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Home My WebLink About20221190.tiffForm No. GWS-25 APPLICANT OFFICE OF THE STATE ENGINEER COLORADO DIVISION OF WATER RESOURCES 818 Centennial Bldg., 1313 Sherman St, Denver, Colorado 80203 (303) 86&3581 JANETA K BARKLEY 17617 HWY 52 FT LUPTON CO 80621- (303) 857-4539 REGISTRATION OF EXISTING WELL LR WELL PERMIT NUMBER 202169 DIV. 1 CNTY. 62 WD 2 DES. BASIN MD Lot: Block: Filing: Subdiv: APPROVED WELL LOCATION WELD COUNTY SW 1/4 NE 1/4 Section 1 Twp 1 N RANGE 66 W 6th P.M. DISTANCES FROM SECTION LINES 2450 Ft. from North Section Line 2050 Ft. from East Section Line 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 the permit does not assure the applicant 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) This well is recorded, and permit approved, in accordance with CRS 37-92-602(5) for historic use as indicated herein and described in CRS 37-92-602(1)(b), being a well producing 10 GPM and used for ordinary household purposes inside three (3) single family dwellings, fire protection, the watering of domestic animals, poultry and livestock on a farm or ranch, and the irrigation of not more than 1/4 acre (10,890 square feet) of home gardens and lawns. 4) The date of first beneficial use, as claimed by the applicant, is June 1, 1940. 2, y4y/s APPROVED JSG ,ild z Sudo Englnober Receipt No. 0412417 DATE ISSUED APR 1 4 1997 BY AY EXPIRATION DATE aj twa9GMS42 E STATE ENGINEER. OFFICE OF THE 818 Ceolersi l lids, 1313 8h® colaado woos - tan 466-3581 ' NECEIVEt fi FEB 2 1997 1 7g- zt e.n STATE ENGINEER W Irg COLO r i „, v. 7t.: (J 8agdpc ft POE lNS1 VCIIONS SEE REVERSE EIDE REGISTRATION OF EXISTING WELL. i - NAME(S) hadliqgAddromm {may. SL Phone Janeta K. Barkley 17617 Hwy 52 rap Ft. Lupton, CO 80621 ( 303 ) 857-4539 2. WELL LOCATION: COUNTY WELD OWIMUSWELLEESIMATION domestic 17617 Hwy 52 Ft. Luton CO 80621 warms) West 1/4 c( the NE 1/4, Sec. 1 Twp. (C1) Range 2050 (Sate) 66 ❑ E. or Wp) 1 I N. or ❑ S.. Ill W. 6th P.M. Distances from Section Lines 2450 Ft. from or ❑ W. Line. 1 N. or ❑ S. Line, FL ham X E. 3. The well has historically been used for the following purpose(s): Ibmestic - House and farm animals 4. Water from the well was first used beneficially on June L 19 40 by the original owner for the above described peapose(s) 5. The total depth of this well is 60 feet. 6. The pumping rate is ten gallons per minute. 7. The average annual amount of water diverted is one acre feet. & The land d or as area of home lawn and garden irrigated as: West 1/2 of NE 1/4 of Section from this well is: 1/4 ❑ Square feet, of 6th P.M. © Acre or 1, Township 1 North Range 66 West ( Subdivision Lot(s) Block Filing/Unit I (we) knowledge. in the have read the statements made herein. know the contents thereo4 and state that they are true to my (our) (a) CRS., the making of false stets herein constitutes perjury 1 misdemeanor.] (Pursuant to Section 24 4 104 (13) second degree and is punishable as a Class 9. Name Janeta /Title (Please type or print) • ignature - / Date 02/26/97 K. Rarkley �I' I .! 17, ' FO FFICE USE ONI!.Y yt•)\iJE" f Ni'' ' '. N� ( - 3 l6; 2. �, r I Best Copy Available Stare Engineer y BYDate Court Case No. Div. 1 Co. (jC .\ WD Basin MD Use INSTRUCTIONS FOR THE COMPIETION.OF REGISTRATION OF =SIM WELL, I PORTANT INFORMATION; CERTAIN WELLS NOT PREVIOUSLY REGISTERED OR PERMITTED MAY BE REGISTERED PURSUANT TO C:. LS. 37 4.602(5). THE WAS MUST HAVE BEEN CONS'IRUC ED AND Fur TO HSYEFIQAL USE PRIQB TO MAY 8. Ira THE TYPES OF WELLS THAT MAY BE REGISTERED ARE IDENTIFIED AS FOLLOWS: 1) Wells not etceeding fifteen ggp�m which are used for ordinary household purposes, fire protection, the water of poultry, domestic animals andlivestodc on farms and ranches, and the irrigation of not over one acre of home gardens and lawns, but not used for more than three single family dwellings. 2) Wells not exceeding fifty gpm which are in production as of May 22, 1971, and were and are used for the purposes described in (1) above. 3) Wells not exceeding fifteen gpm which are used for drinking and sanitary facilities in individual commercial businesses. 4) Wells used exclusively for fire -fighting purposes if said wells are capped, locked and available for use only in fighting 5) Wells within Designated Groundwater Basins may be registeredprovided they do not exceed 50 gpm and arc used for not more than three single family dwellings and the irrigation ofnot over one acre of home gardens and lawns, or the watering of livestock on range and pasture. They may be used in one commercial business, but may be further restricted by applicable Ground Water Management District Rules and Regulations. The Form must be typewritten or printed in maxim, Initial and date any changes you make on the form. INCOMPLETE FORMS ARE NOT ACCEPTABLE AND WILL BE RETURNED. ATTACH ADDITIONAL SHEETS IF MORE SPACE IS NEEDED. 3EE FEE FOR FILING OF A LATE REGISTRATION_ IS 560.00 PAYABLE TO THE "STATE ENGINEER'. IF THE LATE REGISTRATION IS ACCOMPANIED BY AN APPLICATION FOR A PERMIT TO REPLACE THE EXISTING WELL IN THE SAME AQUIFER, THERE IS NO ADDITIONAL FEE. 1. Print the well owner's name and include the mauling address and phone number. 2. If the well location is different than the mailing address of the owner, include the address where the well is located. North Well. The actual well location must include 114,1/4, Range, Township, Section and distances from Section lines. Mark the appropriate boxes for North or South and East or West directions. 3. Describe the use(s) to which the water has actually been applied. 4. Enter the date of first beneficial use by the original owner. This date must be prior to May 8, 1972 5. Enter the total depth of the well. 6. Enter the pumping rate of the well in gallons per minute. 7. The annual amount of water diverted in acre feet must be indicated. One acre foot is equivalent to 325,900 gallons. An average home with lawn and garden irrigation diverts an average of one acre foot. Average home use which does not include lawn and garden irrigation (watering) diverts 1/3 acre foot. 8. Report the area irrigated either as one acre, fraction of one acre or square feet by filling in the correct number and check the appropriate box. Yon must describe the area irrigated using either the legal description of that land or by referencing the Subdivision, Lot, Block and �or Unit number. The watering of home gardens and lawns is considered irrigation and must be reported. If the well is not used for irrigation, place a zero in the acres irrigated blank. One acre is equivalent to 43 square feet. 9. The well owner must sign the form. Print or type your name in the first block if it is different from Item No. 1. if Sitas a representative of a company who owns the well, then your title must also be included in the first block. gng a second block and date the last block. The erdstence and use of the well must be verified by field inspection before thengistration can be processed. For an inapecdon, contact the Division Office where your well is located. Divisions are based on major river drainage areas. For example, the Division One Office administers the South Platte River Basin. DIVISION 1 209 ARDC BUILDING 800 8Th AVE. GREELEY, CO 80631 (303) 352-8712 DIVISION 2 219 W. 5TH RM. 223 PUEBLO, CO. 81003 (719) 542-3368 DIVISION 3 422 4TH ST. ALAMOSA, CO 81101 (719) 589.6683 DIVISION 4 308 S. FIRST ST. MONTROSE, CO. 81402 (303) 249-6622 DIVISION 5 1429 GRAND AVENUE GLNWD SPGS. CO. 81601 (303) 945-5665 DIVISION 6 X321) �y. LINCOLN �/AVE/'1��SSTE E S 1 Dili] � SPGS., CO. 80477 ! (303) 879-0272 DIVISION 7 1474 MAIN ST. DURANGO, CO. 81302 (303) 247-1845 DENVER OFFICE RM. 823 1313 SHERMAN ST. DENVER, CO. 80203 ('um AAA-2SR1 COLORADO DIVISION OF WATER RESOURCES FIELD INSPECTION REP NEU EBzaABW Div. I Water District 2 Purpose of Inspection: Late Reg, x Replacemeh Date of Inspection; .2 /c9C, ! q 7 Other; r��s Applicant: Ji rl C Y K )CI Address: 1-149 17 i-L S 2— F4 . L up4bn , Gobi Phone: 3O3 - $ 5 7 - +-{ 539 Person contacted if not applicant: S C-- W.C. Name and phone #: ROBERT STAHL 303-857-0742 EXISTING WELL LOCATION: Sw 1/4, 1 E- 1/4, Sec I ,Twp. /N Distance:dYSb from &S section line, .7O5O fromW section line;County (if replacement give distance and direction to new well site _ CIRCLE type of existing well N/I1 Rng. w , 6th P.M. (it�C rl AND DUG, .S'PRING WELL, GALLERY WELL, GRAVEL PIT Any other wells on this parcel? /CS (if yes) how many I ; permit#, case', use?Linri r.i 1tereg' lawn wa EST. DATE WELL CONSTRUCTED 1 G I Q DATE OF FIRST USE 19 tf O EST. PUMPING RATE I O gpm. Total # of acres in this parcel 0 Address of property (if different than applicant address) N , �} Additional subdivision/parcel info: NIiar # of acres irrigated (non-exempt/crop irrigated) NI Pr Name of augmentation plan: Nlf1 Use of Well: X Household Use in (indicate how many 3 single family dwelling(s) X Watering of poultry and/or domestic animals ("domestic animals" would include a few cows, horses, etc.) X ,Watering of livestock on a farm or ranch - appr9x. how many head? 40 Is this a feed lot? NO ; how many head? Nil Im ortant : specify estimated historic lawn/garden irrigation) Irrigates /4 sq. fe f lawn and/or garden Fire Protection Commercial - drinking and sanitary only? (write details in comments section) Other (Write details in comments section) WERE THE USES CHECKED ABOVE INITIATED PRIOR TO MA Y 8, 1972, yes or no? I e. S NOTE: If any change in the historic use of this well has occurred since may 8, 1972, please indicate the date(s) the use changed, and ' _ ss this change/anp7or expansion of the current/or proposed use in the comments section of this form. SIGNED: `-� Date: / C/ 7 Additional comments and/or information: r 5 i..�c l I /104- C c- rry n to SecX Lb N'` yl is 2o, i h ` 244 )6S APPLICATION FOR IINDIVIDItAIl SEWAGE DISPOSAL SYSTEM No. 8—R z - , ` WELD COUNTY HEALTH DEPARTMENT New -4%'__ T . 001-19% ENVIRONMENTAL HEALTH SERVICES ISM Flospltal Road, Greeley, CO 90031 Repair — ,! , 1 /J �• 303.0940 Fitt x70 {�P O ER JF:/, /!7 77. ! ?,P%�i�DRA PHONE F 7 ,Lz/-3�3 ADDRESS OF PROPOSED SYSTEM / 1- i _ t!� / LEGAL DESCRIPTION OF SITE PT _ S____I' T- r , SUBDIVISION LOT .BLOCK _ iuNG USE TYPE RESIDENTIAL X /A>lhr/P jz'h 7stLi INSTiyuro N COMMERCIAL OTHER �err�� SERVICES: PERSONS —9 BATHROOMS / LOT SIZE 7 a (-4-C-4—/ BEDROOMS p? BAS ENT PL�lMBIN WATE SUPPLY iCk-'. /1/i .f TYPE OF SEWAGE DISPOSAL REQUESTED: �°.<-c- �v-i Pre FO �? .>2p1-._ Applicant acknowledges that the completeness of this application Is conditional upon further mardato� and additional tests and reports as may be required by the Weld County Health Department to be made end furnished by the applicant or by the Weld County Health Department for purposes of the evaluation of the application; and the iseuanoe of the permit is subject to such terms and conditions as deemed necseeary to Insure compllsnos with rules and regulations adopted under Article 10, Tine 25, Clfti 1873, es amended. The applicant certifies that the proposed system will not be located within 400 feet of a corm moth). sewage system. The undersigned hereby cartiflea that ell statements made. Information and reports eubmftled hem with and required to be submitted by the applicant are, or will be, represented to be true and correct to the beet of my known - 0, end ballet and ere designed to be relied on by the Weld County Health Department In evaluating Ole some for imposes of cuing the permit angled for herein. I further understand that any falslflcallon O11misrepresentationmay result In the denial of Ni. revocstlon of any permit grunted bed opal said application and In legal action for perjury as wended by • Appftoation tee )C! " G - . . / %7 : ,--Li 2-1, . - '/ + -i —._ ReC'd by rte'. - /". , efroi AV` * oats_% " r - ( OvrnerfAgent Signature bate A FOR DEFT. PERCOLATION RAnTE WATER TABLE DEPTH k USE ONLY SOIL TYPE ? PERCENT GROUND SLOPEr6 REQUIRES ENGINEER DESIGN t I YESf No INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT From the application Information supplied and the omelte soil percolation data. the following minimum installation specifi- cations are required: "��'J - SEPTIC TANi(�_GALLONS, ABSORPTION TRENCH SQ. FT. or ABSORPTION BED tr33 SQ. FT. in addition, this Permit Is subject to the following additional terms and condition: This Permit is granted temporarily to allow construction to commence. This Permit may be revoked or suspended by the', Id County Health Department for reasons set forth In the Weld County Indivldust Sewage Dlepossl System tndudlag failure to meet any term or condition imposed thereon during temporary or final approval. The Issuance of Plash does 1101 constitute uewnperon by tine Department or la employees of I ! ths , - loadequecy weeps Envlronrn - = peclaiist This Pewit Is not Irenetcnable end shall become std if system construction hes not commenced within one year of its issuance. Gefore Ieoufng ftnpl approval of this Permit the Weld County Health Department reserves the right to impose additional terms end conditions required t0 meat our regulations on a continuing baale. Final Permit approval Is contingent upon the final In- spection of thercompleted a am by the Weld County Health Department..R /'.", SYSTEM COMPACTOR d1 �9 FINAL INSPECTION NT SYSTEM ENGINEER VA1. -'3 - En The Issuance of this Permit does not mply compliance with other state. county or I • regulatory or building requirements. nor shall It act to certify that the subject system will operate in compitance with applicable state, county and local regolefloile, adopted pursuant to Article 10. Title 25, CRS 1073. as amended. except for the purposes of establishing final approval of-e!tt' Inetefled system for Issuance of a local occupancy permit pursuant to CRS 1973 25.10-111 (2). Original -Applicant; Copy-WCHD WCHD—EHS February,. 1951 mental Sp ' t WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 1555 Noll 17 l Avenue. Greeley. CO 80631 www.weldheoIth.org Septic Permit New Application Number: Owner Name: Site Address: SP -1800134 CHAMBERS WENDY KAY 17617 HWY 52 WELD. CO 80621 App Type: Health\ResidenliallNew OWTS Sept'Ic WENDY CHAMBERS Parcel Number: Legal Desc: 17617 STATE HIGHWAY 52 FORT LUPTON, CO 80621 147101000019-R6000688 15025A W2NE4 1 1 68 EXC UPRR RES (2R) Work Description: MOBILE HOME UPGRAGE EHS SEPTIC GENERAL: Application Status_ Final Pending Applied Date: 04/24/2018 Intake Person: e. LNIX Permit Expiration Date: Application Date Number of Bodrooms Number of .Persons Parcel Acres Private Water Supply Private Water Supply Permit Reference Number Public Water Supply 04/2442018 5 S 80 Well 202170 No vscAh adpl.pn Pubic NeeHhd Virg, receat Clicol torrkos Em:onmanNrlsaam Cmom.ieaSw 'Fmq� 5-014C OF rtluaananR En Ming tR.rp xis 71p�?v4.64n ,,.hr, . I :5 C .4-, \C\CA-c. aCr emu. 111. N tY MOM x x Y If � K x x [ 11 ilLii-x-xl1L711)(Ln r x rr ---- -171 I' x i i�x sa x x 31 z i xLY N x Cno‘o 1 • 1 1 Nx PROMO D HIGHWAY NO. 52 DETAIL- LN ++ 30, C5‘ \c\4 moo SD doexoes, ANNe. a 6_caait' 612-Q�C. R- ``,OcD \3A bQ uS --V+ne, 2 mobi\eS (VA- ULSar Q_Oc rro L voo e-- Ccco GL Q S \Q l \‘c1 �Osk \-Li-Of u c Q V3O. u C& eigh OHM COLOR A DO Division of Water Resources Department Dr Natural Re antes WELL PERMIT NUMBER 324395 - RECEIPT NUMBER 10C15185 RIGINAL PERMIT E'PLICANT S ) vy'ENDY KAY HDEFER- -E HAM.EERS PERMIT TO CONSTRUCT A NEW ELL, APPROVED WELL LOCATION Water Division: 1 Designated Basin: Management District County: Parcel Name: Physical Address: Water 'strict NIA N/A WELD NA Section 1 Township 1.0 N Range 6,6_M W Sixth P.M. UTM COOT I NATES (Meters, p 13, NAD.83 Fasting: 523436.0 Northing: 44 37484.2 ISSUANCE OF THIS PERMIT DOES NOT CONFE:R A WATER R PGHT CONDEMNS OF APPROVAL 1 :I 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 i ra j u ry will occur to another vested water right or preclude another owner of a vested water right from seeking relief in a civil. court action 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. Approved! pursuant to CRS 37=92aOW(3)(b)(Ii)(A) as the only well on a tract of land of 3107 acres described as that portion of Lot B of Recorded Exemption RECX16-0197, Weld County, generally described as a portion of the NW 114 of the NE 1/4 of Sec. Tip. 1 N a Rng. 66 VII) 6th P.M. 5 more particularly described on Exhibit A in the yihell permit file. The use of groundwater from this well is Limited to fire protection, ordinary household i purposes inside not more than three (3) i n*L* family dwellings, the watering of poultry, domestic animals and livestock on a `Farm or ranch and the irrigation of not more ilian one 01) acre of home gardens and Lawns. Production from this well is limited to the Laramie -Fox H i L is aquifer which is located approximately 605 feet below ground surface and extends to a depth of approximately 1,0 Z5 feet. In accordance wi th Rule 10.4.8 of the Water Well Construction Rules, plain steel casing must be installed and grouted from the top of the pe rmi teed production zone up to at least ten feet above the base of the surface. casing, or to the depth re q u it i by Rule 10.5.2.1, if no surface casing is installed. (NOTE: If coals and/or carbonaceous shales are encountered in the borehole, plain casing and grout should be installed through these intervals to exclude poor quality water from entering the ell.) 6) The pumping rate of this well shall not exceed 15 GPM. 7) The return flow from .Hie use of this well must be through an individual wastewater disposal system of the non -evaporative type *hem the water is returned to the same stream system in which the well is located. 8) 111K Well shall be located not more than 200 feet from the location specified on this permit. 9) ADVANCE, NOTICE REQUIRED - Pursuant to Construction Rule 6.2.2.1 (2 CCR 402-2), licensed or private drillers and pump installers must provide advance notification (by 11:59 pm the day amore) to the State Engineer prior to each of the following for this well: the start of well construction, the initial i nsto L la do n of the first permanent pump, and the initial instaLlation of a cistern connected' to the water well supply system. Any change in the date of construction/installation mast be re -noticed prior to the activity (by 11:59 pin the day before). Information rega rid i ng the notification process and a link to the electronic notification form can be found on the Division of Water Resources vvelysite at dwr. co to rado .sr.ov NOTE: This welt is withdrawing water from a non-rere abile aquifer. While the withdrawals from this aquifer are administered based on a 1I r r year aquifer life, water Level declines may prevent this well from diverting the permitted amounts for that 1 , years. NOTE: To ensure a maximum productive life of this well, perforated casing should be set through the entire producing i n ter va L of the approved zone or aquifer i nd i ted above. NOTE: A hydrogeologic. aquifer evaluation has been completed for this permit and the details of the evaluation can be viewed in the hydrorologic aquifer eva l ua do n waged document and the original permit file. Printed 11 st€42O2.1 For questions about this permit call 303.8663 581 or go to h ttps :I fdwr_colorado ov Page 1 of 2 WELL PERMIT NUMBER 324345 - RECEIPT NUMBER 10115185 NOTE: This pe rTn it will expire on the expiration date unless the well. is constructed by that date. A Well Construction and Yield Estimate Report (G' -3J1) must be submitted' to the Division of Water Resources to verify the iweLl has been constructed. An extension of the c piration date may be available. Contact the DWR for additional. information or refer to the extension request form (G S-64) available at dwr.coLo rado.g taint BatenviraLd Issued! By WJ UL DICKINSON Date Issued ; 11 /8/2.021 Expiration Date: 1118/ 7023 Printed 11-04202.1 Forquestions about this permit call. 303,8663581 or go to h ttps:I fdwr_coLorado ov Page 2 of 2 Hello