HomeMy WebLinkAbout20183127.tiff Bill Print Date: 07/20/ 1 7
SERVICE tIODFIESS
5380 WC 36
Little Thompson Water District
835 E Highway 56. Berthoud , CO 80513 ACCOUNT NUMBER I CUE DATE AMOUNT DUE
( 97 0) 532-2096 www Itwci. or Office Hours M-F lam - 5pm 155602 08/ 1S/ 1 7 125400
Customer Name: LUIS & AIDE DOMINGUEZ MARTINEZ
INSTRUCTIONS FOR ONLINE ACCOUNT ACCESS AND PAYMENT OPTIONS ARE ON THE BACK OF THE BILL
Previous Current Days Current Period Same Period
Read Date Reading Read Date Reading Usage Year Ago
06/09 578489 ! 07/ 13 592972 1 34 14483 - 15341
- �tgr usage Silting flexafl _ _ _ 1 _ t IMES
Usage Calculation: Balance Forward 326. 1 7CR
Level 1 : 6000 @ .00237 _ $ 14.22 Payment - Thank you! 07/ 1 5/ 17 125 .00
Level 2 : 8483 tr .0' 2 9 8 _ $ 25 .28
Adjustments100
Water Base 26.86
Usage Calculation Total: $ 3930 Water Usage 3930
THOUSAND GALLONS USED
15
12
Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul
WATER USAGE YID 33,865 Total Current Charges 66.36
Equal Pay Account Balance 384.51 CIS
center for Resource Conversation at 303-999-3824 to
PAY THIS AMOUNT
1NT
[Message: save water & �one�± Call the �
schedule your free sprinkler system inspection appointment.compriimeats of LTWD, Trained J
technicians will check your sprinkler devices, watering zones & schedule, then consult with you to Equal Ray 125.00
improve the efficiency of your system.
PLEASE DETACH AND RETURN BOTTOM PORTION W1 H YOUR PAYMENT
Please writs yinii account number in ih ? memo Iii}e 01 your check
Service Address
4F i 1
_ 5380 WC 36
J : y
Little Thompson Water DistrictI Account Numbed Due Date Amount Duo Amount Paid
835 E Highway 56 , Berthoud, CO 80513155602 08/ 15/ 17 ' 125.00
00015560260000125005
ADDRESSEE REMIT TO :
5226 1 AB 0.400 23 . 19
LUIS & AIDE DOMIINGUEZ MARTINEZ at
' Direct Pay a- This amount will
,.. 53 0CtUNT'�''' R ROAD
PLATTEVILLE,LLE} CO 80651 -9618 -- automatically deduct from your
bank account
..41 Change ot address? i
LT- 1007- 10
P - G De•st8
csentrr -i -esasaas-A"- - r
„0„.. 1c.%:14r a DEPARTMENT OF HEALTH
! 1516 HOSPITAL ROAD it • .0.4! . , . '' d-
GREELEY, COLORADO 30531 ►
` \ ADMINISTRATION (303) 353. 0586
_ 111 its HEALTH PROTECTION (303) 353-0635
COMMUNITY HEALTH (303) 353.0639
LOAN APPROVAL
No : .� 1 +� -- #1SOLORADORequest
Pate Received :„„.„31k211§..........
S8 - -
pate Forwarded : 9107_188 _ ___ , -��
Fee paid : $ 50 , 00 Date : 9 / 02 /88
TO WHOM IT MAY CONCERN : Review and inspection report regarding water and the sewage
disposal system for an existing dwelling :
SEND TO KENT_ NELSON a TITLE REALTY PRONE it _ 772r__
INFORMATION: Address 5380 WCR 30* Platteville , CO Legal : PT NW4 , PT . Sec 12 ! T 03 , E 58W, Age of Rouse 10 years
Subdivision, i �• Lot �- ----- -_ -
Property der_ WILSON , R.I CHARD BRUCE Original Owner Same - - -
Tantk Pumped on _ 5 /$8 - By Bob ' s Son tion -- - -
DEPARTMENTAL RECORD SEARCH : Permit # 0770268 Name Wilson# Richard Bruce
Bathrooms 2- 1 / 2 Bedrooms 3 Total Acreage 11
Tank Capacity - - gals . Field Size eq . ft . Water Supply - Little shorn
Date of Final Inspection March 27 1978 a_ ,
■
INSPECTION S : Date of Inspection September 6 1988 - -
Soil Conditions : Dry X Saturated - = Snow--cov'ered,...,. ,,;,,�
Residence : Occupied X Vacant
t
FINDINGS : Sewage Disposal System : - Satisfactory Other - -
Bacteriological Water Test : Acceptable Other'--7_ - -
COMMENTS :
DATE : September 7 * 1988 SIGNATURE: 'ACt
Environmental Healt Specialist
Neither the County of wild nor any of its agents or employees undertake or assume any
liab it ty to the owner of the above property , to any purchaser 'of th above property or to
any lending agency making a loan - on the above property in connection with either its
examination of the property or in the report .
This 'inspection was conducted solely for the purpose of detecting health hazards observable
at the time of inspection , and does not constitute a warranty that t h e system is without
flaw or that it will continue to function in the future . Inspection requested during
periods of snow cover and high soil saturation may be of questionable value to potential
buyers due to adverse conditions . Water reports t reflect the bacteriological quality
of the water supply at the time the sample was taken .
*a� Scanning Cover Sheet
for
Septic Permits
Permit # X19770268
Permit Type: Health / EHS History / EHS onversion H i tory
Situs Street Address 5380 C R 36
Situs City, State, Zip
ecrro n!Range: 1?aQ3!1a68\ Application Status : /na/ d
Application Date; 03/11 /1996
Parcel # (12 digits) 120712200088-R2080503
Owner Full Name : WILSON RICHARD BRUCE
Owner Address : RT. 4
LON MONI,CO 80501
Owner Phone it: 303 5354923
Contact Name:
Contact Address:
Contact Phone#
Information above has been Verified in Accela by em )oyee noted below
x Oitutec February 04 , 2009
Processed by Date
Report ID: EHS00024vQ03 Page 1 of "I
Print Date -Time: 2/4/2009 2: 12:38PM
%. WELD COUNTY HEALTH DEPAJMENT G3/4. 7 7a 91406
1516 hospital Rand Permit No . ;to
mom•,r.44. Greeley , Colorado
PR . 353 -0340
Application for permit to install , `construct , an Individual. Sewage Disposal System .
i i % ' t nr 4" V 9C25
°Willer gb ; C li) a ife ci 8rure Lull 'son Address it+ PhonetWidag
Direct i d to site : Hwy , - _ Rd . N mi }� t mi , �mi , W mi...........,...___ 3 6 4 1 a ges. - -- -kled e- a -AO Jr2 Van 4 am%Legal Description : Ptn ' `
$ oq Sec . „.19_ , T i3 N 1 Nag W , Sub . _Lot�Blk
1 € ra1 Information I 5cpt . Use On).L1
i
No . Bedrooms I: dNo . Persons _ APireeera Pere rate ( avg . of 3 ).1110&e,‘
No . Baths. 007,00rBasement Plumbing 4 , Soil Type..._....i: L=Al...........
Size of Lot eie I U20 Table Depth tk f
H2O supply ( If well give depth ) , . . - m Lot Grade ''-
New fomeK Mobile Home Modular Ad , n '� Engineer Design Yes itoK,„ No
Type of sewaspasal requested ' Pr If YES- reason :
Septic tanks Privy Other _ _ s , -- Comments : -
This is to certify that the system is NOT within 400 ft . of a public surer �'
0;61/
i Instaiiation instructions : ( Minimum _ Reruir' enents )
Septic Tank dais . Absorption Trenches__ Ilitemr • Seq . Fit .
1 Other - or
Special Instructions Seepage Bed. __ ____Sq . Ft .
I
This system will be constructed and installed in accordance with the above specifications
and regulations regarding individual sewage disposal systems in Weld County , Colorado .
ti
This permit shall expire at the same time as the building permit , or , if no building permit
is issued , the permit shall expire 120 days after its issuance if construction has not
been commenced .
r
Date : jOiI7 '7 Owner :
A;?2-71122110-0..
Ap p I i c a kt•Verea;4440-1,47200:merne re -
The plans and specifications as shown are approved pending payment of permit fee .
Date : ` JO ii3fir)
Sanitarian : : . � '
The above system inspected and found to comply with plan and descripti f
Systems Contractor : (, /tams Date :Sanitarian : 14, 27.0r iii:fludr,ifo,.......
tin
Engineer Review : _ - - _ _
( Date ) ( Signature )
eh ft
Permit Fee : s 5 v tr
Zeikat
r Received by : Da t e : -_-_,/, °" ' -
va tfacer
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4-41 , , „ ., ,-
„2...imtaicoordo h
\ ice" / 2 11
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