HomeMy WebLinkAbout20180367.tiffWATER SUPPLY INFORMATION SUMMARY
Section 30.28.133,1d), ld), C.R.S. requires that the applicant submit to the County, Ad:equate evidence that a water supply that
is sufficient in terms of quantity% quality and dependability will be available to ensure an adequate supply of water.
1. NAME OF
DEVELOPMENT AS PROPOSED
--_
2. LAND
USE
ACTION
`'
3. NAME
OF EXISTING
PARCEL
AS RECORDED
tilt
.. 0. i,
.r.- r
.�. i
4,..
1
SUBDIVISION
FILING
BLOCK
LOT
,## TOTAL
54 NUMBER OF
LOTS
PROPOSED
p ENCLOSED
6r PARCEL
•.-••.. -.-.-.•..•�-+-
A. Was
HISTORY
•--•-•*
parcel
*••Tsf•-•..+..-r+..•a.•�-+.rw..i..::".:...i
recorded
a
Please
with
attach
county
copies of deeds, plat
as LiW Y#tiY#N+Yf M1?+•+•�s.T+'-?Y11 T\y "awi.a.
prior to June 1, 1872?
or other
ray.*w.fl%4W.yr1+k4NNa-VfYia+a*Y+a.y{r.�-ry.*..
D YES
evidence or
D NO
documentation.
.f.TY•Tt { FTi..t4I+I �La.t+#w7Y•.r+Mc+.t �:R fiii+iw4�N�f Fr t: -.+-Ti
B. Has
If
the
yes,
parcel ever been Past of a division
describe the previous action
of land
action since June 1,
1.972?
D YES D NO
-._.-.
7, LOCATION
viwYaw Va TaV aYl�w'
_ •
OF PARCEL
Include
a map deviating the
rL i#•{if
project area and tie to
i]1i iiM.iiJ T•R!•P•/!s?NHlliill.
a section comer.
.M.r +.IT a�r+.a+•li#ri Yli�iM'MT!/b!►MTl7T1l R*[#1Lfi'Y�Y•fMNLfHiRra[#lLlN IH MH�F►LYaL Fi+YYi gtN.a4ib4
114
OF
114 SECTION
TOWNSHIP
D S
RANGE DE
D
W
.,..
_D
...
PRINCIPAL
MERIDIAN:
..L
If
D
fiAM. D UTE 0 COSTIL
...Wh'\YN\\M/...a...
be
.. ... _...__......... .......__.,—..__....—.— �.....�_—'
8. PLAT
w
Location of
ail
wells
on
property
must platted
and
permit numbers
provided.
Surveyors
plat D
Yes
D No If
not scaled
hand
drawn
sketch D Yes D Ne
K'{Uir�.tleAi#yfutlfrrf{Iftfa■R•-!!!f
9.
HOUSEHOLD
ESTIMATED
WATER
,�ti-a-.-��•!!!.}•t-t-rf-rf#f'!'Ia•7!•f!•rl�RA
[�e•�'
4f
REQUIREMENTS
of units
- Gems
f.fl.p'+a-w.!w'-4br
per
r-h•t ti*i.*r4M*9tSW4t+•isn-M.Ti7Lly
Clay or acre Feet per Year
.......'.._._._�`GPO AF
10+
,t
riir
WELL
Ell.
WATER
EXISTING
WELLS 4
4'L7uP
PERMIT
PE3
SUPPLY
t•[Ytl*LHi
SOURCE
.gnt..teLnneg4Y141{A*aq,4ifli�
D
¢y{�.►�M•RS
'idyl
DEVELOPED
SPRING
YLi1#.Lis1A�YiL#{'w•YILILi
t w
I ;{ I iNE Nuns
F i. a p/��,�■v�4 /y��,�p�(��r,4�
: PROPOSEDLU■;:f
a 0 AS UYIAI
Yt It w -{t-{1 r1•T-TI?�T•'fi ?•+fiTl�lfP!#LY.
-
PICK
S • 'L �L'K �� �y
C) U ARAPAHOELis\ ...
., ...
�l
'
'{7j], r}f� �''`j } g,, tE L HO p si
+ � �irlii.Ii OITER � �A'tTiY7�1 'i..� Li7iRi><G �i11� .iAL�+17�
COMMERCIAL
MERCIAL
USE
of
yl��
Sky .. _—..-...... GPO
AF ?
W :... / ..... ... .. a
.. ,�..• FAY' rem .7{/-•�� DAKOTA
.
-
OMER
I
IRRIGATION
N of acres
GPO
AF
STOCK
WATERING
N
of
•
head , GPO AF
'+w+
f
w
tf7a•ff'f?' $.t4i4i4i+A+NYt.Yrtr+L +.M+ r...t�Yi.N twriaiL t•L s+tft-�
f
r
w
OTHER
-' CP AF
D
ASSOCIATION
COMPANY
: WATER
COURT
DECREE
CASE
NO/S
., •{t.{t.
a
a
D DISTRICT
_...
•
9
w
TOTAL
GPO AF
1 NAME
r
LETTER
OF
COMMITMENT
FOR
.
w
r
11.
ENGINEER'S
ATER
SUPPLY
REPORT
0 YES
D NO
W YES, PLEASE
FORWARD
WITH
THIS
FORM}
(TS
may be required before air review is ca lntedJ
"
Y#thi
12.
Yt
TYPE
rt+
OF SEWAGE DISPOSAL
aMfai##A i•1♦r rdi
wq#ri•►a•LMiY
SYSTEM
a•atYilSiftY.iYoW4Srtwt}tr
SW /PO
X#;f-l►M{Ywa Ova 4{ar+•rr4lne Tf nsa__ .-..I 4f T�'•.fifThtr-w-.+N-+ia1•a.aar#iiNt11!`i!'LRi iwi{fiffil �flL!#r#1i11V 17ifN1 �. Yi tr#ViitWit4WtH-aY#i1Yki-4i1H 4�1a1i.ta V4T� bT{. 4JMM.fh T.. ++f
SEPTIC
TANKILEACH
FIELD D CENTRAL
SYSTEM T DISTRICT
NAME
D LAGOON D VAULT
- LOCATION
SEWAGE
HAULED
TO
ENGINEERED
SYSTEM
'Attach * copy of toginseting design) 0 OTHER
Form NQ., • OFFICE OF THE STATE ENGINEER
cwt-zs COLORADO DIVISION OF WATER RESOURCES
878 Centennial Bltlg., 1313 Sherman SL GEnveG Colorado 80203
(303)
APPLICANT
TRENT L JOHNSON
13551 W R 39
PLA I I EVILLE, CO 80651 de
(303) 536-4156
PERMIT TO CONSTRUCT A WELL
ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT
CONDITIONS OF APPRQVAI.
This well shall be used in such a way as to cause no material injury to existingwater 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.
The construction of this well shall be in compliance with the Water Well Construction Rules 2 OCR 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.
Approved pursuant to CRS 37-92402(3)(O for the relocation of an existing well, permit no. 48582. 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 fain must be completed and submitted to affirm that the old well was
plugged.
The use of ground water from this welt is limited to fire prr tin, ordinary household purposes inside not more than 1
single family dwelling(s), the irrigation of not more than 1 acre of home gardens and lawns, and the watering of domestic
animals and livestock,
5) Production from this well is restricted to the Laramie Fox Hills aquifers which corresponds to the interval between 310 feet
and 630 feet below the ground surface. Plain casing shall be installed and grouted to prevent production from other zones.
The maximum pumping rate of this well shall riot exceed 15 GPM.,
7) This well shall be constructed not more than 200 feet from the location specified on this permit.
NOTE: To insure a maximum productive life of this well, perforated casing should be set through the entire producing
interval of the approved zone or aquifer indicated above.
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.
tic
WELL PERMIT NUMBER q•$73rersr,%
DIV, 1 WO 2 DES. BASIN MD
APPROVED }iIVUL LOCATION
WELD COUNTY
SE 114 NE 1/4 Section 30
Township 3 N Range 65 W Sixth P.M.
DISTANCES FROM SECTION LINES
2300 Ft. from North
100 Ft. from East
Section Line
Section Line
Sep 11 OU 10:17a U i u i s t ari of Water Resourc 303-65B-0578
�_2
r ti
4 4 COLORADO DIVISION OF WATER RESOURCES
DEPARTMENT OF NATURAL RESOURCES
013 MERMAN ST" RM. 818, DENVER CO 80203
phone - it: (303) 8664881 maim 1303) 8664581
finEfreekiC
-Rua 970 acemiticie isoe ocazi
RESIDENTIAL t V aor WaterWellPermitApplication
to s , .. - }form Mist Et bbeic ink or
LdhaAPPUCANT INFORMATION
lea M wan
,eare n_L
i
Z. Tjcivitson
7%
Talons rAni..igalli.....• 4(5
1)
la TYPE:OF APPLICATION (chock a cable Wes))
roe&
CI Como new well
Repine godsting
cionge4Wourvel aquifer
weE Otheis
3. REFER TO Wm Melts
CI Use existing well
C Change /Income
piReepracationsissimaio
War sort tateS
a�N
4ais 461•58jaas,a-
lionitorheaC
14414
Wei uome et
4. LOCATIONOF WELL
Chartariquarter
Ata
6• OF ' taaerdtiszje _
�'iauaetions ita daGmAisa fiaida4for lieu nu may gusty a-
l7 A. Oar household use M one sinter dwe�nng
)(quo omit use)
IL prd�uy household teaks I to 3 dnpley
(1( dYlflirtlgt:dwelling
Noma gazdenitawn on, not to
41( ens Waited Ds.t9,
DMantesatic aims!wateiing .
men
.
. animanatabile �, at Liana tan. B.
DATA
Owissigni gpindges ups ASS trassainialnialima
7ontsp 1M Or$
D
Distance Of Weaam . rr.,t
s� r,tintifm O s //1)trot � Q yv
«�. ir.ffZw+e aweadios N .00rasr+d
Rain £cr
D
Iltbudia
uw5,53
�e
maw
I
EL TYPE OrariEstoarnm. SEWAGE SYSTEM
Septic tink/ absorption leach
Central system
vault
Utiation own. to be boded to:
Ci Other
-I
S.PROPOSED .DRS,:E
F
A.
One
10. SIGNATURE of amitairrtis) or authorized agent
F* dupleara was eity stwin end Scion inn old w1 w now vat
feet [ direction
The making of false statements hetein constitutes parjury
in the second degreei which is punishable as a classI misv
deinainor pursuant to CA& 24-4-104413lialt I have lead
the 5Lasns.ts hemline know contents "herad and state
that they we 1 -41.m ' �., ,,,,� •+ -.
CT Otter LOCAnap
A. Yes son clock one 14 ithe folowbg
�7 c m: Name.
Lot no& Block. no.
C' County exemption (munch copy of county want A.
Nanerinoa:Tract no.
OMining claim winch ropy of ciotd or surnyi
Narnetn03
Mw Other (Math leggy dintaitifion m app
imat STATE PARCE
C, fameu.Una
Th
you diet owner of this property
YES NO tttnow sere i i i .
•
r J
API
Os
9
ONAL INFORMATION
USGISirio isms
�-R
office Usc Orgy 1111S" -AsoED
—
Dl
Invoice I 466342 CC .62
9111/09 "' 11143:22 All
LAS Cashier ID: 11WD
WR MAMYLA E1 !
4
E. WM this be the only well on INs Vaal
EXEMPT WELL DATA SHEET - DENVER BASIN, COLON
APPLICANT: JOHNSON` RECEIPT NO. 466342
LOCATION: 821/4 OF NE1/4 OF SEC. 30, T.3NT, , R.65W. (2300 NSL, 100 ESL)
PROPOSED AQUIFER; .RAMIE -FOX -TILLS
SURFACE ELEVATION: 4925 NUMBER OF ACRES IN TRACT; 20
IS PROPERTY WITHIN SERVICE BOUNDARIES OF MITI" I IPALI TY S. E .5 CONSENT MAPS? I
IF SUBDIVISION TS UNDER AUGMENTATION PLAN/ CASE NO. I
IF SUBDIVISION WAS RECOMMENDED FOR APPROVAL BY THE WATER MANAGEMENT BRANCH,
INFORMATION ON SUBDIVISION OR TRACT OF LA /SPECIAL RESTRICTIONS:
eva:
AQUI FER
— — — a .. a a
UPPER DAWSON
LOWER DA ON
DENVER
UPPER ARAPAHOE
LOWER ARAPAHOE
* AMIE- FOX HILLS
ELEVATION DEPTH TO ANNUAL
��+{�
NET w ! r tr w n - - - - - - - .. APPROP SJi STK
BUT. TOP SAND BOT . TOP A- F
— a — —
— — —
— 1r -
a id — —
a a a —
-
ar• w- — a
— — — —
- — —' —
.r a a —
..
SSSS
S
S SSS
-
•�� an
— al Iii a
4295 4513 172 (Z6 6 312 5.160
note: E indicates location is at aquifer boundary and values may be t
* indicates the proposed aquifer.
Tr "OW I
— a —
L a
W a 1
All values are interpolated from the Sja,5 data base assembled in Noun
Scanning Cover Sheet
for
Septic Permits
Permit #
Permit Type:
619760220
Health ! ENS History / ENS Conversion History
Situs Street Address 13551 CR 39
Situs City, State, Zip
Sec/Town/Range: 30 -03N -65W
Parcel # (12 digits) 121330000008-84956886
Owner Full Name: PECK JOE
Owner Address: 2051 WCR 29
PLATTEVILLE,CO 80651
Contact Name:
Contact Address:
Application Status: F/na/ed
Application Date: 03/11/1996
r
Owner Phone #: 303 6591202
Contact Phone#
Information above has been Verified in Accela by employee noted below
X
February 13, 2009
Processed by: Date
Report ID: EHS00024v003
Print Date -Time: 2/13/2009 11:46:2 3AM
Page 1 of 1
Sr- )
at
New Owr%er: Toe Peck
WELD COUNTY HEALTH DEPARTMENT
1516 Hospital Road
• Greeley, Colorado PERMIT N
Ph. 353-0540
Application for permit to Install, Construct, an Individual Sewage Disposal S stem,
tit)/74I in 1 rWC tt ,+$3e13oa
Owner Address Phone
Direction to site: Hwy
m i{
ce-hr,
Legal Description: Ptn
Rd.
Kit/ .312,
RDOZ2O
O ,•c)0
N ml., ml., mi., W mi. Plate
� -•�.. err . \3fli3S5I 9.
Sec.2! , T { I, R( -SW Subdiv. Lot Bik
i
General Information
i1/42
No. Bedrooms i No. Persons
No. Baths
Size of Lot
H2O supply wegive I if well depth) 360 t
4
New Home/ Mobile Home / Modular Aden
Q
Basement Plumbing
gi a 6
AA,
ciikae
'Type of sewa g disposal requested:
Septic tank Privy Other
Dept. Use Only
Pere. Rate (Avg. of 3) / 'f •c. �
Soil Type L514-4
H20 Table Depth a>
Lot Grade ac- jQ �o
Requires Engineer Design Yes
be
If yes — reason
Comments:
,
Septic Tank
Other
Installation Instructions: (Minimum Requirements)
4000 Gals.
.
Special Instructions
f
e
s afir st mod'
fa A cd,
Absorption Trenches 6270 Sq. Ft.
or
Seepage bed Sq. Ft.
ear atehlaAd
This system will be constructed on installed in accordance with the above specifications
yarding individual sewage disposal systems in Weld County, Colorado
This permit shall expire at the same time as the building permit, or, if no buildil permit is issued, the perrnit
shall expire -F20 days after its issuance, if construction has not been comm
/�, , :�i ,,lei ..y _� fj. sj3j -
7 4.
Date: J, �✓\ Al %'-1 SI , yr hw.
9
Owner :
..44
a
and
regulations
Applicant:
The plans and specifications as shown are approved pending payment of permit fee.
Date:7/(z.
Sanitarian ..rarteab 37'
The above system inspected and found to comply with plan and description.
011/4,.754.gbf1/4)
Systems Contractor
Engineer Review:
Ri'rr"
ifFssizerytAr
D a to :
Sanitarian:
aLtit.
re -
Permit Fee: $ ., .
Received by- ._1, _ AU,
(Date)
P:67/Cit
v
Dote:
Signature)
m.,,(19,1 , - / 9
7e
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