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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7) The average annual amount of groundwater to be withdrawn shall not exceed 0.675 acre-feet and the total volume of
groundwater to be withdrawn shall not exceed 67.5 acre-feet.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:
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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.
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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
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