HomeMy WebLinkAbout20190480.tifftttex kcr sonct'ntrnn
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Zhis is to t>erti Atha µ c E'er (;-
is a member of Mountain ViewWater Users Association, Ada s"County, a corporation without capital stock,
organized under the laws of the State of Colorado, with its principal place of business at Box 485, Brighton,
Colorado, and is entitled to all of the benefits and subject to all_ ofthe rules and regulations of theAssociation,
including liability for assessments, as provided in its Articles of Incorporation and By -Laws.
The holder hereof is entitled to one vote only in the affairs of t:heAssociation which its members are entitled to
vote, and the holding of additional. Membership Certificates by the holder hereof shall not entitle him to more
than one vote.
In witness whereof, Mountain ViewWaterUsersA isoda( ion, Adams County, has caused this certificate to be
signed by its duly authorized officers and sealed with its corporate seal this
day of. ►° : 19�`.
(Corporate seal)
EXCELSIOR LEGAL. INC. Sc,,, 5683 ARLNGTON. TX 7 60 1 1
Application Number:
Owner Name:
Site Address:
WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
1555 North 17th Avenue, Greeley, CO 80631 www.wefdhealth,org
Septic Permit New
SP -1800099
BEN TOTEMS
2218 15 CR
BRIGHTON, CO 80603
App Type: HealthlResidential\New OWTS\Septic
Parcel Number:
Legal Desc:
1324 ELMER DR
NORTHGLEN, CO 80233
146920300030-R4229806
PT W2SW4 20-1-67 LOT A RE -4282
Work Description: HOUSE
EHS SEPTIC GENERAL:
Application Status:
Final Pending
Applied Date:
03/28/2018
Intake Person:
IVAZQUEZ
Permit Expiration Date:
Number of Bedrooms
Number of Persons
Parcel Acres
Private Water Supply Permit Reference Number
Public Water Supply
Public Water Supply Utility
4
5
4.50
MOUNTAIN VIEW
Yes
Other
licalhh Admin[Amlian
Vi!d Record:
•
PPublia Fletlflhh &
CHnkal Servleo2
1k: 9,D 3i7. 6420
FaX: 97D-304-.5.114
Environmordol Herzll.h Commanicalicm.
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Page 1 of 3
PublicUelv]th
EHS PERC TEST (SITE) :
% Ground Slope
Engineer Design Required
Engineer Evaluation Received
Engineer Job Number
Limiting Zone Feet
Limiting Zone Qualifier
Long Term Acceptance Rate
Percolation Rate Qualifier
Percolation Rate Value
Slope Direction
Soil Description
Soil Type
Soil Type Suitable
Treatment Level
3
Yes
Yes
15-1064
8
Greater Than
0.1
Greater Than
121
Southeast
Sandy Lean Clay
5
Yes
Level 1
SEPTIC SIZING INFORMATION:
From the application information supplied and the on -site soil percolation data the following minimum installation
specifications are required according to the Engineer's evaluation:
Engineer's Specified Installation Recommendations:
Absorption Bed
Engineer Design Absorption Area Specified
Engineer Septic System Design Type Specified
Lift Station Specified
Lift Station Tank Size
Pump Size
Pump Specified
Septic Tank Size
7350
7350
NDDS
Yes
1250
30
Yes
1250
CONDITIONS:
Description: New Permit Conditions
Comment: Approved based on Engineer evaluation. Onsite wastewater treatment system must be 10
feet from property line. An engineer approval letter approving system as installed per
engineer design is required. Engineer designed OWTS must be inspected by the design.
Engineer prior to backfilling. Install the soil treatment area within 50 feet of the soils test
location. Construct onsite wastewater treatment system according to Engineer design.
Sewer line to septic tank must have at least 1/flinch/ft. fall. Effluent line from septic tank to
distribution box must have at least 1/8inch/ft. fall. All Weld County regulations are applicable.
INSPECTION RESULT:
Description: Site Status: Approved to Issue
Comment:
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Page 2 of 3
Public Health
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 Onsite Wastewater Treatment 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.
Jon Peak
Environmental Health Specialist
!tepihh Qcfmjni7lrolion
Yilp Reccrdc CtinceIServicer,
April 02, 2018
Date
Public Health S Ervr•¢rmen!a1 Health CommvniCvtion,
Seevcoe Educcli'n E- I"U nnln{
1,
E rt1 ergprnty Propnrpdnov,
Rnsponsv
Page 3 of 3
PublieHiaeelkls
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