HomeMy WebLinkAbout20183107.tiffWATER SUPPLY INFORMATION SUMMARY
Section 30.28.133,Id1, C.R.S. requires that the applicant submit to the Caunty,'Adequate evidence that a water supply that
is sufficient in terms of quantity, quality and dependability will he available to ensure sn adequate supply of water.
1. NAME OF DEVELOPMENT AS PROPOSED
i Lv(4L ‘-', i'l IL i .--L 0tiL r L,..�- a ., r—' L,
2. LAND USE ACTION
3. NAME OF EXISTING PARCEL AS RECORDED
SUBDIVISION FILING BLOCK LOT
4. TOTAL ACREAGE
15. NUMBER OF LOTS PROPOSED PLAT MAP ENCLOSED 0 YES
8. PARCEL HISTORY • Please attach copies of deeds, pieta or other evidence or documentation.
A. Was parcel recorded with county prior to June 1, 1972? 0 YES 0 NO
B. Has the parcel ever been part of s division of land action since June 1, 1972? 0 YES 0 NO
If yea, describe the previous action
7. LOCATION OF PARCEL • Include a map doliniatine the project area and tie to a section corner.
114 OF 114 SECTION TOWNSHIP 0N ❑ S RANGE ❑ E 0 W
PRINCIPAL MERIDIAN: 0 8TH ❑ k.M. ❑ UTE 0 COSTILLA
8. PLAT • Location of aA walla on properly must be plotted and permit numbers provided.
Surveyors plat 0 Yes 0 No If not, scaled hand drawn sketch 0 Yes 0 No
9. ESTIMATED WATER REQUIREMENTS • BeNmu per 4w or Jkr. Fur pm Yvv
-
HOUSEHOLD USE I of units GPO AF
10. WATER SUPPLY SOURCE
, ❑ EXISTING 0 DEVELOPED
WELLS SPRING
WELL PERMIT NUMBERS
Lt � I
•
• 0 NEW WELLS -
rnaroem AMMFme • IQ1[tx ONE
i o um. ❑ urns OOAPM E
PM
I o e ouwear WN O l MR rio HILS
❑ p UM
COMMERCIAL USE I of S.F.
IRRIGATION I of acres
GPD AF
OPD AF
WATER COURT DECREE CASE NO.'S
0 MUNICIPAL
❑ ASSOCIATION
0 COMPANY
❑ DISTRICT
NAME
STOCK WATERING t of head GPO AF
OTHER GPO AF
TOTAL
GPO AF
•
I
LETTER OF COMMITMENT FOR
SERVICE 0 YES 0 NO
1
11. ENGINEER'S WATER SUPPLY REPORT 0 YES 0 NO IF YES, PLEASE FORWARD WITH THIS FORM. Me may be mound bu1en our wee a coonleieti
1Z TYPE OF SEWAGE DISPOSAL SYSTEM
❑ SEPTIC TANKJLEACH FIELD
0 LAGOON
0 ENGINEERED SYSTEM Rifle& . cloy
❑ CENTRAL SYSTEM
0 VAULT • LOCATION
of anew* dootanl 0 OTHER
• DISTRICT NAME _._._____
SEWAGE HAULED TO
,
_--
Form 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
DONALD HEPP
11525 WCR 13
LONGMONT, CO 80504-
(303) 776-7347
PERMIT TO CONSTRUCT A WELL
698
WELL PERMIT NUMBER 14835
A
DIV. 1 WD 5 DES. BASIN MD
APPROVED WELL LOCATION
WELD COUNTY
SE 1/4 NE 1/4 Section 1
Township 2 N Range 68 W Sixth P.M.
DISTANCES FROM SECTION LINES
2850 Ft. from South
220 Ft. from East
UTM COORDINATES
Northing: Easting:
Section Line
Section Line
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 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 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)(c) for the relocation of an existing well, permit no. 14835. The old well must be
plugged in accordance with Rule 16 of 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
plugged.
4) The use of ground water from this well is limited to fire protection, ordinary household purposes inside not more than '1
single family dwelling(s), the irrigation of not more than 2600 square -feet of home gardens and lawns, and the watering of
domestic animals.
5) Production is limited to the alluvium. The depth of this well shall not exceed 45 feet or the depth at which sandstone or
shale is first encountered, whichever comes first.
6) The maximum pumping rate of this well shall not exceed 15 GPM.
7) This well shall be constructed not more than 200 feet from the location specified on this permit.
NOTE: This well is decreed in Divsion 1 Water Court cases W-5976, 82CW263 and 86CW232.
NOTE: This permit has been approved with a change to the well location based on decreed location. You are hereby
notified that you have the right to appeal the issuance of this permit, by filing a written request with this office within sixty (60)
days of the date of issuance, pursuant to the State Administrative Procedures Act, (See Section 24-4-104 through 106,
C.R.S.) 44) 1S/01
APPROVED
JMW
Receipt No. 0508689
,ild
State Engineer
DATE ISSUED 03-28-2003
TION DATE 03-28-2005
Scanning Cover Sheet
for
Septic Permits
Permit #
Permit Type:
Situs Street Address
Situs City, State, Zip
SP -0500136
Health I Residential / Repair
11525 CR 13
Sec/Town/Range: 01 -02N -68W
Parcel # (12 digits) 131301100066-R3843805
Owner Full Name:
Owner Address:
Application Status: Fina/ed
Application Date: 04/22/2005
HEPP DONALD R & WYONNA MARIE
11525 CR 13
LONGMONT,CO 80504
Contact Name: RUTLEDGE JOSEPH
Contact Address: 601 S BOWEN
LONGMONT,CO,80501
Owner Phone #: 720.280.0503
Contact Phone# 303.678.9851
Information above has been Verified in Accela by employee noted below
X _
Processed by:
cf„,
May 05, 2008
Report ID: EHS00024v003
Print Date -Time: 5/5/2008 10:19:26AM
Date
Page 1 of 1
Permit #:
Owner:
Applicant:
Permit Type:.
Parcel #:
Location:
WELD COUNTY DEPARTMENT OF PUBLICHEALTH AND ENVIRONMENT
1555 NORTH 17TH AVENUE
GREELEY, CO 80631
PHONE (970) 304-6415 FAX (970) 304-6411
SP -0500136 Sec/Twn/Rng: 01 02 68
HEPP DONALD R & WYONNA MARIE
RUTLEDGE JOSEPH
RREP C —Commercial, R=Residential + NEW, REPair, VauLT
1313-01-0-00-008
11525 CR 13 LONGMONT
Legal Description: 25046A PT NE4 1 2 68
S1D10'W OF NE COR S1
Installer: 5 Lo I t i SW -fa
c.
BEG AT PT 2110.88'
finaled
Status: ISSUED
Applied: 04/22/2005
Issued: 04/26/2005
Finaled: 5-•fj'6
Description: HOUSE
Commercial: N
Residential:Y Acres: 4
# of Persons: 2 Basement Plumbing: N
# of Bedrooms: 3 Bathrooms - Full: 1 3/4: 0 1/2: 1
Water Public: N Water Source:
Water Private: Y Cistern: N Well: Y
• Well Permit #:
Percolation Rate: 25.5 Limiting Zone: 8 ft 0 in Description:
% Ground Slope: 0 Dir: Soil Suitable: (Y/N)
Engineer Design Required: (Y/N) N In 100 Year Flood Plain: (Y/N) N
Minimum Installation
Septic Tank: 1000 gallons Absorption Trench: 680 square feet
or Absorption Bed: 0 square feet
Actual Installation
Septic Tank: . IOW gallons Absorption Trench: Co&a square feet
Absorption Bed: square feet
• Design Type: G, A / Chamber Model ST
S.
Chambers*
1h
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.
Et'llvironmdtal Health Specialist
Form: S FINAL
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