HCLZ 3
HOLE 4 _
HOLE 5
HC La o - -
weer NC
YES NO
E.,
NO
YES NC
YES ---NO
PERCOLATION RATE MEASU RE' A T
PERC CL 110 N RA IN. 'I +.) - . 1.
34,
. DEEP HOLE
_34 DEEP HOLEasPi
-
3C DE.EP HOLE :3 tibia
3‘. DEEP HOLE + AL 47-1
ji___DEEP HOLE
3C _DEEP Hai: 6 424,. 83
AVERAGE 19.25
•
GROUNDWATER
i...NCCU * ED erg
ESTIMATED DEPTH TO %4AX MUM SEr CSL
• WATER TABLE IF NOT DICOUNTERED
PROFILE:
IS AREA BELIEVED TO BE SUBJECT TC cASDNAL
FLUCTUATIONS WHICH COULD RESULTT -� A
SESCNAL WATER T ! WIT
O
SLOPE DETERMINATION IN ABSCRPTION
AREA: TO THE _ D1R E ; ON)
BEDROCK*
C O UN . �.D8FT.
..
ESTI A T -Z0 DEPTH IF NOT E IC'' L i�r er' = Er
PRCFILL
TYPE OF BEDROCK: —SANDSTONE
-CLAYSTONE SI'LTSTONE
OTHER ,
IS BEDRC CSC FRACTURED OR WEATH! '
,YES —NO
I SIEDROCX MINED TO BE PERMEAI?
(PERC RATE <50 MIN., IN.)
`�ES�_2IC
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FILE NO.0 T-4-
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PROFILE HOLE IMMFORlyiATION (CONT.')
(SOILS MUST OE CLASSIFIED USING UNIFIED SYSTai ASTM D24371
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cERTIFICAT!ON:
�TlF1� THAT THE �� �iF RAT1ON
1 CORRECT AND COMPLETE TO THE
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BEST OF MY KNOWLEDGE AND THAT ALL
TESTS ERA PERFORMED IN
WELD COUNTY HEALTH DEPARTMENT
�����A►�E WITH THE PROVISIONS {��UFE�1�����f��i,
INDIVIDUAL SEWAGE DISPOSAL REGULATIONS
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SIGNATURE
ismaimberruass
DATE
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.-g° 12330 <(1 h Plains Engineerina
4T� /35 Denver Ave.
efrdisigto( /Ft Lupton, CO 80621
303a857a9280
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WELD COUNTY DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT
1555 NORTH 17TH AVENUE, GREELEY, CO 80631 PHONE: (970) 30444415 FAX: (970) 304,-6411
Permit Number: SP -0000395
06-22-2000 Amount: $315.00 Payment Method: Cash
Owner Name: RETANA ENRIQUE
Applicant Name: RETANA ENRIQUE
Parcel Number:
Site Address:
Location: 15282 HIGGINS AVENUE FT LUPTON 26,27-2-6
APPLICATION 1 RECEIPT
Initials: RB
Receipt Number: HA 33
Notation: PAID IN CASH
.
Total Fees:
This Payment:
$315.0(?
$315.00
Total All Payments: 315.00
Balance: $0.00
Account Code
256041400-4221400
25604140074221-400
2560414 -422.1-400
256041400-4730-400
Description: MOBILEHOME
Description
New Septic Permit
Repair Septic Permit
Vault Permit
Potable Water
Commercial: (Y/ N Residential: (YIN) Y Acres: I
r
Number of Persons: 2 Basement Plumbing: (YIN) N
Number of Bedrooms: 3 Bathrooms: Full - 3/4: 0 112: 0
Amount
$315.00
$0.00
$4.00
$a.04
Water Public: (YIN) Y Water Source: ARISTOCRAT
Water Private: (YIN) N Cistern: (YIN) N Well: (YIN) N Well Permit Number: N/A
NOTICE
Applicant acknowledges receipt of the individual sewage disposal system guide and that 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 to be made and furnished by the applicant or by the Weld County Department of Public Health and
Environment for purposes of the evaluation of the application; and 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 10, title 25, CRS as amended. The
applicant certifies theat the proposed system will not be located within 400 feet of a community sewage system. The undersigned
hereby certifies that all statements made, information and reports submitted herewith and required to be submitted by the applicant
are, or will be, represented to be true and correct to the best of my knowledge and belief, and are designed to be relied on by the
Weld County Department of Public Health and Environment in evaluating the same for purposes of issuing the permit applied for
herein. I further understand that any falsification or misrepresentation may result in the denial of the application or revocation of
any permit granted based upon said applicaion and in legal action of perjury as provided by law. This application expires one
ey r� from#te signature date.
oiler/Applicant Date
Form: RT_HAPP
o
SEPTIC INFORMATION FORM
To obtain an I..D.. permit, one must file an "Application for Individual
Sewage Disposal System" at the Weld County Environmental Protection
COLORADO 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.:
ASSESSOR'S OFFICE AT (970) 353-3845 EXT 3650
PROPERTY OWNER �r} r r q
MAILING ADDRESS 9O7.._ &0i9e Dr err/.�_�c.[�7t—t� OST ZAP
HOME PHONE - $`�WORK PHONE F + • '7l 7 - O FAX
THIS CAN BE OBTAINED FROM THE
APPLICANT NAME CO in 19cdr _ PJena
MAILING ADDRESS,a% stPr. CITY „� 1i1 r,, � . ST ZIP
HOME PHONE (3a3) $,57n-4/893 WORK PHONE
FAX
LEGAL DESCRIPTION PT PT SEC°14947TWN RNG �rP ACRES I _
SUBDIVISION LOT ,3 BLOCK -7'/ FILING.
DESCRIPTION OF BUILDING (ex: House, Mobile Home, Modular, Shop, Office) Al6th talta
SITE/LOCATION ADDRESS J 54o'- $07 �r 99 j t't s ,au.t,t Derv? Lb BC2fr_Zz
DIRECTIONS TO SITE _ g� . r � ��,rn
[Arc/S
NEW PERMIT 1/2:3/�_
$315
e
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REPAIR PERMIT
$315
I.
IF OBTAININQ A REPAIR PERMIT, PLEASE LIST PREVIOUS OWNERS OF THIS PROPERTY
CENSUS TRACT
RESIDENTIAL
O
NUMBER OF PERSONS
NUMBER OF BEDROOMS
WATER SUPPLY: PUBLIC
COMMERCIAL YES 1 NO
BASEMENT PLUMBING YESa)
BATHROOMS: FULL oZ
NQ . UTILITY NAME
p
1
PRIVATE YES i.NO CISTERN YES f NO WELL YES I NO
1/2
tool cr-
WELL PERMIT #
'-,20,
• %
1
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ARWP} INC.
PO BOX 247 FT LUPTON CO 80821 PH: 303.457-4210
CUSTOMER HISTORY 12/17/2004 to 03!01/2022
Acct: RET 41 RETANA ENRIQUE Ho c:30 -851x1 &92
16282 HIG rI S AVE FT LUPTON CO80821 Current Balance: $111,11 ACTIVE
Lcpc ID: R TM 1 t � 15282 HIGGINS AVE FT LUPTON
Rte: A Seq." 3460 Mtr SIN 15/02771 D.p:$O.O0
Cock riptian
anw—rer NUN AUVMN for _
$150.00
WATER Credit Oard605478 for
$322 42.
WA R Read on 09/29/2021
RemMR
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`021 WATER Read on 10/29/2021
RemMR
11 WATER ONLINE 4EJ U6 for
$100.00
Previous
Present
Used
IS
Charge Payment Balance
150 00
322.42
32242 0.00
559,313 567,269 7,956 123.47
12347
567,269 573,796
5,529
112.62
236 09
199.00 136 09
244 61
0 00
12/1/2021 WATER Read on 11/29/2021
RemMR
12/3/2021 WATER ONLINE 4VVHH7 for
$244.61
573,798
579,787 5,989 108.52
244.61
1/1/2022 WATER Read on 12128/2021
RemMR
579,787 588,985 7,198 117.70
117.70
1/412022 WATER ONLINE MLDA6D for
$117.70
2/1/2022 WATER Read on 01/30/2022
RerMR
2,02022 WATER ONLINE QC43G3 for
$197.16
117.70 OC
586,985 504,538 17,653 197.16
197.16
197.16 0.00
3/1/2022 WATER Read on 02/27/2022
RemMR
604,638 010,958 6,330 111.11
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