HomeMy WebLinkAbout20210106.tiffCOLORADO
Division of Water Resources
Department of Natural Resources
WELL PERMIT NUMBER 310470 -
RECEIPT NUMBER 3687419
ORIGINAL PERMIT APPLICANT(S)
SURE SHOT PROPERTIES
AUTHORIZED AGENT
SHAYNE OHOTTO
PERMIT TO CONSTRUCT A NEW WELL
APPROVED WELL LOCATION
Water Division: 1
Designated Basin:
Management District:
County:
Parcel Name:
Lot: B
Physical Address:
Water District: 2
N/A
N/A
WELD
RECX17-OOO7
N/A
Block:
Filing:
NW 1/4 SW 1/4 Section 13 Township 2.0 N Range 67.0 W Sixth P1/1.
UTM COORDINATES (Meters, Zone:13. NAD83)
Easting: 513044.0 Northing: 4442996.0
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 shalt 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 37-92-602(3)(b)(I) and policy of the State Engineer under the following conditions, for a 7.58 -acre
parcel known as Lot B Recorded Exemption RECX17-0007. Weld County.
4) The use of ground water from this well is limited to ordinary household purposes inside one (1) single family dwelling, the
watering of eight (8) large non-commercial domestic animals, and the irrigation of not more than 28,200 square feet of home
gardens and lawns.
5) Production is limited to the Laramie -Fox Hills aquifer which is located approximately 230 feet below land surface and extends
to a depth of approximately 530 feet. In accordance with Rule10.4.8 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 annual withdrawal of ground water from this well shall not exceed 1.81 acre-feet.
8) The return flow from the use of this well must be through an individual waste water disposal system of the type so that not less
than 2% of the total amount of water withdrawn is returned to the same stream system in which the well is located.
9) This well shall be constructed not more than 200 feet from the location specified on this permit.
10) Pursuant to Construction Rule 6.2.2.1 (2 CCR 402-2), licensed or private drillers and pump installers must provide advanced
notification (at least 24 hours) to the State Engineer prior to each of the following for this well: well construction, the initial
installation of the pump, and initial installation of a cistern connected to the water well supply system. Any change in the
anticipated date of construction/installation must be re -noticed (at least 24 hours prior to revised anticipated date).
Information regarding the notification process and a link to the electronic notification form can be found on the following
webpage: http://water.state.co.usigroundwater/BDE/Pages/VariancesWaivers.aspx
NOTE: The ability of this well to withdraw its authorized amount of water from this non-renewable aquifer may be less than the
100 years upon which the amount of water in the aquifer is allocated, due to anticipated water level declines.
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.
Printed 10-24-2018
For questions about this permit call 303.866.3581 or go to www.water.state.co.us Page 1 of 7
WELL PERMIT NUMBER 310470- RECEIPT NUMBER 3687419
NOTE: This permit will expire on the expiration date unless the well is constructed by that date. A Well Construction and Yield
Estimate Report (GWS-31) must be submitted to the Division of Water Resources to verify the well has been constructed. An
extension of the expiration date may be available. Contact the DWR for additional information or refer to the extension request
form (GW5-64) available at: http;//www.water.state.co.us
Date Issued: 8/8/2018
1
Issued By DEBRA GONZALES
Expiration Date: 8/8/2020
PERMIT HISTORY
10-24-2018 PERMIT AMENDMENT (LOCATION)
Printed 10-24-2018
For questions about this permit tail 303.866.3581 or go to www.water.state.co.us Page 2 of 2
WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
1555 North 17th Avenue, Greeley, CO 80031 wv,,w.weldhealth.org
Septic Permit New
Application Number:
Owner:
Site Address:
Application Type:
Applicant:
Application Status:
Applied Date:
Intake Technician:
Expiration Date:
Parcel Number:
Legal Description:
Work Description:
SP -1900082
SURE SHOT PROPERTIES
9124 CR 23
FT LUPTON, CO 80621
Health/Residential/New OWTS/Septic
SURE SHOT PROPERTIES
10188 CR 23
FT. LUPTONM, CO 80621
Final Pending
3/19/2019 9:08:48AM
JBEEBE
131113300022-R8948970
PT N2SW4 13-2-67 LOT B REC EXEMPT RECX17-0007
HOUSE
SEPTIC GENERAL INFORMATION:
Application Date 03/19/2019
Number of Bedrooms 5
Number of Persons 2
Parcel Acres 8.15
Private Water Supply Well
Private Water Supply Permit Reference 310470
Ftaollh AdmItatirokun
Villa, Roared♦
Tefe: 9710344-6410
Fax; 970.304.6414
rabb4e lieaNh t
Ctinicd Sitrdiees
Tele; 970-304-6420
FCIC 97-X1.641h
Emrironmaniol Health
Merit ea
Tele_ 976-304-6445
Fox; 970.3046411
Communication,
ldveollon & Pionninq
Tele: 470--3044470
Fpx; 970•.)04.44$2
Emergency Fraparedneee
L Rewpenae
Tefe: 970-304-6470
Fax'. 9 70-14•1•445$
PuhlleHealth
Page 1 of 4
WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
1555 North 17th Avenue, Greeley, CO 80631 www.weldhealth,org
Septic Permit New
EHS PERC TEST (SITE) ;
Profile Pits
Soil Type
Soil Description
Long Term Acceptance Rate
Limiting Zone Qualifier
Limiting Zone Feet
Soil Type Suitable
% Ground Slope
Slope Direction
In 100 Year Flood Plain
2
2A
loam
0.5
Greater Than
8
Yes
1
East
No
SEPTIC SIZING INFORMATION:
From the application information supplied and the on -site soil percolation data the following minimum
installation specifications are required:
Septic Tank Size (GAL):
Bed Absorption Area for Rock & Pipe(Sgft.)
Trench Absorption Area for Rock & Pipe (Sgft.)
Bed Absorption Area for Chambers (Sgft.)
Trench Absorption Area for Chambers Sgft.)
1500
1440
1200
1008
840
Hwllh Adminlslkalian
Vila' Rocords
Tele: 970-304-6410
Fo.: /0.304.-6412
Public kloelll►&
C1knFead teas
Tele: 970-30-6420
Feu 47[-304.6416
Emiannnonial Hoaflh
Sonlaas
Tele: 470-304^6415
Fax: 470.304.6411
Communication,
education L Planning
Tele: 470-304-6474
roc 970.3046452
lnsorQirnay alreparadnisl
t Response
Tele: 970-X4-6470
Face 970-J04-6452
PublicHealth
Page 2 of 4
WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
15,55 Forth 17th Avenue, Greeley, CO 80631 www.weldhealth.org
Septic Permit New
a
Number of
Chambers
Required for a
Bed
Number of
Chambers
Required for a
Trench
Maximum Number
of Chambers Per
Row
Chamber Options;
1) Standard Biodiffuser & Infiltrator H-10
56
47
16
2) Biodiffuser ARC36 Std. or High Capacity
68
56
20
3) ADS ARC36 Std.
68
56
20
4) ADS36 High Capacity
68
56
20
5) ADS ARC36 Low Profile
68
56
20
6) Quick4 Plus Standard or High Capacity
84
70
25
7) Quick4 Plus Standard
84
70
25
8) Quick4 EQ36
126
105
25
9) Quick4 Plus Low Profile
84
70
25
itaellh ,4drninislralien
Yllal R*cwdF
Tee: 970-304-6410
ILLS: 970 301.6417
Public NoaMh t
CLalcal Sorriest
Tele: 970-304-6424
Fue: 9/0-104-64I6
Emrironmanlal Health
Sorvias�
Tele: 970-304-6413
For; 470.304 6441
Communication.
Education t Planning
Tele: 970-304-6470
Fax: 97x,304.4452
EmsrpeacY P+rpaednova
L Response
Tete: 970-X4-6410
For: 970 304 x492
PublicHealth
Page 3 of 4
WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
1555 Forth 17th Avenue, Greeley, CO 8 631 www.weldheolth.orrg
Septic Permit New
CONDITIONS:
Onsite wastewater treatment system must be 10 feet from property line. Install the soil treatment area within 50
feet of the soils test location. Septic tank must be at least 50 feet from any well. Soil treatment area must be at
least 100 feet from any well. Sewer line to septic tank must have at least 1/Binch/ft. fall. Effluent line from septic
tank to distribution box must have at least 1/8inch/ft. fall. Install inspection ports at the ends of each trench or
corners of each bed. All Weld County regulations are applicable.
INSPECTION RESULT:
Status: Approved to Issue
Description Site
Comment:
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 non -transferable and
non-refundable. 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.
Alex Clemments March 22, 2019
Environmental Health Specialist Date
Hfolth AdaelnhhaHen
Veal Records
Tele: 970-30;-6410
Pwc 9./0.304.6412
Public Needles L
Cllinieal Service*
Tele; 970-30.'-6420
Pail; 9/0-X4-4416
Env ronm■nlat Health
Sealea
Tele_ 970-304-64I5
Fox; 970•304.64i 1
60mm►unleollon,
Idvedtlon i Planr•tne
Tele! 97f-304-6474
F0A: 4 Q404.64$2
Imergency Preporodneaa
L Rtafterle•
Tete:47o_?G4-6470
Fars 970.j0s-b;Sx
Public Health
Page 4 of 4
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