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HomeMy WebLinkAbout20213139.tiffgo COLORADO Division of Water Resources Department of Natural Resources WELL PERMIT NUMBER 85459-F RECEIPT NUMBER 10008305 ORIGINAL PERMIT APPLICANT(S) VICTORIA MCCUNE PERMIT TO CONSTRUCT A NEW WELL APPROVED WELL LOCATION Water Division: 1 Water District: 2 Designated Basin: N/A Management District: N/A County: WELD Parcel Name: NELSON Lot: 5 Block: 1 Filing: Physical Address: 2346 APPALOOSA AVENUE BRIGHTON, CO 80603 NE 1/4 SE 1/4 Section 24 Township 1.0 N Range 66.0 W Sixth P.M. UTM COORDINATES (Meters, Zone:13, NAD83) Easting: 523983.0 Northing: 4431680.0 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 pursuant to CRS 37-90-137(4) and the findings of the State Engineer dated April 19, 2021. 4) The use of groundwater from this well is limited to inhouse use and the irrigation of not more than 7,400 square feet of home lawns and gardens. 5) Production from this well is limited to the Laramie -Fox Hills aquifer which is located approximately 770 feet below ground surface and extends to a depth of approximately 1195 feet. In accordance with Rule 10.4.8 of the Water Well Construction Rules, plain steel casing must be installed and grouted from the top of the permitted production zone up to at least ten feet above the base of the surface casing, or to the depth required 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the well.) 6) The pumping rate of this well shall not exceed 15 GPM. 7) The average annual amount of groundwater to be withdrawn shall not exceed 0.675 acre-feet and the total volume of groundwater to be withdrawn shall not exceed 67.5 acre-feet. 8) The entire length of the hole shall be geophysically logged as required by Rule 9 of the Statewide Nontributary Ground Water Rules prior to installing casing. 9) The owner shall mark the well in a conspicuous location with well permit number(s), name of the aquifer, and court case number(s) as appropriate. The owner shall take necessary means and precautions to preserve these markings. 10) A totalizing flow meter must be installed on this well and maintained in good working order. Permanent records of all diversions must be maintained by the well owner (recorded at least annually) and submitted to the Division Engineer upon request. 11) This well shall be constructed not more than 200 feet from the location specified on this permit. 12) Pursuant to CRS 37-90-137(9)(b) and the Denver Basin Rules, no more than 98% of the nontributary groundwater withdrawn annually shall be consumed and the well owner shall demonstrate to the reasonable satisfaction of the State Engineer that no more than 98% of the water withdrawn will be consumed. 13) This well is subject to administration by the Division Engineer in accordance with applicable decrees, statutes, rules, and regulations. Printed 05-04-2021 For questions about this permit call 303.866.3581 or go to www.water.state.co.us Page 1 of 2 WELL PERMIT NUMBER 85459-F RECEIPT NUMBER 10008305 14) 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 before) to the State Engineer prior to each of the following for this well: the start of well construction, the initial installation 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 must be re -noticed prior to the activity (by 11:59 pm the day before). Information regarding the notification process and a link to the electronic notification form can be found on the Division of Water Resources website at dwr.colorado.gov NOTE: This well is withdrawing water from a non-renewable aquifer. While the withdrawals from this aquifer are administered based on a 100 year aquifer life, water level declines may prevent this well from diverting the permitted amounts for that 100 years. NOTE: To ensure a maximum productive life of this well, perforated casing should be set through the entire producing interval of the approved zone or aquifer indicated above. NOTE: This permit will expire on the expiration date unless the well is constructed and a pump is installed by that date. A Well Construction and Yield Estimate Report (GWS-31) and Pump Installation and Production Equipment Test Report (GWS-32) must be submitted to the Division of Water Resources to verify the well has been constructed and the pump has been installed. A one- time extension of the expiration date may be available. Contact the DWR for additional information or refer to the extension request form (GWS-64) available at: dwr.colorado.gov NOTE: A hydrogeologic aquifer evaluation has been completed for this permit and the details of the evaluation can be viewed in the hydrogeologic aquifer evaluation imaged document and the original permit file. Issued By DEBRA GONZALES Date Issued: 5/4/2021 Expiration Date: 5/4/2022 Printed 05-04-2021 For questions about this permit call 303.866.3581 or go to www.water.state.co.us Page 2 of 2 WRJ•25.72 THIS FORM MUST SUBM1TTEF�i PRIOR TO THE EXPIRATION OF THE PERM"t$. TYPE OR PRINT') RI ACK-INK. COLORADO DIVISION Ok) WATER RESOURCES 101 Columbine Bldg., 1845 Sherman St. Denver, Colorado 80203 X STATEMENT OF BENEFICIAL. USE OF GROUND WATER AMENDMENT OF EXISTING RECORD STATE OF COLORADO COUNTY OF ti THE AFFIANT(S) a (I • whose address is Y ` PERMIT NUMBER }SS. •! if] // / f, r,3 .!dryr,, f t Er, c RECEIVED JUN06'7L r; WATER STATE HBrN�Es 000. ER being duly sworn upon oath, deposes and says that he (they) is (are) the owner(s) of the well described hereon; the well is located in thAf e' 1/4 of the _ Range_ -6 .' and _ 1/4 of Section �}- : P.M. at distances of , Township. / feet from the t F (N. or S.) section line (E. or W.) (North or South) feet from the section line; the total depth of the well is ' ( feet; water from this well (East or West) was first applied to a beneficial use for the purpose(s) described herein on the day ofr4°�;`` the maximum sustained pumping rate of the well is / a, gallons per minute, the pumping rate claimed hereby is__442•___ gallons per minute; the average annual amount of water to be diverted is acre-feet; for which claim is hereby made far " _ purpose(s); the legal description of the land on which the water from this well is to be used is /-0 7` 3 % T,i.f-i' . 470/5---- I ;°,:. !; r}. , L u/e / ( 4 . t which totals acres and which is illustrated on the map on the reverse side of this form; that this well was completed in compliance wi h the permit approved therefor; this statement of beneficial use of ground water is filed in compliance with law; he (they) has (have) read the statements made hereon; knows the content thereof; and that the same are true of his (their) knowledge. Signature(s)_ a ' 24.14zi Subs ed-'and sworn lc -before me on this 140 day of 197 Y, My Commission expires: Sea!) Notary Public t ACCEPTED FOR FILING IN THE OFFICE OF THE STATE ENGINEER OF COLORADO ON THIS DAY OF 19- -• STATE ENGINEER FOR OFFICE USE ONLY Prior. Date , 19 Well Use_it ;/4, 1i 1J4, Sec. T. __ _ —____, R. P.M Yield W.D. / ' 0 Co. index WHITE COPY FOR DIVISION OF WATER RESOURCES PINK COPY FOR WELL OWNER WRJ-26-72 THIS FORM MUST BE SUBMITTED WITFUN 60 DAYS OF COMPLETION OF THE WORK DESCRIBED HERE- ON. TYPE OR PRINT IN BLACK INK. COLORADO DIVISION OF WATER RESOURCES 300 Columbine Bldg., 1845 Sherman St. Denver, Colorado 80203 WELL COMPLETION AND PU PERMIT NUMBER go9 4 IP INSTALLATION REPORT �� �1ti O WELL OWNER -f ! , r�) 5g '/4 of the 5t: '/a of Sec. 2 41 ADDRESS 9 t7 69 . T. / N , R. It 1 6� fl/ P.M. DATE COMPLETED, 5 - WELL LOG S 19 V1HOLE DIAMETER From To Type and Color of Material Water Loc. �-3 I-7 /33 134 170 2-11) 330 Use a ACt4.-vd TOTAL DEPTH . D / dditional pages necessary to complete log. In. from O toft. in. from to ft. in. from to ft. DRILLING METHOD CASING RECORD: Size & kind from 0 tO3 -2- ft. tv Size ,59-'& kind Size & kind from _XV _ to Z4Z. ft. from to ft. Perforated Casing Size /�& kind 27o j3€ ft. Size & kind from Size __ & kind 1 t from GROUTING RECORD Material Intervals Placement Method o ft. to ft. GRAVEL PACK: Size Interval TEST DATA Date Tested Static -Water Level Prior toest A LJ Type of Test Pump Length of Test Sustained Yield (Metered) Final Pumping Water Level , 19 ft. PUMP INSTALLATION REPORT Pump Make `3/144 Type Powered. by Pump Serial No. Motor Serial No. Date Installed Pump Intake Depth Remarks HP WELL TEST DATA WITH PERMANENT PUMP Date Tested Static Water Level Prior to Test JJ Length of Test Sustained yield (Metered) Pumping Water Level Remarks Hours GPM J WATER TABLE 'CONE OF DEPRESSION CONTRACTORS STATEMENT The undersigned, being duly pump installation described thereof, and that the same is Signature sworn upon oath, deposes and says that he is the contractor of the well or hereon; that he has read the statement made hereon; knows the content true of his own knowledge. State of Colorado, County of _ My Commission ex.ires: Notary Public Subscribed and sworn to before me this day of My Commission expires May ;491975 License No. '7,O•� SS ,197/ FORM TO BE MADE OUT IN QUADRUPLICATE: WHITE FORM must be an original copy on both sides and signed. WHITE AND GREEN copies must be filed with the State Engineer. PINK COPY is for the Owner and YELLOW COPY is for the Driller. WRJ-5-71• TYPE OR FEINT IN BLACK INK. APPLICATION FOR: A PERMIT TO r A PERMIT TO REPLACEMENT A PERMIT TO OTHER APPLICANT Street Address COLORADO DIVISION OF WATER RESOURCES 101 Columbine Bldg., 1845 Sherman Street, Denver, Colorado 80203 j�� ,� f(-4._/' APPLICATION MUST BE COMPLETED BEFORE ACCEPTANCE. E 9 2 l4(Nt wkr. 4, WATER TO BE USr -),Retie � J DOMESTIC (1) R C(r`°. LIVESTOCK (2) INDUSL IV* MUNICIPAL (8) IRRIGATION . OTHER USE GROUND WATER CONSTRUCT A WELL FOR NO. INSTALL A PUMP &/ City & State 1p o net9.647t-- Telephone No, NAME OF AQUIFER GROUND WATER IS TO BE OBTAINED FROM: Q� - m000// PROPOSED TOTAL DEPTH OF WELL .S0/o gSO`t. ESTIMATED MAXIMUM PUMPING RATE /6— GPM AVERAGE ANNUAL AMOUNT OF GROUND WATER TO BE APPROPRIATED Acre-feet ANTICIPATED GROUT PROGRAM Material. Intervals Placement Method PROPOSED CASING: Plain Perf. Driller in. from 0 ft. to SO ft. in. from 512o ft. to 7,i'` 7 ft. in. from_ 7_5 —Oft. to 5:;--cit. in. from ft. to ft. ,s -c_4 e 6' No. �J GROUND pAirciegval7/ WELL LOCATION COUNTY i of me the ,— of Section T T. / ,Vor -d , B. a 408.57`, C-//- P.M. IN ADDITION TO THE ABOVE, THE WELL MUST BE LOCATED WITH RI 'ERENCE TO GOVERNMENT SURVEY CORNERS, MONUMENTS OR SECTION LINES BY DISTANCE AND BEARING (DOMESTIC WELLS MAY BE LOCATED BY LOT, BLOCK, & SUBDIVISION.) ft. from section tin (North or South) ft. from section lin 1rac+ LOT 3 B3 3CK FILING (East or West) SUBDIVISION Ale fS O iZ Ground Water Basin Water Mgmnt. Dist. Anticipated drilling date c/-47 /S-19 7Z Owner of land on which well is located: Aowe-ll A- M, /ieA Other water rights on this land / Address U C37 L� l � 74h 06,-eva;spa, 7 IF WELL IS USED FOR IRRIGATION, BACK SIDE OF THIS APPLICATION MUST BE COMPLETED. _5.1/7Z_ Signature o, CONDITIONS OF APPROVAL FOR OFFICE USE ONLY APPLICATION APPROVED: VALID FOR ONE (1) YEAR AFTER DATE ISSUED UNLESS EXTENDED FOR GOOD CAUSE SHOWN TO THE ISSUING AGENCY. PERMIT NO, 61855 DATE ISSUED STATE ENGINEER BY JUN 7 1972 THE LOCATION OF THE PROPOSED WELL MUST BE SHOWN AND THE AREA TO BE IRRIGATED MUST BE SHADt1 OR CROSS -HATCHED ON THE DIAGRAM BELOW This diagram represents nine (9) sections. Use the CENTER SQUARE (one section) to indicate the location of the well, if possible. 1 Mile N I .. I r T 1 I T - + - + - 4- - __ + - ...} -r -I- - + --. + .... + - .,1- - + - + NORTH SECTION LINE I- - ± - + n . o .n o + _ + - `0 0 N o 41 f + -�- + m1 m + - + SOUTH SECTION AGE - -IF _'- + — -IF — + - + — + i r# I •1 I E -4- -. + - + -- + - + - + 1 J a _ I j I ..J Owner of irrigated land THE SCALE OF THE DIAGRAM IS TWO INCHES EQUALS ONE -MILE Legal description of irrigated land Number of acres to be irrigated WATER EQUIVALENTS TABLE (Rounded Figures) An acre-foot covers 1 acre of land 1 foot deep. 1 cubic foot per second (cfs) .... 449 gallons per minute 1 acre-foot .... 43,560 cubic feet 325,900 gallons. 1,000 gpm pumped continuously for one day produces 4.42 acre-feet, 1OO gpm pumped continuously for one year produces 16O acre-feet. 5}-55 West Virginia Avenue Lakewood, Colorado ())60-° Division of Water Resources 101 Columbine Building 1845 Sherman Street Denver, Colorado 80203 Dear Sire I'm writing in regard to to expire on June 7th, 1974. April 27, 1974 RECEIVED 12— 74 oftliatiftsmswas STATE ROOMINIP COM Well Permit No.61655 which is 1 would like to ask for an extension of one year on this permit. We bought a house soon after we took out the permit. Remodeling this house has tsix0n the money we had reserved for the well. We would still IVAA to develop this property but feel that we would be more financially ready next year. 1 would appreciate consideration of this request for an ex- tension of our well normit. Thank you. SinCery1Y, Lowell A. Miller May 8, 1974 Mr. WW1 A. Miller 5455 Most Virginia Avenue Colorado RE Extension of shell Permit Ito. 618SS Dear = Sir: Your request for an extension of the expiration date for the above permit has been received and reviewed. It is the determination of the State Engineer that insufficient cam was shown for the extension. 'therefore, you are notified that your request for an extension has been denied. Should you be unable to delete the well prior to June 7,11974, the cove permit wlfexpire and be of no force or effect. A new application for a permit to construct a well at the proposed location ice: be submitted. After evaluation under existing policies, a new perMit any or may not be granted. If you have any further questions concerning this matter. please contact Mr. Robert Boesen of this office. Very truly yours, Harlan W. Erker Deputy State Engineer Ground Water Section RWII/RWB:lks C) ilvvLay From: Victoria Lapera To: Chris Gathman Subject: 2346 Appaloosa Ave -Remaining Items for your application Date: Wednesday, August 4, 2021 9:03:05 AM Caution: This email originated from outside of Weld County Government. Do not click links or open attachments unless you recognize the sender and know the content is safe. Hey Chris, Per our conversation the morning here is my follow up E-mail. Originally yes with the state of Colorado we were trying to get them to approve us using our existing well to support a second residence. But due to our current well not being deep enough to support a second residence, Deb at the state of Colorado said with our current land lot we can opt to have a second well drilled, which is the new well permit we have obtained and included within this application. I hope this helps clarify. Please let me know if you have any further questions. **I also did not receive the form to sign the surrounding property owner list. Will you send this to me please. Victoria Sent from Yahoo Mail for iPhone Dear Victoria, Sorry. I thought I had sent this on Monday. I was out of the office yesterday. The following items are needed for the application: Per the Department of Environmental Health - The application states in one place existing well will he used and another document states a new well will he drilled. Well permit states for in house use only and not for two residences. provide a copy of the application that was sent to the state to change the well permit to allow for two houses on the existing well. Per the Department of Planning Services — Provide a copy of a completed Certificate of Conveyances (current within 30 days) — see attached form. Sign the attached Surrounding Property Owner List. Once deemed complete — you can pay the application fee (cash, check or charge). We can except credit card payment via phone or e-mail. We would need: credit card number, name, expiration date, 3 -digit security code and zip code. Regards, Chris Gathman Planner III Weld County Department of Planning Services cgathman@weldgov.com 970-400-3537 ` r s H SP1 O6P INDIVIDUAL SEWAGE DISPOSAL- SYSTEM PERMIT NO. 0.940306 WELD COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH SERVICES 1517 16TH AVENUE COURT, GREELEY , GO 80651 353--0635 EXT.2225 NEW PERMIT OWNER DEHISON,RICHHOND/L1EANETTE ADDRESS 580 S CLINTON APT 12B PH (304) 344-0343 4P-344 AKr DENVER CO 80216 ADDRESS OF PROPOSED SYSTEM APPALOOSA BRIGHTON CO £30601 LEGAL DESCRIPTION OF, SITE: 5E4 SEC 24 TWP 1 RHO 66 SUBDIVISION; NELSON LOT 5 BLOCK 1 FILING 0 USE TYPE: RESIDENTIAL MANUFACTURED HOUSE SERVICES: PERSONS 2 BATHROOMS 2.00 LOT SIZE 2.50 ACRES BEDROOMS 3 BASEMENT PLUMBING NO WATER SUPPLY DWELL APPLICATION FEE $265,00 RECD BY CINDY SAL..AZAR DATE 06/16/94 SIGNED BY DAVID E. WALTERS DATE 06/16/94 PERCOLATION RATE 3.1 MIN PER INCH LIMITING ZONE 0 FEET SOIL TYPE UNSUITABLE PERCENT GROUND SLOPE 0% DIRECTION REQUIRES ENGINEER DESIGN YES IN 140 YEAR FLOOD PLAIN ZONE NO FROM THE APPLICATION INFORMATION SUPPLIED AND THE ON -SITE SOIL PERCOLATION DATA THE FOLLOWING MINIMUM INSTALLATION SPECIFICATIONS ARE REQUIRED: SEPTIC TANK 1000 GALLONS, ABSORPTION TRENCH SQ. FT. OR ABSORPTION BED 645 SQ_ FT. IN ADDITION., THIS PERMIT IS SUBJECT TO THE FOLLOWING ADDITIONAL TERMS AND CONDITIONS1 THIS PERMIT IS GRANTED TEMPORARILY TO ALLOW CONSTRUCTION TO COMMENCE. THIS PERMIT MAY BE REVOKED OR SUSPENDED BY THE WELD COUNTY HEALTH DEPARTMENT 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. ?IS 0. 9- 9' PAM SMITH ENVIRONMENTAL SPECIALIST 08/15/94 DATE THIS PERMIT is NOT TRANSFERABLE AND SHALL BECOME VOID IF SYSTEM CONSTRUCTION HAS NOT COMMENCED WITHIN ONE YEAR OF ITS ISSUANCE. BEFORE ISSUING FINAL APPROVAL OF THIS PERMIT THE WELD COUNTY HEALTH DEPARTMENT RESERVES THE RIGHT TO IMPOSE ADDI- TIONAL TERMS AND CONDITIONS REQUIRED TO MEET OUR REGULATIONS ON A CONTINUING BA- SIS. FINAL PERMIT APPROVAL IS CONTINGENT UPON THE FINAL INSPECTION OF THE COM- PL.ETED SYSTEM BY THE WEL.D COUNTY HEALTH DEPARTMENT. SYSTEM INSTALLER SYSTEM ENGINEER TYPE OF SYSTEM INS A LED tbul FINAL INS APPROVAL DATE ENVIRONMENTAL SPECIALIST 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 F'ERSUANT TO ARTICLE 10, TITLE 25, CRS 1973, AS AMENDED, EXCEPT FOR THE PURPOSE OF ESTABLISHING FINAL APPROVAL OF AN INSTALLED SYSTEM FOR ISSUANCE OF A LOCAL OCCUPANCY PERMIT PURSUANT TO CRS 197;3 25 -10 --ill (2). ORIGINAL-APPLICANTF .COPY-WCHD WCHD-EHS MAY, 1984 c f r 4 u ALPHA ENGINEERING CO. . LAND DEVELOPMENT PROPERTY SURVEYS 617 5TH STREET --- P.O„ BOX 392, FORT LUPTOA COLORADO 80621 FAX & DENVER 573-5186 OR 1-800-767-5186 ----- FT. LUPTON 857-2308 August 26, 1994 • Weld County Health Department 1617 16th Avenue Court Greeley, CO 80831. RE: inspection of Septic System at 2348 Appaloosa Ave. Weld County, Colorado. (Dave Walters) Deer Sir, linapsoted the above septic system and found it to be substantially constructed in accordance with the approved plane far this site Alpha Engineering File 8 24-1N6-17 Sincerely, f Cecil R. Crows, PE & LS 12330 File 6 24-1N$-17 WELD COUNTY BOARD OF HEALTH ENGINEER DESIGNED SYSTEM REVIEW APPLICANT: Denison, Richmond/Jeanette PERMIT NO.: G-940306 New LEGAL DESCRIPTION: PT: SE4 SECTION: 24 TOWNSHIP: 1 N RANGE: 66 W. SUBDIVISION: Nelson LOT: 005 BLOCK: 001 FILING: 000 SITE ADDRESS: Appaloosa & Nelson, Brighton FACILIT!: Residential Manufactured Home (3 bed) ACRES: 2.5 PERC RATE: 3.1 SOIL: Unsuitable WATER SUPPLY: PWell SLOPE: OE LIMITING ZONE: 0 ft. (sand) Yes ENGINEER DESIGN (3.5) No EXPERIMENTAL DESIGN (3.14) ENGINEER: Cecil R. Crowe, P.E., Alpha Engineering Co. ADDRESS: 617 5th St.-P.O. Box392, Ft. Lupton, CO B0621 ESTIMATED FLOW: 675 G.P.D. PRIMARY TREATMENT: Septic Tank CAPACITY: 1000 gallons DISPOSAL METHOD: Absorption Field SIZE: 645 Square feet REQUEST poi VARIANCE: N I A STAFF COMMENTS: The sandy moils at this site will be replaced by 10 mpi sails to a depth of 4 ft. below the bottom of the proposed field and to 4 ft. on the sides of the field. The system is adequately designed for the proposed load. STAFF RECOMMENDATION: Approval. ENVIRONMENTAL PROTECTION SPECIALIST: Allen Stolle REVIEWED BY BOARD: Aug. 23, 1994 B.Q.H. DECISION: APPROVED: DENIED: Ire. jekow w/#a1+tar) Chaimnan Weld County Board of Health TABLED: I, HSPIO8P INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT NO. a.-9403+6 WELD COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH SERVICES 1517 16TH AVENUE COURT, GREELEY, CO 90631 353-0635 EXT.2225 NEW PERMIT OWNER DENZSON,RICHMOND/JEANETTE ADDRESS 580 S CLINTON APT 128 PH (304) 344-034: DENVER CO 80216 ADDRESS OF PROPOSED SYSTEM APPALOOSA & NELSON BRISHTON CO 80601 LEGAL DESCRIPTION OF SITE: SE4 SEC 24 TWP 1 RNG 66 SUBDIVISION: NELSON LOT 5 BLOCK 1 FILING 0 USE TYPE: RESIDENTIAL MANUFACTURED HOUSE SERVICES: PERSONS 2 BATHROOMS 2.00 LOT SIZE 2.50 ACRES BEDROOMS 3 BASEMENT PLUMBING NO WATER SUPPLY PWELL APPLICATION FEE $265.00 REC'0 BY CINDY SALAZAR DATE 06/16/94 PERCOLATION x 1) / RATE/ MIN PER INCH LIMITING ZONE 0 FEET6a444 SOIL TYPE4456(401 A3rrtllii[r ERCENT GROUND SLOPE DIRECTION ## HEOUIRES ENGINEER DESIGN IN 100 YEAR FLOOD PLAIN ZONE A_Jo FROM THE APPLICATION INFORMATION SUPPLIED AND THE ON -SITE SOIL'PERCOLATION DATA THE FOLLOWING MINIMUM INSTALLATION SPECIFICATIONS ARE REQUIRED: SEPTIC TANK /MI, GALLONS, ABSORPTION TRENCH SO. FT. OR ABSORPTION BED 4;44Y -SO. FT. IN ADDITION, NtgAipERMIT IS $U9 C IN TO THE FOLL WG ADDITIONAL TERMS AND CONDITIONS: ral r irrii-UIY nIQIL SIGNED BY DAVID E. WALTERS DATE 06/16/94 THIS PERMIT IS GRANTED TEMPORARILY TO ALLOW CONSTRUCTION TO COMMENCE. THIS PERMIT MAY BE REVOKED OR SUSPENDED BY THE WELD COUNTY HEALTH DEPARTMENT 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 DEPARTMpg OR ITS EMPLOYEES OF LIABILITY FO THE AILURE OR INADEQUACY OF THE SEW . POSAL SYSTEM. ENVIRONMENTAL SPECIALIST DATE TH�F PERMIT IS NOT TRANSFERABLE AND SHALL BECOME VOID IF SYSTEM CONSTRUCTION HAS NOT COMMENCED WITHIN ONE YEAR OF ITS ISSUANCE. BEFORE ISSUING FINAL APPROVAL OF THIS PERMIT THE WELD COUNTY HEALTH DEPARTMENT RESERVES THE RIGHT TO IMPOSE ADDI- TIONAL TERMS AND CONDITIONS REQUIRED TO MEET OUR REGULATIONS ON A CONTINUING BA- SIS. FINAL PERMIT APPROVAL IS CONTINGENT UPON THE FINAL INSPECTION OF THE COM- PLETED SYSTEM BY THE WELD COUNTY HEALTH DEPARTMENT. ORIGINAL -APPLICANT; COPY-WCHD WCHD-EHS MAY, 1984 WELD COUNTY MALT! DEPARTS I�V • EIROSl1ENTAL PIIOTELTIO11 SERVICES E fVlli■UA' I ONIUZE g i i�,e f r 1 erm APPLICATION NO. t 4t # 6 SITE I i 4.14 ,41, pr_sta Sit TI E DATE: I SUBDIVISION: mmeassEmaissairmonsmenziumismainawmaireasimemaannagaiem Irmammuumissouammiamnumniemscip PUCOLAT1Os TOST DATA: Start Tins: 4, Bole Ito. Bola Depth B=O Renal .in. /C! min. sin. min. min. mini lain■ reia. m�ia. . a- _. - �j p c. Q ' r� 20 . a e 1 ,f Q -- t../ Jo or 1 jar rr Pb .q Z.0 z. 'a 'jfle *co +IO !, a ,34r 33,E '.Ti 0S .-M, J•6 A COP , 7 , 4 Gee' + , io p i *au fie) 3 o , 4r- . - -.•47 r 6 I. All e■sats in .m unless othsrvi Indicated. Ad Total /P P Envirasaatal Specialist Age:- • �. Avsraa# late Z / --ml son Immix ... dli it 0 a4 or C444kmot "e $* dihtgatc hwy. HSPIO6P APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM NO. G-940304 WELD COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH SERVICES 1517 16TH AVENUE COURT, GREELEY, CO 80631 353-0635 EXT_2225 OWNER DENISON,RICHMDND/JEANNETTE ADDRESS 560 S CLINTON DENVER ADDRESS OF PROPOSED SYSTEM APPALOOSA & NELSON BRIGHTON CO 80601 LEGAL DESCRIPTION OF SITE: SE4 SEC 24 TWP 1 SUBDIVISIONS NELSON LOT 5 USE TYPE; RESIDENTIAL MANUFACTURED HOUSE SERVICES; PERSONS 2 BATHROOMS 2.00 LOT SIZE BEDROOMS 3 BASEMENT PLUMBING NO WATER APT 128 CO 80216 NEW APPLICATION PH (304) 344-034; RNG 66 BLOCK 1 FILING 0 2.50 ACRES SUPPLY PWELL APPLICANT ACKNOWLEDGES THAT THE COMPLETENESS OF THIS APPLICATION IS CONDITIONAL UPON FURTHER MANDATORY AND ADDITIONAL TESTS AND REPORTS AS MAY BE REQUIRED BY THE WELD COUNTY HEALTH DEPARTMENT TO BE MADE AND FURNISHED BY THE APPLICANT OR BY THE WELD COUNTY HEALTH DEPARTMENT FOR PURPOSES OF THE EVALUATION OF THE APPLICATION; AND THE ISSUANCE ❑F 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 1973, AS AMENDED. THE APPLICANT CERTIFIES THAT 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 SE SUBMITTED BY THE APPLICANT ARE, ❑R 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 HEALTH DEPARTMENT IN EVALUATING THE SAME FOR PURPOSES OF ISSUING THE PERMIT APPLIED FOR HEREIN. I FURTHER UNDER- STAND THAT ANY FALSIFICATION OR MISREPRESENTATION MAY RESULT IN THE DENIAL OF THE APPLICATION OR REVOCATION OF ANY PERMIT GRANTED BASED UPON SAID APPLICATION AND IN LEGAL ACTION FOR PERJURY AS PROVIDED BY LAW, APPLICATION FEE S265.00 RECD BY CINDY SALAIAR DATE 06/16/94 VID E. WALTERS ER/AGENT SIGNATURE 06/16/94 DATE ORIGINAL -APPLICANT; COPY-WCHD WCHD-EHS MAY, 1984 420 rimpowc II&1►TIM Val. APPALOOSA AVENUE 1814 MET. ROVE 70' 41 - 1.. OR NZ"? AV e.. 14' SEPTIC TANK A'I _ 36' 420 LOT 5 auf. SITE PLAN Ralf) f . fp SEC CROSS SECTION arc V•`-�V SOIL PRQFILE DERMA DATA: MIME E Cr TIY OI MON N 7O ?MOVER A AFnc IIYI TT2 MI A TIM SIOROOM aMIOTN MALT HONE ANIMA= Nh141M 1IOM RATS AO SMARMED MY i00LAT10II T24T TERFORIED AT MN.O CODIITY IfNLTH INDARTR141T N LAN TIWI ■ 1N IYNA FEN MLTI. A CIAY LATIN AFPI1MNNIATELT $ FOOT TWO MUST OE IIBIIDVS AIM TOM mall -IMO SOIL 4 FENT DA EACH WI APO SLOW 7IE RaIOVIN AND 7TN/ AINA IOLIo IATTI$1bIAIMII•tEOES INCH IMICOLATION#ATE 04W. ?OPTIC TAME IMICI:ICATONIA SA} MIIIMIM 19N1 OA4- OArn4TI'Y, MEM T MO Ip DOMPARTIMMIT1 of Mon M A INIlI. AYOIMTION PAY IAN SODOM SOL?MICOLATION NATI I TO 10 TMIWITA IRE 41CM, 211.OUARN MIT PIO ISIDROOIII 13EDMICOM• MO MAIM OAT. um A lo rRT 2 3 l T AN66IMIOM ND. WITEL t MOMS AIIMANMOrMMIINFUTI[T1YUOMIS OMTMISIITMIM SON ANO SEPTIC TAIII. 7. NOVOI A MIINMN OM 11N ON MET 9w' WW1 PPE Orman TTA DIFTMILFIXIM ORM AT TIN 1.A MAX PROMO A 2IMNgi244F NOE II1+81T NT:TVMN TINT. mPTIC THE IRO ANY NNNaMO6. 1, ALL COINTMIOTIOM Ii To *E N ACCOIOANt WTh wiLo COIRTTr. comma IlAL71T IMPARTMENTS MOUITMAi'MAIM DIIPIMAL tYET>r 1. I INY ONRFY THAT TIN ODlTIO iriIJE MORN? ON TM !IAN WA! own NY IIf 4? MODER MY MNTCT IHFIN4INOM AND IN ACCURATE TO TIE MST OF ITT MIIW IOQ on Ems. APPLICATION NO. G-940308 SEPTIC SYSTEM DESrCN FOR 2346 APPALOOSA AVENUE, WELD COUNTY, COLORADO ALPHA ENGINEERING CO. 417 IIH 91AEET - PANIC 1.12, FORT L11PTOn, DOTONA110 04421 FAA A 6E1hNI lm-sTIA R 1-106-7i7-3IN 1-1 LIPTON 1W--210! PATH: C\PATVIIIApY1L\211.2SITAC0 CLINT: DAVE WALTERS IEYISIO II I IW DATE CT36T: NAH SCALE: AS WILD P021S: 2ATE:AUGusr 2. 1224 PQ FLT NO. 24-O4-17 APPALOOSA AVENUE SITE PLAN awt r -r LOT 5 @LK. 9ELI CROSS SECTION i'a- 3' Cr 6'O. fare 4•'-.r 0, O• S' O D' / acn fiR1fA.LEWAL CMSI.II 2' STIIJN0 2/4' TO 2-1/2' CRAWL EI.1`.,THc L OIIn SOIL PROFILE SM I OOPON DATA: P111r0SE OF TILE DOWN IE TO mom A EvIK NYITEIAI tWl A nog! EWRCaN DOE PANDA Haws. AYEEASE PEIICOLA110N RA7I III EIYARINEXI NY PYICOLATNNO THTT EOIPa1NE1N IY MO COUNTY IWALTN CIrAITDNRT ■ UM 'DAN 1 IIIPITCE TEA 11g1, A o'LAr IAYEI APPROXIMATELY 1 TOOT TACT MIT EE imnffvEO ANC T14 OOETIMI goo. 4 EEET 4N ESEAL IWI APO MAW III INID NEMOYED ANC nip ANA mono NTH AO IMAM IEiA DOM IMMOLATION OUTS RM. REMO TAINT SP CW1OA114N.: DAIMON 1000 DAL tJMMY. MTN TNO it CCFWMTIAWWTN OR WITM NE A 1!PN- Apacornow MLA W: airawrioIBDPIACOMTION NATN 1 TO 10 menu PEI MOM. 2T5I ARE rEgr PIM WIDOW X 7 MOODY& - /4I AWARE PINT. MIE A 1I PE !T X EI RET IUOIP0Wa Ia. POT►SI 1. mower A M1wIRIWA or me 111 OM MYREN TIE INDIIIIfU TOP FOX ANa M11C TAPS. Z. PPOvoE A AMAIN OP ALA AEI PYT Cl IIOLIO PPE MIMEO T1# a1ETIEirmq AOODC AERI TIE t,1.11AiS, MANN A PENSION OJP NVE IN PEIT 6ST01pEI 'ow MEMO TAATL AMP AMT MIMONO&. T. ALL COll1 ,IGTIaw E TO #F Pr AODI IC TAGS ri11N YIELD COMRTY. COWIAad IISALTH CllAI1PEP[TI 011LIMTIEA4 MIME COIPWE & NYSIdN CEI1IVICATN1PO mew mow THAT IRS BMW MINN NOM WI Till EI,ASl WAS DOTE ST OF widen SAY aMiC.T WPEI TMON ARO d ACCURATE To TIE !cm 4P 16T RNOI R@EE on MAY. re 12330 �coLOR w.M APPLICATION NO. G64k3c • SEPTIC SYSTEM DESIGN FOR 2346 APPALOOSA AVENUE, WELD COUNTY, COLORADO ALP#14 ENGINEERING CO. 611 STN sTN.ET - P,v.BWL 122, curt IL Earl. CULDRAIO 00821 FAN A CENVTR 573-1166 0A r604-TI7-2SI ---- K IAPTCI 01T-2396 PAYE: CjPA1\s'In}vrvL\I�7Y3ETAW CLEW; DAVE WAL TEAS REYP8:9NS IMr DAIS ODIC 7M; NAB 19C.LLE: A3 NOTED FDUle 1607E AUGUST Y. 1194 FILE $1.0. 24-Tl1-11 Scanning Cover Sheet for Septic Permits Permit # Permit Type: G19940306 Health 1 EHS History! EHS Conversion History Sltus Street Address 2348 APPALOOSA AVE Situ: City, State; Zip • SeclTownlRange: 24 -01N -88W Pai10i # (12 digits) 147124401003-R0263686 Application Status: Fins f ed • Application Date: 0311111996 Owner Full Nam: DENISON RICHMQNDIJEANETTE Owner Address: 580 S CLINTON APT 12B DENVER,CO 80218 Contact Nome: Contact Address: Owner Phone #: 304 3440343 Contact Phone# in a ' ab hs n Ve fa rn Ac ! G e tad el w August 18, 2008 Date Report ID: EKS00024403 Print Data -tine: 8/1812008 1:40:21 PM Page 1 oil Hello