HomeMy WebLinkAbout20183044.tiff�ar�r 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
GEORGE & PAT SAGNER
11097 CR 22.5
FT LUPTON, CO 80621-
(303) 229-2386
PERMIT TO CONSTRUCT A WELL
LIC
WELL PERMIT NUMBER 291979
DIV. 1 WD2 DES. BASIN MD
Lot: A Block: Filing: Subdiv: 1311-12-2-RECX12-0101
APPROVED WELL LOCATION
WELD COUNTY
SW 1/4 NW 1/4 Section 12
Township 2 N Range 67 W Sixth P.M.
DISTANCES FROM SECTION LINES
2105 Ft. from North
226 Ft. from West
Section Line
Section Line
UTEVI COORDINATES (Meters.Zone:13,NAD83)
Fasting: Northing:
ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT
CONDITIQNS 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.
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)(b)(I) and policy of the State Engineer under the following conditions, for a
4,06 -acre parcel known as Lot A, County Exemption no. 1311-12-2 RECX12-0101, Weld County.
4) The use of ground water from this well is limited to ordinary household purposes inside one (1) single family dwelling, the
watering of no more than four (4) large non-commercial domestic animals, and the irrigation of not more than 12,400
square feet of home gardens and lawns.
5) Production is limited to the Laramie Fox Hills aquifer which is located approximately 210 feet below land surface and
extends to a depth of approximately 510 feet. Plain casing must be installed and grouted to prevent the withdrawal of
ground water from other aquifers and the movement of ground water between aquifers. (NOTE: If coals and/or
carbonaceous shales are encountered in the borehole, plain casing and grout should be installed through these intervals
to exclude poor quality water from entering the well.)
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 0.97 acre-foot.
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
'Tess 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 constructed not more than 200 feet from the location specified on this permit.
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.
NOTE: To ensure a maximum productive life of this well, perforated casing should be set through the entire pr d ing
interval of the approved zone or aquifer indicated above. `15
APPROVED
JLV
State Engineer
Receipt No. 36600488 DATE ISSUED 07-17-2013
EXPI RATIO
-2015
Weld County Environmental Health Services Department
1555 N. 17th Avenue
Greeley, CO 80631
Phone: (970) 304-6415
Fax: (970) 304-6411
Web: weldhealth.org
Septic Permit - Final
Application Number: SP -1300096
Owner Name: SAGNER GEORGE W
Site Address: 10606 CR 23
App Type: HealthlResidentiallNewlSeptic
GEORGE SAGNER
11097 COUNTY RD 22.5
FORT LUPTON, CO 80624
Parcel#: 131112200037-R2724604
Legal Desc: PT SW4NW4 12-2-87 LOT A REC EXEMPT RE -3466 (1.12R)
App Specific Info:
Application Status:
Ready to Final
Applied Date:
05/10/2013
Issued Date:
05/13/2013
Finaled Date :
Location Description
Repair Reason Type
Associated Building Permit
Associated Building Permit Number
Application Date
Septic Permit Expiration Date
Waive Fees
Number of Persons
Number of Bedrooms
Basement Plumbing
Full Bathrooms
3/4 Bathrooms
1/2 Bathrooms
Public Water Supply
Private Water Supply
Parcel Acres
TBD
New
Yes
MFG 13-00033
05/10/2013
05/10/2014
No
2
3
Yes
2
0
0
No
Well
4.060
Actual Installation:
Septic Tank: I Z 3C1P gallons
Design Type: 6 A
Absorption Trench: sq ft
Absorption Bed : 2 Z 56 sq ft
Chamber Model
Chambers
gC
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 oertify 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 pr}rrnit is naro•transforable 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 sysic by the Weld Count anent of Public Health and Environment.
/1./3
X
Environmental Health Specialist
Date
Report ID: EHS00033v006 Page 1 oft
Print Date Time: 10/31/201 32:45:50PM
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