HomeMy WebLinkAbout20194992.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) 866-3581
RAY GROVES
419 5TH ST
EATON CO 80615-
(970) 454-2032
PERMIT TO CONSTRUCT A WELL
21
WELL PERMIT NUMBER al 41 I
DIV. 1 CNTY, 62 WD 1 DES. BASIN MD
Lot: Block; Filing: Subdiv:
APPROVED WELL LOCATION
WELD COUNTY
SW 1/4 SE 1/4 Section 34
Twp 7 N RANGE 65 W 6th P.M.
DISTANCES FROM SECTION LINES
122 Ft. from South Section Line
2096 Ft. from East Section Line
ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT
CONDf1lONS 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 Weil 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)(c) for the relocation of an existing well, permit no qL _. The
old well must be plugged and sealed according to the Water Well Construction Rules within ninety (90) days of
completion of the new well. The enclosed Well Abandonment Report form must be completed and submitted to
affirm that the old well was properly plugged and sealed.
4) The use of ground water from this well is limited to ordinary household purposes inside three (3) single family
dwellings, the watering of domestic animals, and the irrigation of not more than 1 acre (21,780 square feet) of
home gardens and lawns.
5) The maximum pumping rate shall not exceed 15 GPM.
6) This well shall be constructed not more than 200 feet from the location specified on this permit.
APPROVED
JSG
av
DATE ISSUED MAR 2 6 199 EXPIRATION DATE 2 5 Z of
Receipt No. 04427858
WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
1555 NORTH 17TH AVENUE
GREELEY, CO 80631
PHONE (970) 304-6415 FAX (970) 304-6411
Permit #:
Owner:
Applicant:
Permit Type:
Parcel #:
Location:
Legal Description: 14612 SE4 34 7 65 (4 R2D15L) %21543 WCR 7
4% 21543 74 CR WELD
Installer: NI On L.;
SP -0600325
GROVES FARM LLC
GROVES FARM LLC-DALE TROWBRIDGE MNGR
RREP C=Commercial, R=Residential + NEW, REPair, VauLT
0709-34-0-00-012
21543 CR 74 EATON
Sec/Twn/Rng: 34 07 65
Description: HOUSE
Commercial: N
Residential: Y
# of Persons: 4 Basement Plumbing: N
# of Bedrooms: 3 Bathrooms - Full: 2 3/4: 0 1/2: 0
Water Public: N Water Source:
Water Private: Y Cistern: N Well: Y
Well Permit #:
Status: ISSUED
Applied: 09/26/2006
Issued: 09/27/200p
Finaled:
Acres: 175
Percolation Rate: 16.2 Limiting Zone: 8 ft 0 in Description:
% Ground Slope: 0 Dir: Soil Suitable: (Y/N) Y
Engineer Design Required: (Y/N) N In 100 Year Flood Plain: (Y/N) N
Minimum Installation
Septic Tank: 1000 gallons
Absorption Trench: 776 square feet
or Absorption Bed: 1032 square feet
Actual Installation
Septic Tank: gallons Absorption Trench: 9q square feet
Absorption Bed: square feet
Design Type: ,A
Chamber Model
Chambers*
NOTICE
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 persuant to
Article 10, Title 25, CRS as amended, except for the purpose of establishing final approval of installed system for issuance of a local
occupancy permit persuant to CRS 1973 25-10-111 (2).
This permit is non transferable and non refundable. 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 was
contingent upon the final inspection of the completed system by the Weld County Department of Public Health and Environment.
Erivironrneltal Health Specialist Date
Form: S_FINAL
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