HomeMy WebLinkAbout20211388.tiffj Form - !
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STATE
OFFICE
618 Centennial
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OF
OF
8664581
COLORADO
THE STATE
Bldg..
Fax t
ENGINEER
1313 Sherman
3) 866-
3
St. Denver, CO 60203
For Office Uie Only
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(`A 131
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REGISTRATION
OF EXISTING
WELL
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en
Warrbeoditiand the well owner. 1
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Mailing e - :
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!mead
►,. st zip 1 eQ
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Phone l 7:15t• c2VC/4
nuassmat can/ Tb - - threes We, Designa5an 1' SOP ' , ileset
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...t...: c+v f ) 170)—V4
of a 1)4, Sec. 6 , Twp. 7 is a or
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S., Range SCOn . of El w., P.M.
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e ct FL From
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IL or t_!
$,. ft Fronta., E. or
DW.Lke.
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Sutickvisiori Name
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Left , Block 1 FT
The welt has Isbacaty been used b fibs k� ss(s):_1142j ate],
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Water &urn to well was first used benefiday by It original owner for Le ads described poses on Mae.:
T) of this wel is O feet
The pumping rate of is rrel bs _lac_________ gaffs per minute.
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The annual not of water averted isr ace et
The lard irrigated water iron this well is Ace or O Square feet. described as:
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{ frieL- • EiaiEJAmi/yhieiJI&*wcr
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- - - - - -- Logs) Ffing/Unit
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i ) chin and fay that I (n) are the ow wens) d Ili 'ti did abet& knot tie contents &f Ins statements made therein, and state tat >hery are frue
blnYiall fhosed91-
!ems print the Signs Name 3 Tile _
S tLr (s) of the owner.
Date
('b of
NI,.1/4,3:1:141.
stkiat
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taatss. 4 r'`,'ti - LIPASACi ita,
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1 Acc2ovet
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twin�-- JAN 2 2 2001
TOPO WAIMassitei
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WELD COUNTY HEALTH
Lii doc:21_, yrt.,- riotzisth stmetp...td ititvei,a,
i -gra
. d Application for Pe'it
Sean, Colorado'
ponsor
to install, Construct. Alte‘baaars.;:i ) A r tam v1/4:4 !hill a A241i1
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or Repair Individual Sewage Disposal System.
Ati
Address of Site
Mailing Address
Gen
1. Living Units
2. of of
. No. of Baths
. Basement Drain
5. Automatic Dishwasher
6. Garbage Disposal sca
7. Atitioniatic Lam`
8. Size of Lot e
TYPe of S _ea,
10, Percolation Test
ii. Water Supply
12. Lot Grade
No.
Lanni
Septic Tank
1. Liquid Catty / Aos
2. Dinwnsions
3. Material
4. Type Inlet
Type Outlet
Gallons
T
\it*
4
old
U
yonder/ Treatment
•
Bed
S
K
1. No. of distribution lives Pt fassaa-
Filler Material ;
` _ - . Water Table Depth
SIMMINMESIMMIsiidialalbid
e:°: 1 44; Other
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•
a
S72
10 750
/57%-ilifi.eamo•ii...c..
4. Depth of Mate Vie;
* Gravel Size
6. Type Tile
A
7. Depth of Cover Nntotinvis
_.
& Other
•
The Permit is to remaiforee and effect for six (6) manths from date, until revoked for non-compliance.
This system will be constructed in accordance with the above specifications and regulations governing nonce
muthcipai sewage disposal systems, in accordance with Regulation Not 1 of the Wald County iliaith.Den
partment
Date:
IIP
r,
a
Applicant:
The plans and specifications as shown are approved, pending paym
S tar' an
Date: if
The above system ins
Installed by
PERMIT FEE
deceived b
'lease use reverse side for Plot Plan or use separate sheet of paper.
y
't d to comply with the plan and description.
Swami
Date
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01.7
to, M
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aReeLsY „. swauNt
+ems
Maxwell Nader
From: Lauren Light
Sent Thursday, December 17, 2020 8:08 AM
To: Maxwell Nader
Subject: RE: USR (PRE2O-0087) Drainage report
Follow Up Flag: Follow up
Flag Status: Flagged
Can this email be attached to accela and we just add a COA that the SDWR ok's the permit? thanks
Lauren Light, M.B.S.
Program Manager/Environmental Planner, Environmental Health Services
Weld County Department of Public Health & Environment
1555 N. 17th Ave.
Greeley, CO 80631
I l icj htweldgov. com
970-400-2211 (office)
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Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for
the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise
protected from disclosure. If you have received this communication in error, please immediately notify sender by return
e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the
contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited.
From: Maxwell Nader <rnnader@weldgov.com>
Sent: Tuesday, December 15, 2020 1:06 PM
To: Lauren Light <llight@weldgov.com>
Subject: FW: USR (PRE20-0087) Drainage report
FYI. PRE20-0087 talked to Ilene at CDWR. I am going to say this is good to go to a USR. Just wanted to let you know
about the individual they spoke to.
Best,
Maxwell Nader
Planner I
1555 N 17th Ave
Greeley, CO 80631
mnader@weldgov.com
Phone: (970)-400-3527
1
From: todd americanbuildingsystems.net <todd@abs.Ilc>
Sent: Tuesday, December 15, 202010:14 AM
To: Maxwell Nader cmn ader@weldgov.co m>
Subject: RE: USR (PRE2Q-0087) Drainage report
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.
Ilene at the Division of Water Resources — Ground Water Division
From: Maxwell Nader <mnader@weldgov.com>
Sent: Friday, December 11, 2020 1:27 PM
To: todd arnericanbuildingsystems.net <todd@abs.11c>
Subject: RE: USR (PRE2O-0087) Drainage report
Thanks Todd. Just one question who at the state did you speak to?
Best,
Maxwell Nader
Planner I
1555 N 17th Ave
Greeley, CO 80631
mnader@weldgov.com
Phone: (970)-400-3527
From: todd americanbuildingsystems.net ctoddabs.11c>
Sent: Friday, December 11, 2020 10:36 AM
To: Maxwell Nader <mnader@weldgov.com>
m>
Subject: RE: USR (PRE20-0087) Drainage report
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.
Files attached, thanks.
From: Maxwell Nader <mnader@weldgov.com>
Sent: Thursday, December 10, 2020 2:02 PM
2
To: todd americanbuildingsystems.net ctodd@abs.11e>
Subject: RE: USR (PRE2O-0087) Drainage report
Todd,
Thank you. I will make sure Public Works receives this. Have you answered the other questions on the PRE2U-0087
Completeness Review Memo?
Best,
Maxwell Nader
Planner I
1555 N 17th Ave
Greeley, CO 80631
mnaderweldgov.corn
Phone: (970)-400-3527
From: todd americanbuildingsystems.net ctodd @abs.Ilc>
Sent: Thursday, December 10, 2020 10:26 AM
To: Maxwell Nader <mnader@weldgov.com>
Subject: USR (PRE2O-0087) Drainage report
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.
ABS
Todd Curlee
American Building Systems, LLC
970.520.1437
3
Hello