HomeMy WebLinkAbout20190944.tiffA.1Hot
_ USE BY SPECIAL REVIEW (USR APPLICATION
_
DEPARTMENT OF PLANNING SERVICES * 1555 N. "17TH AVENUE * GR.EELEY, CO 80631
www.vveldqov.com * 970400-6100 * FAX 970-3044498
FOR PLANNING DEPARTMENT USE:
AMOUNT $ 1210
APPLICATION RECEIVED BY ii_a_eParcel Number: --0.-- __ U
Address of site:
Legal Descri do n : Section:
Zone District: Art7 Acreage: s Flcodplain: O'1
FEE OWNER(S) OF THE. PROPERTY:
Name: '14 -i
tilappetk
Company:
Phone #: "tat Ca alet
" Email:
Street Address: esel17.2:91_,
City/State/Zip Code: vrt 1°.
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Name:
Company:
Phone #: _ Email:
Street Address: -
City/State/Zip Code:
Name: _
Company:
Phone ##:
Street Address:
City/State/Zip Code:
APPLICANT OR AUTHOR! 0_ AGENT: (Sae below: Authorization must accompany ell applications signed by Authorized Agents)
d 5011
DATE RECEIVED:
ED: I1 1 1 S =
CASE # ASSIGNED: U 18 -0'L
PLANNER. ASSIGNED: tiol A1/4)
{*A 12 digit number on Tax ID.
information. obtainable at
www .weld flov.com).
N Range:491 W
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Township
ealagical Hazard: Yd+lzi Airport Overlay: Yolip
Email:
Name:
Company.
}Phone #:
Email:
Street Address: OA, ilAitifoomor
City/State/Zip Code: 0
PROPOSED USE:.
I hereby depose and state under penalties of perjury that all statements, proposals, and/or plans submitted with or
(We)Signatures of all fee owners of property
contained within the application are true and correct to the best of my (our)knowledge.
must sign this t ication-if- n-Autho riz ent- signs( ashttsro.ut awr zatIor _:ali_fee_owners_must. be includ1 ith t_h
e
application, �
If a corporation fee owner, notarized evidence must f e included indicating that the signatory has to legal
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to sib forte c
11 17
Print Name
gent Date
Rev 4/2016
USE BY SPECIAL REVIEW (USR) QUESTIONAIRE
Planning Questions:
1. Proposed use of property is to retain current structure as caretaker f multi -generation family
use, while tearing down the existing (uninhabitable) home on the land.,. and rebuilding a similar
size home for primary residence. We intend to maintain our current agricultural status and
remain unincorporated Weld County.
2. This proposal is consistent with the intent of Weld County Code, Chapter 22 of the
Comprehensive plan:
a. 22-2-10 R. This USR does not take away any aspect of the agricultural use of this
property. It does not lessen the amount of growing land and does not increase the
footprint of residential living space onto any agricultural ground. 22-2-10B also
provides, "at the same time, to protect the rights of private property owners to convert
their agricultural lands to other appropriate land uses." Again, this is not a request to
"convert" agricultural land for this use.
The house that is uninhabitable will be torn down, and a new home constructed in its
place. This request does not change or convert agricultural land for this use.
b. 22-2-10 E. States, "to provide uncomplicated, unburdensome.... Provides opportunities
for land divisions that are exempt from subdivision regulations and allows land use by
small agricultural operations and home businesses.! The current living quarters in the
40' x 60' shop will act as a caretaker quarter / multigeneration family use only.
c. 22-2-10 F. "muses which provide rural lifestyles.., and opportunities to both live and
work in rural areas." After constructing the new home where the existing home is, the
shop living quarters will provide a nice place for the land caretaker or multigeneration
family use for someone that doesn't need a lot of space to call home. While living in a
nice peaceful rural area.
d. 22-2-20. C. A. Goal 7. "County land use regulations should protect the individual
property owner's right to request a land use change"
l.A.Policy 7.1 "...when the impact to surrounding properties is minimal.., and where
adequate services are currently available or reasonably attainable." AND
22-2-20. HA. Goal 8. 1A. Policy 8.1. The land use....sanitary sewage and water systems
are available for the intensity of the development.'
With this USR Request, there will be no new impact to surrounding properties.
3. This proposal is consistent with Weld County Code Chapter 23-3-40. M. This living quarters is
meant for either a caretaker place or for multigeneration use. It is a 1 bedroom 1 bath living
space.
4. The surrounding land uses to this site are agricu turai-an mmerc arbasediresidences. _ TO -The _
West is property belonging to the owner / operator of Coal Ridge animal hospital. To the North
is property owned by the town of Firestone. To the East is agricultural property. To the South is
agricultural property.
5. N/A
N/A
7. N/A
8. Residence is meant for caretaker or multigeneration family use. 1 Bedroom 1 Bath
9. N/A
10. Nothing new being built. 40 x 60 shop is existing. And new house wilt go where existing home
is,
11. N/A
12. There is existing landscaping around the entire property, consisting o►f grass, shrubs, trees, etc.
13. Current fence will not change and borders North, West, and South sides of property. Standard
square wire with T Post.
14. N/A
15. N/A
16. MVFP Area
17. N/A
Engineering questions:
1. Passenger Cars / Pickups and or RV — 6 roundtrips / day. Same as current
2. Utilize existing access from CR 20 from the South. Occasional access from North (Firestone)
3. 95% of travel from South. 5% from North
4. Morning and Afternoon
5. Existing access utilized. Will not change
6. Grading is sufficient as is. 6 A. N/A 6 B. N/A
Environmental Health Questions:
1. Water well. Permit # 286885
2, Septic System: Permit 4* G-19732722
3. N/A
4. N/A►
S. N/A
6. N/A
7. N/A
8. N/A
9. WA
10. N/A
Building questions:
. Existing: 2581 sq ft house, 2,400 sq ft pole barn
Proposed: 20' x 40' parking I storage shelter for personal vehicles, tractors, etc. North of
existing pole barn structure
2. Existing house will be torn down and new home constructed as primary residence. Existing pole
barn with living quarters will be used as caretaker / multigeneration family residence.
Answered in #2
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COLORADO DIVISION OF WATER RESOURCES
DEPARTMENT OF NATURAL RESOURCES
1313 SHERMAN MAN ST., Ste 821, DENVER, CO 80203
Main: (303) 866-3581 dwwrpermitsonline state.co.us
RESIDENTIALNote: Also use this form to apply for livestock watering
Water Well Permit Application
Review form instructions prior to completing form.
Hand completed forms must be completed in black or blue ink or typed.
1. Applicant Information
Name(s)
Office Use Only
Form GWS-44 (7/2012)
Kathryn Beiland
Mailing address
6251 WC R 20
City
Longmont
Telephone (w/area code)
303-746-2811
State
CO
E-mail
Zip code
80504
kathrynbeiland@gmail.com
6. Use Of Well (check applicable boxes)
2. Type Of Application (check applicable boxes)
❑ Construct new well
❑ Replace existing well
• Use existing well
• Change or increase use
■
■
■
■
Change source (aquifer)
Reapplication (expired permit)
Rooftop precip. collection
Other:
See instructions to determine use(s) for which you may qualify
❑ A. Ordinary household use in one single-family dwelling
(no outside use)
■ B. Ordinary household use in 1 to 3 single-family dwellings:
Number of dwellings: 2
■ Home garden/lawn irrigation, not to exceed one acre:
area irrigated 5000 7 sq. ft. acre
■ Domestic animal watering — (non-commercial)
❑ C. Livestock watering (on farm/ranch/range/pasture)
3. Refer To (if applicable)
7. Well Data (proposed)
Maximum pumping rate
15 gpm
Annual amount to be withdrawn
maximum allowed
acre-feet
Well permit #
286885
Water Court case #
Designated Basin Determination #
Well name or #
37-92-602(3) Exempt Well
4. Location Of Proposed Well (Important! See Instructions)
Total depth
350
feet
Aquifer
Laramie Fox Hills
8. Water Supplier
Is this parcel within boundaries of a water service area?II YESIDI NO
If yes, provide name of supplier: Central Weld County
County
Weld
NW 1/4 of the SW 1/4
9. Type Of Sewage S yste m
Section
18
Township N or S
2 'i r
Range E or W
67 E 1f
Principal Meridian
Sixth
Distance of well from section lines (section lines are typically not property lines)
2200 Ft. from r N Ix S 1300 Ft. from IT E I Vtil
For replacement wells only— distance and direction from old well to new well
feet Direction
• Septic tank / absorption leach field
❑ Central system: District name:
❑ Vault: Location sewage to be hauled to:
❑ Other (explain)
10. Proposed Well Driller License #(optional):
Well location address (Include City, State, Zip) I— Check if well address is same as in Item 1.
Optional: GPS well location information in UTM format. GPS unit settings are as follows:
Format must be UTM
I! Zone 12 OF Zone 13
Units must be Meters
Datum must be NAD83
Unit must be set to true north
Was GPS unit checked for above? ■ YES
Easting: 505331
Northing: 4442994
Remember to set Datum to NAD83
11. Sign or Enter Name of Applicant(s) or Authorized Agent
The making of false statements herein constitutes perjury in the second
degree, which is punishable as a class 1 misdemeanor pursuant to C.R.S.
24-4-104 (13)(a). I have read the statements herein, know the contents
thereof and state that they are true to my knowledge.
Sign or enter name(s) of person(s) submitting application
Kathryn Beiland
Date (mm/ddfyyyy)
10/01/2018
5. Parcel On Which Well Will Be Located
(You must attach a current deed for the subject parcel)
A. You must check and complete one of the following:
El
Subdivision: Name
Lot Block Filing/Unit
• County exemption (attach copy of county approval & survey)
Name/# 1311-2-4 AMRE 3310 Lot # 3310
❑ Parcel less than 35 acres, not in a subdivision attach a deed with metes
& bounds description recorded prior to June 1, 1972, and current deed
❑ Mining claim (attach copy of deed or survey) Name/#:
❑ Square 40 acre parcel as described in Item 4
❑ Parcel of 35 or more acres (attach metes & bounds description or survey)
❑ Other: (attach metes & bounds description or survey)
If signing print name and title
Office Use Only
USGS map name
DWR map no.
Surface elev.
B. # of acres in parcel
4.6
014
C. Are you the owner of this parcel?
YES Li NO
D. Will this be the only well on this parcel? El YESEr NO (if no — list other wells)
E. State Parcel ID# (optional):
AQUAMAP
WE
WR
CWCB
TOPO
MYLAR
Receipt area only
SB5
DIV WO BA MD
COLORADO DIVISION OF WATER RESOURCES
DEPARTMENT OF NATURAL RESOURCES
RESIDENTIAL WELL PERMIT APPLICATION INSTRUCTIONS
GWS-44 RESINST (7/2012)
Applications must be computer generated online, typewritten, or
printed in BLACK or BLUE INK. ALL ITEMS in the application
must be completed. Incomplete applications may be returned for
more information. Applications are evaluated in chronological
order. Please allow approximately six weeks for processing.
This form may be reproduced by photocopying. Reproductions must
retain margins and print quality of the original form. If filing online
see online filing instructions! You may also save, print, scan and
email the completed form to: dwrpermitsonlinestate.co.us
DO NOT use this form for the registration of an existing well in
use prior to May 8, 1972; (use Form GWS-12).
FEES: This application must be submitted with the appropriate filing
fee. The filing fee for applications is $100. Exceptions are as follows:
1) An application to replace or deepen an existing permitted well that is
in the same source (aquifer) which does not have a "-F" or "-R" suffix
after the original permit number is $.. 2) Applications to register an
existing well (use Form GWS-12), and replace or deepen the well (use
Form GWS-44) into the same aquifer is $100 if submitted together.
Fees are nonrefundable. Acceptable forms of payment are check or
money order, payable to the Colorado Division of Water Resources.
Payment by Visa, MasterCard or Discover cards can be accepted by
phone through the Records Office at 303.866.3581.
USES: This form (GUNS -44) is to be used when applying for a permit
for the following types of uses:
A. Ordinary household use inside one single-family dwelling
(NO outside water use allowed): Generally, this is all that can
be approved on parcels less than 35 acres.
B. Ordinary household use in 1 to 3 single-family dwellings,
irrigation of up to one acre of home garden and lawn, and
watering of domestic animals: Generally, permits can be
approved on parcels of land of 35 or more acres, or in areas
inside the Designated Basins, the Denver Basin, limited areas
on the Western Slope, and for subdivisions under a court -
approved plan for augmentation that allow outside uses.
C. Livestock watering on farm, ranch, range, or pasture (on
parcels of 35 or more acres).
ITEM INSTRUCTIONS: (numbers correspond with those on the
front of this form)
1. The applicant is the entity for whom the permit is to be issued.
Since the well owner is ultimately responsible for the use of the
well, their name should be in this area. The mailing address is
where the applicant currently receives mail.
Check all boxes that apply. If you check the box for Rooftop
precip, collection, you must also complete and submit Form
No. GWS-78.
3 Complete all boxes that apply.
4. You must provide a well spot location under the following
circumstances: (a) the location is decreed by a water court; (b) the
well will be inside the Denver Basin or other location where a site -
specific well depth restriction will apply; (c) your application is for a
permit to use an existing well. When a spot location is required,
you must provide the county, 14 of the '/a section designation
(example: NE % of the SE 'f4), section #, township, range, principal
meridian, and either distances from section lines or a GPS location
(UTM coordinates). If providing a GPS location, the required GPS
unit settings must be as indicated on this form. Colorado
contains two UTM zones (12 & 13). Zone 13 covers most of
Colorado. The boundary between Zone 12 and Zone 13 is the
108th Meridian (longitude). West of the 108th Meridian is UTM
Zone 12 and east of the 108th Meridian is UTM Zone 13. The
108th Meridian is approximately 57 miles east of the Colorado -
Utah state line. On most GPS units, the UTM zone is given as
part of the Easting measurement, e.g. 12T0123456. Check the
appropriate box for the zone.
For all other applicants, you must provide the following
minimum information: (a) the county, section #, township, range
and principal meridian; and, (b) the subdivision lot, block &
filing/unit designations as applicable if in a subdivision. You do
not need to provide distances from section lines or a GPS
location (UTM coordinates).
Provide the property address of the well location if one exists. If
it is the same as the mailing ng address, check the box next to the
well location address..
5. A current deed for the subject parcel must be attached. If the
subject parcel is 35 or more acres, a complete metes and bounds
type legal description or surveyor's plat map that references a
section point is required to enable us to plot the parcel in our
mapping system. If the parcel is less than 35 acres and not in a
subdivision, a deed with metes and bounds legal description,
recorded prior to June 1, 1972 is required. Complete Items 5A
through 5E (5E is optional). If you answered NO to Item 5C
please indicate who the landowner is. If you are under a contract
to purchase the subject property, please state this as well. If the
parcel is inside the Denver Basin, the application must be in the
name of and signed by, or their name entered by, the current
landowner. If filing online please see online filing instructions
for how to submit deed and or legal description attachments.
6. See above comments under USES to determine those uses for
which you may qualify, and then check the applicable box or
boxes.
7. The maximum pumping rate is limited to 15 gpm for most
residential type well permits. The annual amount of water to be
withdrawn is a volume measured in acre-feet. One acre-foot
equals 325,851 gallons.. For ordinary household use inside one
single-family dwelling and no outside use, the annual amount will
be about 1/3 acre-foot. For ordinary household use in three
single-family dwellings, one acre of home garden/lawn irrigation,
and watering of domestic animals, the annual amount will be about
3 acre-feet. For 100 head of livestock, the annual amount will be
about 1.35 acre-feet. Please indicate the estimated depth of the
proposed well. The proposed aquifer for the well must be
indicated if the well is to be located within the Denver Basin (the
approximate area of the Denver Basin extends south from Greeley
to an area east of Colorado Springs and from Golden east to
Limon), the San. Luis Valley, the Southern High Plains basin in
Baca or Prowers Counties, or in areas where it is believed the
well will penetrate a confining layer. Aquifer information should
be provided if known, for well locations outside of these areas.
8. The issuance of well permits may depend on the availability of
another source of water, pursuant to CRS 37-92-602(6), such as
water from a municipality or water district. (Statutes can be
accessed through the CDWR web site.)
9. Check the applicable box, and complete or attach any additional
information as requested in this item.
10. Wells must be constructed by a Colorado licensed well driller, or
under the "private driller" provision as defined in CRS 37-91-
102(12). A listing of licensed well drillers/pump installers is
available at
http://water.state.co.us/q rou ndwater/BOE/Paqes/LicensecIContract
ors.aspx
11. The individual signing the application or entering their name (and
title if applicable) must be the applicant or an officer of the
corporation/company/agency identified as the applicant or their
attorney. An authorized agent may also sign or enter their name
on the application if a letter signed by the applicant or their
attorney is submitted with the application authorizing that agent to
sign or enter their name on the applicant's behalf. Payment must
be received via phone if filing online at 303.866.3581 (Records
Office) prior to processing the application.
IF YOU HAVE ANY QUESTIONS please call the Colo. Division of
Water Resources (303-866-3581), or the nearest Division Field
Office in Greeley (970-352-8712), Pueblo (719-542-3368), Alamosa
(719-589-6683), Montrose (970-249-6622), Glenwood Springs
(970-945-5665), Steamboat Springs (970-879-0272), or Durango
(970-247-1845), or refer to the CDWR web site at
http://www.water.state.co.us for general information, additional
forms, and access to state rules or statutes.
ORIGINAL PERMIT APPLiCANT(S)
KATHRYN BEILAND
PERMIT TO USE AN EXISTING WELL
APPROVED WELL LOCATION
Water Division: 1 Water District: 5
Designated Basin: N/A
Management District: N/A
County: WELD
Parcel Name: 1311-2-4 AMRE 3310
Lot: 3310 Block: Filing:
Physical Address: 6251 WCR 20 NIWOT, CO 80504
NE 1/4 SW 1/4 Section 18 Township 2.0 N Range 67.0 W Sixth P.M.
UTM COORDINATES (Meters, Zone: 13, NAD83)
Easting: 505331.0 Northing: 4442994.0
•
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.
The construction of this well shall 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 4.6 -acre
parcel known as Lot B, Recorded Exemption no. 1311-2-4 AMRE 3310. Weld County.
4) The use of ground water from this well is limited to fire protection, ordinary household purposes inside not more than two (2)
single family dwelling (s), the irrigation of not more than 9,800 square feet home gardens and lawns, and the watering of four
(4) large domestic animals.
5) Production is limited to the Laramie -Fox Hills aquifer.
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 1.2 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 located not more than 200 feet from the location specified on this permit.
10) The issuance of this permit hereby cancels permit no. 2 86885 .
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.
r
art)
Issued By DEBRA GONZALES
Date Issued: 11/5/2018
Expiration Date: N/A
Printed 11-05-2018
For questions about this permit call 303.866.3581 or go to www.water.state.co.us Page 1 of 1
CENTRAL WELD COUNTY WATER DISTRICT
October 4, 2018
Kathryn Beiland
6251 County Rd 20
Firestone, CO 80504
RE: PT SW4 18.2-67 LOT B AMEND REC EXEMPT -3310 Parcel # 131118300076
Dear Ms. Beiland,
Please review the District's policy in reference to your request to drill a well and have the District sign off
on the Non -Opposition Consent Form provided from the Department of Natural Resources Division of
Water Resources.
SECTION 8
MAIN LINE EXTENSION POLICIES
WATER SERVICE WITHIN SERVICE AREA OF DISTRICT. On June 5, 1986, the District
adopted its Statement of Purposes as required by the Special District Act, Section 32-1-208, Colorado
Revised Statutes. As a part of the District's Statement of Purposes the area to be served by the District
for water service was identified. Subsequently additional areas have been added to the water service area
of the District; and agreements have been entered into by the District with municipalities within the
District's water service area that allocate the responsibility for provision of water. The designated service
area of the District may change in the future. The District has stated and hereby reaffirms that the District
is ready, willing and able to serve all requests for water service within all of its designated water service
area under the terms of its Tariffs, Rules and Regulations. In the event that the District is requested to
state its position regarding the installation of any exempt or nonexempt water well on property that is
within the Service Area of the District, the District shall:
1. provide a copy of its Service Area Map and,
2. provide a copy of the District's Main Line Extension Policy including this Policy, and
3. provide, on further request, a statement of the cost estimate for the installation of a water
tap(s) that would serve the applicable property under the Tariffs, Rules and Regulations of the
District.
The District will not approve or disapprove the installation of any water well to serve land within the
Service Area of the District unless there is a direct impact from the drilling of the well on the distribution
of water from the District's water distribution system.
Please submit this letter in lieu of the Non -Opposition Consent Form. If there are any further questions,
please contact the office.
Sincerely,
CENTRAL WELD COUNTY WATER DISTRICT
4
an Linker
District Manager
SLR
2235 2nd Avenue * Greeley, Colorado 80631 i Phone (970) 352-1284 • Fax (970) 353-5865
Processed by:
4
Permit #
Permit Type:
.■
Scanning Cover Sheet
for
Septic Permits
619732722
I _
Health I EHS History / EHS Conversion History
Sites Street Address 6251 CR 20
Situs City, State, Zip
Sec/Town!Ran e: 18-G2N-67W
Parcel # (12 digits) 131118300076-R4003208
Owner Full Name:
Owner Address:
Contact Name:
Contact Address:
SMITH CARL M
RT. 4 BOX 116-1
LON MONT,CO 80501
Application Status: Expired
Application Date: 03/11/1906
Owner Phone : 303 8333500
Contact Phone#
Information above has been Ver/fied in Acce/a by employee_ noted below
March 13, 2009
Date
Report 1f: EHS00024 003 Page 1- of 1
Print Date -Tf rn e : 3/13/2009 8; 33; O9A
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WELD COUNTY HEALTH DEPARTMENT
1555 17th Ave..
Greeley, Colorado
Ph. 353-0540
BY.
M.H. No.
Application for Permit to Install, Construct, Alter or Repair individual Sewage Disposal System.
w r dress ._ Phon`\.
ay
Aft 4#9 sticovevuor dg:23'• a gni el
Legal Description _ � SF�'ride&
Direction 071 ait vesS *en e a de? deft #113 Son deg • OO eaCies
12 a *4°O CAPS • 19C tokil lasalet c‘:
Septic Tank a - 3
don ye_ eietsopay or) )7or*'t? r • '` F in1/4“:
"� !
Feral For atiap
bac • e tenet+ '`
1. Living Units N2. o. of Bedrooms
S. Baths
No. of re
4. Basement Drain
5. Automatic Dish ashet
6. Garbage Disposal
0
7. Automatic LaundryAA!),
8. Size of Lot 0
9. Type of Soil '4-6.70 ,y _
l . Percolation Test
.e iii. Water Supply
'1!. Lot Grade -
i 13 Water Table Depth
14. Other
1
Y
•I.
1iy
1. Liquid Capacity /On EI) Gallons
2.. Dimension W L ..,:__ D
3. Material
Satz --
4. Type Inlet
Type Outlet
Field
L
Secondary Treatment
1. No. of distributio Ines
2. Trench: width_
3. Type Filler Material t
Bed
th _
4. Depth of Fier, Material
Gravel Size iajr5
Type Tile
7. Depth of ppive
8. Other
en
(:), ("Ls\
Wrz
The Permit is too remain in full force and effect far six (6) months .ths, from date, until revoked for non-compliance.
This system will be constructed in accordance with the above specifications and regulations governing non -
municipal sewage disposal systems, in accordance with Regulation No. 1 of the Weld County Health De=
partmer.t. Owner cannot transfer permit. �
,
Date:
Applicant:
The plans and specifications as shown are approved, pending paymen . of
Sanitari
Date:
Pie
The above system inspected and found to comply with the plaW and description.
Installed by
PERMIT FEE $_
Received by
it49j_i.fr 4 . ,
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A
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Sanitarian:
a
0
Date: _
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Please use reverse side for Plot Plan or use separate sheet of paper.
Date
t
03
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COLORADO
March 19, 2002
Carl Smith
6251 County Road 20
Longmont, Colorado 80501
RE: Carl Smith ISDS No.: 02-022
Permit No.: G19732722
Dear Mr. Smith:
DEPARTMENT OF ?mimic HEALTH AND ENVIRONMENT
1555 NI 17TH AVE
GREELEY, CO 80631
WEBSITE: vvww.co.weld.co.us
ADMINISTRATION (970) 304-6410
FAX (970) 304-6412
PUBLIC HEALTH EDUCATION AND NURSING (970) 304-6420
FAX (970) 304-6416
ENVIRONMENTAL HEALTH SERVICES (97O 304-.6415
FAX (970) 304-6411
On March 18, 2002,an evaluation of the existing individual septic disposal system at 6251 County Road
20, Longmont, Colorado -Section 18, Township 02 North, Range 67 West, was conducted by Pam Smith,.
an. Environmental Specialist of this department.
The existing individual septic disposal system is of sufficient size and capacity to adequately handle the
proposed load. This evaluation is based an a final treatment capacity for a 3 bedroom residence.
Be advised, neither the County of Weld nor any of its agents or employees undertake or assume any
liability to the owner of the above property, to any purchaser of the above property or to any lending
agency making a loan on the above property or in the report.
This inspection was conducted for the purpose of determining compliance with current regulations and
for detecting health hazards observable at the time of inspection.. This does not constitute a warranty that
the system is without flaw or that it will continue to function in the future. Inspections requested during
periodsof snow cover and high soil saturation may be of questionable value to potential buyers due to
adverse conditions. Evaluations based on Statements of Existing (S.O.E.) relies on information the
property owner provides, under oath, indicating current status of the system and representing to the best
of his/her knowledge the system is not failing to function properly.
If we can be of any further assistance, please contact our office at (970) 304-6415.
Sincerely, Vade)7\1
am meth
Environmental Health Specialist
P mJ02 smith cart
cc: Weld County Department of Planning
INDIVIDUAL (DUAL E E DISPOSAL
SYSTEM EVALUATION
COLORADO
OWNER: IhgteS 11C 11 I
1/1
MAILING DRE S :
SITE ADDRESS:
LEGAL DESCRIPTION: PT:
SUBDIVISION' f
WATER SUPPLY:
PT:
SEC:
LOT:
REQUEST N4 . : _ OCel' 00Ree
RECORDED EXEMPT
DATE RECEIVED:
RECEIVED BY: ' ►,, .- ''.
FEE $90.00:
DATE INSPECTED:
S33
TY
r
ELK:
TATE
N
S
1469,R
(1501
FLG:
RNG:
CpbutimacIAL TOTAL ACRES:
PERMIT ON RECORD: Name.
Permit No
Syst - ,a Size: Tank: gallons
Percolation Rate: minutes per inch
Engineer Design: YES/NO
a
O.E.: YE
Trench: square feet Bed: square feet
Soil Type:
Percent Ground Slope: Direction:
The septic system identified
ire of sufficient size to accommodate f the proposed
litb to\ the structure (s) served by this system.
CURRENTFLOW
Description:
Persons:
Bedrooms:
Bathrooms .
Basement Plumbing:
ADDITIONS
+F
e riptiOn:
s existing septic is RE •.UIRED
acco - -.te the pro *.f sed aitera
he structure
PROPOSED TOTAL
Descript io
to have th id l
alt = - ons made to
Neither the County of Weld nor any of its agents or employees undertake or assume any liability to
the owner of the above property, to any purchaser of the above property or to any lending agency
making a loan on the above property or in the report.
This inspection was conducted for the purpose of determining compliance with current regulations
and for detecting health hazards observable at the time of inspection. This does not constitute
a warranty that the system is without flaw or that it will: continue to function in the future.
Inspectidns requested during periods of snow cover and high soil saturation may be of questionable
le
value to potential buyers due to adverse conditions Evaluations based on Statements of Existing
( . O . E.) relies on information the propertyowner provides, under oath, indicating current status
of the system and representing to the best of his/her knowledge the system is not fail' - to
function properly.
Aked mixt/
�CC�I�L`�G�i Grady
flhtZAXb
mJccL1
cat
Notice of Inquiry
Development within a Coordinated Planning Agreement
or Intergovernmental Agreement (CPA or IGA) Boundary
Date of Inquiry
9/28/2018
Municipality
with
CPA
or IGA
Firestone CPA
Name
of
Person
Inquiring
Kathryn
Beiland
Property
Owner
Kevin
Reiland
&
Kathryn
Beiland
Plannerplet,Opidet‘Andr
k f
td eoLefin
Legal
Description
Lot
BB of
AMRF-3310:
SW4 of
818,
T2N,
R67W
Parcel
Number
131118300076
Nearest
Intersection
CR
20 and
Colorado
Blvd
Type
of
Inquiry
2nd dwelling
within
2400
pole
frame structure
The above person inquired about developing a property inside your designated CPA or IGA boundary. This person
has been referred to community by Weld County Planning to discuss development options on this site. Visit
Chapter 19 of the Weld County Code for specifics on your agreement.
Weld County Comments
Annexation Interest?
�eS _--rkf-litA'n
ainneg bu±
uocsk �
E
J_
f
does not
Name/Title of Municipality Representative aY'lAsoSCUrter
n
Municipality Comments
k-d\eQvz u.s . esc..isfi:vns acteSS oic of kkv\J'j ?AD.
-nn-e v\r ha sir g Can} a.vto—t-l�.air a. C ce s s
PC) i Ine A Q4 411&C3 tn¼Q.
Signature of Weld County Planner
Signature of Municipality Representative
Plase return the signed form to:
Weld County Planning Department
1555 N 17th Avenue, Greeley, CO 80631
(970) 353-6100 x3540 ti (970)304-6498 fax
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