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Home My WebLink About20194650.tiffScanning Cover Sheet for Septic Permits Permit # Permit Type: G19920184 Health / EHS History! EHS Conversion History Situs Street Address 21269 CR 47 Situs City, State, Zip Sec/Town/Range: 14 -04N -65W Parcel # (12 digits) Owner Full Name: Owner Address: Contact Name: Contact Address: 105514400023-O0011427 Application Status: Finaled Application Date: 03/11/1996 AGRICULTURAL PRODUCTS INC 19009 HWY 392 LUCERNE,CO 80646 Owner Phone #: 303 3566788 Contact Phone# Information above has been Verified in Accela by employee noted below X Processed by: October 15, 2008 Date Report ID: EHS00024v003 Page 1 of 1 Print Date -Time: 10/15/2008 3:01:41 PM HSF'j.06P' INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT NO„ G-920184 WEI...D COUNTY HEALTH DEPARTMENT T MEN'T .ENVIRONMENTAL HEALTH SERVICES 1517 :I.ErT'i'•I AVENUE COURT,t:;l4k:l::LE::Y CO 80631 353-0635 EXT 22/'ti,.- REPAIR PERMIT AMER AGRICULTURAL PRODUCTS INCADDRESS 1.9009 H-HWY 392 PH (303) 356-678E LUCERNE CO 80646 '1UDRI :ss OF PROPOSED SYSTEM 2:L269 WCR 47 LASA1...L 1: CO 80645. ...E:::L:IAI... DESCRIPTION :ti TION OF S31:T'i•: ^ I:::2 Sal:::'4 S:;L:(:I :L4 'T'WP fT 1 I.1G 65 :3l. BDIV7:si:C)NN L..OT 0 BLOCK 0 FILING 0 ..JSE TYPE N RE:::S3IIDE:NTIAL.. SINGLE FAMILY DWE1...I...INl S., PERSONS 3 BATHROOMS :1...00 L..OT SIZE 1r.;..00 ACRES E::S :aE:.FtiV:I;(::1:::,•� F'E::Fi,.>CIN..a BEDROOMS 3 BASEMENT N T PLUMBING N YES WATER SUPPLY CWCWD 1E::'PL. 3: CAT 3.. ON FEE $115.00 . :ZEC ' I) BY 3OANNA GAL.L.E::(3o DATE 07/20/92 SIGNED D BY SCOTT t: OE::1:::E i iG DATE 07/20/92 :i::.Rt.r(.IL AT .I.t.)i4l RATE .y5k0 MIN PER INCH L.IEYI:J:1:l:Nl(:) ZONE til FEET ::3CI:1:I... TYPE SUITABLE PERCENT GROUND SLOPE 0% DIRECTION :{E::(:3U3:I:il':S;3 ENGINEER DESIGN Ni(J F4t:)ETI THE APPLICATION INFORMATION SUPPLIED AND THE ON -SITE SOIL.. PERCOLATION DATA T1••lE FOLLOWING MINIMUM INSTALLATION SPECIFICATIONS ARE R1:::Ol.JIRED SEPTIC TANH< :1.000 GALLONS, ,, ABSORPTION TRENCH 675 S: Q . FT. . �� OR ABSORPTION BED 909 SQ.. F T . ≤ 9flan �JC :1:N ADDITION„ Till. S3 F= :�E:�E*I • r IS SUF 'TEC'T T.0 THE VOLLO 3:NO 'DD:'T3:ONA1... it'S A'iD THIS PERMIT IS GRANTED TEMPORARILY TO ALLOW CONSTRUCTION TO COMMENCE. THIS I'.l::i:iI:I:'T MAY B1::: REVOKED Uk SUSPENDED NDI I) BY THE WELD I) COUNT'( HEALTH DEPARTMENT TMY1ENT FOR REASONS AS3ONS:3 ;:31:::'T' FORTH :I:141 THE WELD COUNTY :i:NDIV:i:DUAL.. SEWAGE DISPOSAL SYSTEM REGULATIONS INCLUDING FAILURE TO MEET ANY TERM OR CONDITION .IMPOSED THEREON DURING TEMPORARY OR F:1:HAl... '1F'RUVAL., THE ISSUANCE OF THIS PERMIT DOES NOT CONSTITUTE TUTS ASSUMPTION BY -l"{..ii- DEP'AR'TMENT OR ITS EMPLOYEES OF LIABILITY FOR THE:: FAILURE OR INADEQUACY OF. THE $E:WAOE DISPOSAL.. SYSTEM. PAM SMITH ()8/26/92 L} e/9 % ENVIRONMENTAL SI::'ECIAI..:i:ST DATE THIS PERMIT IS NOT TRANSFERABLE AND SHALL BECOME VOID IF SYS'T'EM CONSTRUCTION HAS MOT COMMENCED WITHIN ONE YEAR OF ITS ISSUANCE. BEFORE ISSUING F='i:141AL... APPROVAL.. OF THIS PERMIT THE WELD COUNTY HEALTH I••I DEPARTMENT N'T RESERVES S THE RIGHT TO IMPOSE ADD3:••- t:rCINAI... TERMS AND CONDITIONS RE:::(:TUIREI) TO MEET OUR REGULATIONS ON A c;CINT3:NU I:Nc BA- 3IFINAL .PERi I:T AlP OVAL IS CONTINGENT UPON THE : FINAL :I:NSI:'E :CT-:I:UN OF THE COM- PLETED SYSTEM BY THE WELD COUNTY HEALTH DEPARTMENT. SYSTEM M INSTALLER SYSTEM ENGINEER R TYPE OF SYSTEM INSTALLED rtf_Selt. FINAL IllS3Pl:` APPROVAL. (:::NV:1:RMuiE:ICI T` 1... IALIST 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 Y THAT THE SUBJECT SYSTEM WILL OPERATE IN COMPLIANCE WITH APF'l.:I:CAB1...E STATE., COUNTY AND LOCAL... REGULATIONS ADOP'T'ED 1::Fi:::SUA141.T.. .TO ARTICLE 10., TITLE 25., CRS 1973,, AS AMENDED., EXCEPT FOR THE PURPOSE OF ESTABLISHING FINAL. A'1F:`F'F:OVAL... OF AN INSTALLED SYSTEM FOR ISSUANCE OF A LOCAL OCCUPANCY PERMIT PURSUANT TO CRS 1973 25-10-111 (2). 1d / lZ ke ( 1-1\ t C5 1 t 2K -f ne LkcA hc, se_ 4.zn 1ireS i pt tee( d_o 2-I ,ti HSP.I O6P INDIV:I:DUAL... SEWAGE DISPOSAL SYSTEM PERMIT iirr NO. G-920184 WELD COUNTY HEALTH DEPARTMENT ENVIRONMENTAL HEALTH SERVICES 1517 16TH AVENUE COURT, yGREEL EY q CO 80631. 353-0635E»J".'1 .. 2225 REPAIR PERMIT 7WIN1: R AGRICULTURAL_ PRODUCTS INC ADDRESS 1.9009 HWY 392 PIN (303) 356--678 LUCERNE CO 80646 1DDRE::: S OF PROPOSED SYSTEM 21.x'69 WCR 47 LASAL..L..E:: CO 8064.5 ._EGAL.. DESCRIPTION OFSITE: E2 5E4 SEC 14 TWP 4 RNG 65 3(.JBI)IVISION:: LOT 0 BLOCK 0 FILING 0 ISE TYPE: RESIDENTIAL SINGLE FAMILY DWELLING 1 RVI:C:ES:: PERSONS 3 BATHROOMS 1.00 LOT SIZE .14..00 ACRES BEDROOMS 3 BASEMENT PLUMBING YES WATER SUPPLY CWCWD PPLICAT:EoN FEE $115 .00 it:C ' D BY JOANNA GAL LEC OS DATE: 07/20/92 SIGNED BY SCOTT GOERING NG DATE 07/20/92 'E:RCOL.AT I -UN RATE:. MIN PER INCH LIMil .LHG ZONE �5f FEET 30:11.. TYPE : S 4-e PERCENT GROUND SLOPE -77); DIE ECliION ___ .E::Qt.JIE ES ENGINEER DESIGN ......•i 'ROM THE APPLICATION :EINF'C)RMA'r ON SUPPLIED D AND THE ON -SITE SOIL.. PERCOLATION DATA FEE:: F•OI...L.OWIIN(s MINIMUM INSTALLATION SPECIFICATIONS ARE RE(:l.J'1 "'ED:. sl:::PI I:Cr TANK MIL_ GALLONS, ABSORPT'6RN TRENCH S1:. FT. ABSORPTION ICED q(n_ SO.. FT. riN ADDITION, TI••1:t:f3 PERMITis st.JBjEC:-T' TO THE FOLLOWING ADDITI:ONAL. TERMS AND C)NDIT I:c i s: rHIs PERMIT IS GRANTE:D TEMPORARILY TO ALI...OW CONSTRUCTION TO COMMENCE::. THIS PERMIT 'IAY BE REVOKED OR SUSPENDED BY THE WELD COUNTY HEALTH DEPARTMENT FOR REASONS SET OrTU IN THE: WELD COUNTY INDIVIDUAL... SEWAGE DISPOSAL... SYSTEM REGULATIONS INCLUDING 7 AII...uI :.: TO MEET ANY TERM OR CONDITION IMPOSED THEREON DURING' TEMPORARY OR FINAL 4F'PROVAI... „ 'T'HE: ISSUANCE OF THIS PERMIT DOES HOT CONSTITUTE ASSUMPTION BY THE )I: PAF THE NT OR ITS EMPLOYEES OF LIABILITY FOR THE FAILURE OR INADEQUACY OF T'1'•i1::. 3EWA(3E DISPOSAL SYSTEM PQn._......_.._....__.._............._._.._...._._....... �i......... & .. � - a-� `�� ENVIRONMENTAL SPECIALIST DA'T': PlaAi -HIS PERMIT IS NOT TRANSFERABLE AND SHALL.. BECOME VOID IF SYSTEM CONSTRUCTION HAS I0T COMMENCED WITHIN ONE YEAR OF ITS ISSUANCE.. BEFORE ISSUING FINAL-. APPROVAL OF -NIS PERMIT THE WELD COUNTY HEALTH DEPARTMENT RESERVES THE RIGHT TO IMPOSE ADDI-- '-IONAI... TERMS AND CONDITIONS REQUIRED TO MEET OUR REGULATIONS OH A CONTINUING BA- s: I5 FINAL PERMIT Al ROVAL... IS CONTINGENT I.IF'UN THE IEE FINAL INSPECTION OF THE COM - ='I.-.ETE:I) SYSTEM BY THE WELD COUNTY HEALTH DEPARTMENT. APPLICATION 7:01+.1 FOR :ri•IJ?i:v1::(?UA[._ SEWAGE DISPOSAL SYSTEM NO. G-92018. lfdl:::l.-.I) COUNTY HEALTH DEPARTMENT TME:1+1..C REPAIR A1::1.:L.ic::t 't':1:(:!I ENVIRONMENTAL HEALTH TH SERVICES.L .!.1.7 :16TH r•eVEHE.JE- _ COUR'T , c REELEY ;, CO 80631 353-0635 ( )WNER AGRICULTURAL PRODUCTS INC ADDRESS 19009 HW ' 392 PH ( a03) 356-67a LUCERNE i : Co 80646 )DnR1::s6 OF PROPOSED SYSTEM 2:I.269 WCR 47 I.»F'YCsr-I...L.1':: CO 80645 _EGAL DESCRIPTION 7:PT':i:(:ON OF SITE:'. F,. +`''. L'4 SEC :[.4 '1•'wr' 4 1 N(:i 6 3LUBT::i:vi;:s:ON:: LOT0 BLOCK 0 FILING 0 jc:sl::: TYPE ;: RE::::,:I:1)I:::NTIAI... SINGLE FAMILY DWELLING E:::t v:1:(:rE:: S; PERSONS 3s BATHROOMS :L ..00 LOT SIZE 1.'3..00 ACRES 6I :Dl OC)M8 3 k BASEMENT PLUMBING YES WATER I: IR SUPPLY cWCW E:: E::'L..:I (::l I'l I ACKNOWLEDGES THAT I 'T'L•E?::. COMPLETENESS OF THIS APPLICATION IS CONDITIONAL Pt 14 FURTHER THEE R MANDATORY AND ADDITIONAL TESTS AND REPORTS I I I' AS MAY BE::: REQUIRED BY THE J1`i._1) COUNTY HEALTH rl1 DEPARTMENT TO BE MADE I)E::: AND FURNISHED BY THE APPLICANT OR BY THE JE:::E...I) COUNTY HEALTH DEPARTMENT FOR PURPOSES OF THE l EVALUATION r:T:i: N ()Ti"' THE APPLICATION ti -TD ..(.E..EI::: ISSUANCE OF T1' -IF PERMIT E"l:I I IS SUBJECT (::.T. TO ;:sLt(':I1 TERMS AND CONDITIONS AS DEEMED IE CE' '::3`::i3 RY rc INSURE COMPLIANCE W:I:'rF1 RULES S ND REGULATIONS :(:,IJL..A'E'T'IC)FISS ADOPTED TED l.iFI1)E1 ARTICLE :.0 TITLE 25, CRS 1.97'3., AS AMENDED. THE APPLICANT CERTIFIES THAT THE I::RoI::OSE:D sl'S:iT'l:::ill WILL NOT BE..: LOCATED WITHIN I '100 FEET OF A COMMUNITY SEWAGE SYSTEM. .. THE W -I AJZS:I:ONE:I) HEREBY CERTIFIES THAT AI...L, STATEMENTS I'ADIE., INFORMATION A1NI) REPORTS ;I-.JI:ciI:(:1"'TI: I) HEREWITH AND REQUIRED T€:l BE:: SUBMITTED re' THE APPLICANT 1N'T' ARE, OR WILL BE, 4E:PRE:S:SE:::N'TE :I) TO BE..: TRUE::: AND CORRECT TO THE I:tE::S~I'I OF IlY KNOWLEDGE AND BELIEF, Al ft. d;41::: DESIGNED TO BE RELIED ON BY THE WELD COUNTY T r HEALTH DEPARTMENT I ME:;:l l T IN EVALUATING :HE SAME::: FOR PURPOSES OF ISSUING THE PERMIT APPLIED FOR HEREIN. :I: FURTHER 11:::I UN••II)I - 'T' -sND THAT ANY ' FALSIFICATION OR MISREPRESENTATION MAY RESULT IN THE DEN:1.Al... 01: THE 'APPLICATION OR REV(:)c(FT:E:ON OF ANY PERMIT GRANTED BASED UPON SAID APPLICATION :LO1+'I AND :FI LEGAL ACTION FOR PIEI:; jL.n: 1' AS PROVIDED I) BY LAW. >3F'F"'I....l. (:.lt T .1. (.)ICE FEE : $115.00 `-'(.:(.)'T'T G€.iF.l. E^i(:.i E:::(:; ' I) BY .;T€:)A1•••EI'•IAF (;( L...1...E:::(-ll) s DATE 07/20/92 -UWNER.fAFOENT SIGNATURE 07/20/92 DATE e .r'.s rr•s.s. , .1C‘E.Jt^ 1.01, -1 (:SY'.)i WATER SUPPLY INFORMATION SUMMARY Section 5010,133M, C.R.S. requires that the applicant submit to the Caunty,'Ad:equate evidence that a water supply that is sufficient in terms of quantity, quality and dependability will he available to ensure an adequate supply of water, 1. NAME OF DEVELOPMENT AS PROPOSED 2. LAND USE ACTION 3. NAME OF EXISTING PARCEL AS RECORDED SUBDIVISION FILING BLOCK LOT A 4. TOTAL ACREAGE . J 6. NUMBER OF LOTS PROPOSED ) PLAT MAP ENCLOSED O YES 6. PARCEL HISTORY Please attach copies of deeds, plats or other evidence or documentation. A. Was parcel recorded with county prior to June 1, 1972? YES 0 NO B. Has the parcel ever been part of a division of land action since Juno 1, 1972? 0 YES Mc NO 3f yes, das:rrbre the aredous action 7. LOCATION OF PARCEL • Include a map deliniatinp the project area and tie to a section corner. 114 01 114 SECTION 1 L/ TOWNSfIIP ()` 0 N` NOS RANGE 6,`7 OE t clt PRINCIPAL MERIDIAN: O 6TH 0 1a,M. O UTE 0 COSTILLA B. PLAT • Location of all wells on property must he plotted and permit nursers provided, !V (' ;-''2 �'( E Surveyors plat 0 Yes O No 13 not, ualsr$ hand drawn sksit O Yes D No 9. ESTIMATED WATER REQUIREMENTS HOUSEHOLD USE # of units - Gallons per pay ar Acrs Farr per yaw 1 GPO _ AF c ,f. GPO C—. AF 10. WATER SUPPLY SOURCE 0 EXISTING 0 DEVELOPED WELLS SPRING WELL PERMIT NUMBERS 0 NEW WELLS - rant n Auras - (Mfrs r_ o sir c OPER WANE ":2 MIMI 0 lows MAINE 0tc uawvron 0 utanaur FR Bala 0eta �, COMMERCIAL USE # C- of S.F. IRRIGATION # -' of acres' --' GPO (/' AF WATER COURT DECREE CASE NO.'S 0 MUNICIPAL O �` STOCK WATERING # of head l r GPO (2) AF , OTHER GPO Af © ASSOCIATION O COMPANY O GISTRICT NAME TOTAL . GPO AF LETTER OF COMMITMENT FOR SERVICE 0 YES 0 NO f LI. ENGINEER'S WATER SUPPLY REPORT 0 YES 0'NC IF YES, PLEASE FORWARD WITH THIS FORM. (This may tra rrga sd re€va eve savaew is srmpiriodi 12. TYPE OF SEWAGE DISPOSAL SYSTEM SEPTIC TANIREACH FIELD 0 LAGOON O ENGINEERED SYSTEM [Alma a cagy 0 CENTRAL SYSTEM O VAULT - LOCATION at .eeinesrinp e.s 0 OTHER • DISTRICT NAME SEWAGE HAULED TO CENTRAL WELD COUNTY WATER DISTRICT June 17, 2019 Alyson Buum 21269 County Road 47 LaSalle, CO 80645 RE: Additional Water Service Dear Mrs. Buum, This letter is in response to a request for water service to serve the following property described as follows: PT SE4 14-4-65 LOT A REC EXEMPT RE -4628 Parcel: 105514400006 Water service is presently available to the above described property through tap number 249 located on Weld County Road 47 between 44 & 46. Central Weld County Water District is aware that this tap will service a business at the above tap 249. Additional water service can be made available to this property, provided all requirements of Central Weld County Water District, Northern Colorado Water Conservancy District and the Bureau are satisfied. Please note that it is your responsibility to contact Northern Colorado Water Conservancy District at 800-369-:'24x5 jor petitioning confirmation into the Northern Colorado Water Conservancy District. Central Weld cannot issue a tap until all requirements are satisfied This is in accordance with the Rules and Regulations of Northern t olorado_ Water Conservancy District. A water tap installation is for a specific parcel of property and a customer will not be permitted to extend a service line from one parcel or property to another parcel to provide additional water service. An additional dwelling unit charge will be added to each monthly billing for the addition of a second residence for a family member. Monthly charges may be subject to a surcharge rate if the annual allocation is exceeded. An additional water tap will not be required unless the parcel will be split to create an additional parcel. Central Weld County Water District requires that contracts be consummated within one (1) year from the date of this letter or this letter shall become null and void unless extended in writing by the District. The District will not notify, by separate letter, any prospective landowners of cost increases. The District has the right to review the annual allotment and compare it to actual usage to determine if additional raw water will be purchased and transferred to the District by Tap Holder. It is your responsibility to confirm with your local Fire Protection Authority if fire flow water capacity is required for your project. If you have any questions regarding the above, please contact this office. Sincerely, CENTRAL WELD COUNTY W TER DISTRICT Stank l'ink6f; District Manager SL/bg 2235 2nd Avenue • Greeley, Colorado 80631 • Phone (970) 352-1284 • Fax (970) 353-5865 Stan Linker, District Manager Hello