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Home My WebLink About20180974.tiffPLEASE DETACH AND RETURN BELOW STUB ift?4TH YOUR PAYMENT TO ENSURE OPER CREDIT TQ YOURACCOUNT LONGS PEAK WATER DISTRICT • • • • • + ! • • • • • • • • • • • s • • • • • • * 9875 Vermillion Road * Langmon#,CO 80504 • (303) 776-3847 TEMPEST DONELLY PO BOX 247 MEAD, CO 80542 00170003 1/11/2016 LONGS PEAK WATER DISTRICT • • • • . • • . • • . ! •. 4875 Veemiikiao Read Losgmant,CO 89544 {393)77n-384? TEMPEST DONELLY PO BOX 247 MEAD, CO 80542 AblekINT EWE 1132 HIGHWAY 66 Weld County Environmental Health Services Department 1555 N. 17th Avenue Greeley, CO 80631 Phone: (970) 3046415 Fax: (970) 304-6411 Web: weldhealth.org Septic Statement of Existing Application Number: SE -1600001 App Type: Health\Residential\Statement of Existing\na DAVID HOSKINS FLATIRON MORTGAGE LENDING LLC 12656 WATERSIDE LN LONGMONT, CO 80504 Owner Name: FLATIRON MORTGAGE LENDING LLC Parcel #: 120729000031-R4770986 Legal Desc: 25622C PT W2NW4 29 3 68 BEG 89D47'E 660' FROM NW CUR S1405' S89D47'E 668.8' M/L N1405' N89D47'W 671.26' MIL TO BEG EXC BEG S89D47'E 971.26' FROM NW COR S89D47'E 360' SODO6'W 302.5' N89D47'W 360' NOD06'E 302.5' TO BEG (.25R) Site Address: 1132 HWY 66 WELD, CO 80504 Additional Info: Status: Recorded Applied: 01/13/2016 Work Description: HOUSE App Specific Info: Absorption Bed Size Absorption Trench Size Number of Bedrooms Number of Persons Other Public Water Supply Utility Public Water Supply Public Water Supply Utility Septic Tank Size Tank Material Year Installed UNKN UNKN 2 1 LONGS PEAK WATER Yes Other 1000 CONCRETE UNKN Septic Statement of Existing EHS029 Page 1 of 1 Print Date - Time:1/13/2016 12:38:39PM 1 PARCEL# /12,07-7 PROPERTY OWNER MAILING ADDRESS WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 1555 N. 17TH AVENUE GREELEY, COLORADO 80631 PHONE: (970) 304-6415 FAX: (970) 304-6411 SE # CoCOOOt REPA:R # LOAN # ISDS # ) L90()0 STATEMENT OF EXISTING FOR SEPTIC SYSTEM THIS DOCUMENT IS NOT A SEPTIC PERMIT 2-ci 00003 I LAr-r n, M .14,,+14ce 11 PHONE NO. (72 } 'i 33 S� j e 726 SITE/LOCATION ADDRESS 2 o‘ City City LEGAL DESCRIPTION: T SECTION TOWNSHIP SUBDIVISION �1 f LOT SIZE/ACRES COMMERCIAL: YES/ DESCRIPTION OF BUIL NUMBER OF PERSONS RESIDENTIAL E ` / NO G AND YEAR BUILT BATHROOMS FULL / WATER SUPPLY: PUBLIC PRIVAT OT BLOCK State Zip CD cil,Fil State Zip RANGE Co 16 FILING ex. house, mobile/modular home, shop, office): /9 o NUMBER OF BEDROOMS -2-- 3/4 1/2 Z/A WATER DISTRICT NAME ' Ali` f &e S / NO WELL YES / NO CISTERN YES / NO Permit# _ Circle which applies TIER TIER 2 SYSTEM SIZE AND STRUCTION: /� SEPTIC TANK: Septic tank material is constructed of 24,4.1/4ri-z and has A915O gallons capacity. FIELD: Trench,, �C,,, square feet or Bed TIER 3 square feet YEAR INSTALLEDOJA, ,1—.1 Provide a drawing indicating dimensions and location of the existing septic system, including distances from property lines, easements, dwelling, other lot improvements, water line, water well, surface water features such as ponds, irrigation ditches, etc. The undersigned property owner hereby certifies that the above described septic system is in fact installed, as described, and exists at this time on the parcel identified by the above legal description. I further understand that any falsification or misrepresentation may result in invalid results in determining compliance with current regulations based upon this information hereby submitted and in legal action for perjury as provided by law. DA day of 1a//l t,JCt r y Subscribed and sworn to before me this _ by O r, Cbk Witness my hand and official seal. My commissi$n expires: DATE STATEMENT OF EXISTING ACCEPTED Bl�' NOT ,201:, 910 fl1radV S3 lIdx3 NOISSWWIQOAw 9£0£t01,t►OOZ 01 AZIVJ.ON 01M10-103 -40 a LYJ.E F l9ftd AtIV.ON 11,1I30 d V[A1IS OFF CE TECHNICIAN DATE .l.t1T''.1i�J �i A3V►J1 .7i,ifll}9 VT4Aro,! OO a.+ro3 O 31 -ATM ae.)S r0w.\GS Oi v';4A1 0.4 stet ,!T 3f9A 2333fgx3 '401?,P41000 11.4 (fiii*q\ 1110€. COLORADO DEPARTMENT OF PLANNING SERVICES 1555 N 17th AVE GREELEY, CO 80631 PHONE: (970) 353-6100, Ext. 3540 FAX: (970) 304-6498 AUTHORIZATION FORM Dave Hoskins represent (Agent/Apphcant) located at 1132 HWY 66, Longmont, CO 80504 Flatiron Mortgage Lending, LLCfor the property (Owner) LEGAL DESCRIPTION; SEC 29 TWN 3 RNG 68 SUBDIVISION NAME: NIA LOT BLK I can be contacted at the following phone #'s; Home 720.933.5698 Work _ Fax # 720.933.5698 The property owner can be contacted at the following phone #'s Home 720.933.5698 Work 720.933.5698 Fax # Correspondence mailed to (only one): O Agent/Applicant DATE 11/12/15 OWNER'S SIGNATURE x Property Owner PLEASE DRAW A DETAILED MAP TO YOUR PROPERTY with directions from the nearest two county roads. If the property is in a security or gated area, please indicate the code or other instructions for entry on the map. N 1 • Label all roads • Label subject property with address • Indicate nearby landmarks, such as businesses, structures, natural features 7 i i Health Administration Vital Records Tele: 970.304.6410 Fax: 970.304.6412 DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 1555 N. 17th Avenue Greeley, CO 8O631 Public Health & Clinical Services Tele: 970.304.6420 Fax: 970.304.6416 Web: weldhealth.org Environmental Health Services Tele: 970.304.6415 Fax: 970.304.6411 Communication, Education & Planning Tele: 970.304.6470 Fax: 970,304 6452 Public Health Emergency Preparedness & Response Tele: 970.304.6420 Fax: 970.304.6459 Our vision: Together with the communities we serve, we are working to make Weld County the healthiest place to live, learn, work and play. January 21, 2016 Owner: FLATIRON MORTGAGE LENDING LLC 12656 WATERSIDE LN LONGMONT, CO 805045252 Application Number: ISDS-1600001 Septic Permit Reference Number:SE-1600001 Inspection of final treatment capacity subject to: 2 Bedrooms Site Location: Site Address: 1132 HWY 66 Parcel Number: 120729000031-R4770986 Section/Township/Range: 29 -03N -68W Legal Description: 25622C PT W2NW4 29 3 68 BEG 89D47'E 660' FROM NW COR 51405' 589D47'E 668,8' M/L N1405' N89D47'W 671.26' M/L TO BEG EXC BEG S89D47'E 971.26' FROM NW COR 589D47'E 360' S0D06'W 302.5' N89D47'W 360' N0D06'E 302.5' TO BEG (.25R) On January 18, 2016 an evaluation of the existing individual sewage disposal system was conducted by Nicolas Trautner, an Environmental Specialist of Weld County Environmental Services at the referenced property. It cannot be determined that the existing individual sewage disposal system is of sufficient size and capacity to adequately handle the proposed load. The absorption area was observed and had no evidence of failure. It is advised that the tank risers be brought to grade. 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 the periods of snow cover and high soil saturation may be of questionable value to potential buyers due to adverse conditions. Evaluations based on Statement(s) of Existing (S.O.E.) rely 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, Nicolas Trautner Environmental Health Specialist II Print Date Time: 1/21/2016 8:03:42AM ISDS Approved Letter EHS047 Page 1 of 1 DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 1555 N. 17th Avenue Greeley, CO 80631 Web: weldhealth.org Public Health Health Public Health & Environmental Communication, Emergency Administration Clinical Health Education & Preparedness Vital Records Services Services Planning & Response Tele: 970.304.6410 Tele: 970.304.6420 Tele: 970.304.6415 Tele: 970.304.6470 Tele: 970,304.6420 Fax: 970.304.6412 Fax: 970.304.6416 Fax: 970.304.6411 Fax: 970.304.6452 Fax: 970.304.6459 Our vision: Together with the communities we serve, we are working to make Weld County the healthiest place to live, learn, work and play. January 21, 2016 Owner: FLATIRON MORTGAGE LENDING LLC 12656 WATERSIDE LN LONGMONT, CO 805045252 Application Number: ISDS-1600001 Septic Permit Reference Number:SE-1600001 Inspection of final treatment capacity subject to: 2 Bedrooms Site Location: Site Address: 1132 HWY 66 Parcel Number: 120729000031-R4770986 Section/Township/Range: 29 -03N -68W Legal Description: 25622C PT W2NW4 29 3 68 BEG 89047'E 660' FROM NW COR 51405' 589D47'E 668.8' MIL N1405' N89D47'W 671.26' M/L TO BEG EXC BEG S89D47'E 971.26' FROM NW COR S89D47'E 360' SOD06'W 302.5' N89D47'W 360' NOD06'E 302.5' TO BEG (.25R) On January 18, 2015 an evaluation of the existing individual sewage disposal system was conducted by Nicolas Trautner, an Environmental Specialist of Weld County Environmental Services at the referenced property. It cannot be determined that the existing individual sewage disposal system is of sufficient size and capacity to adequately handle the proposed load. The absorption area was observed and had no evidence of failure. It is advised that the tank risers be brought to grade. 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 the periods of snow cover and high soil saturation may be of questionable value to potential buyers due to adverse conditions. Evaluations based on Statement(s) of Existing (S.O.E.) rely 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, /I i Nicolas Trautner Environmental Health Specialist Print Date Time: 1/21/2016 8:03:42AM ISDS Approved Letter EHSO47 Page 1 of 1 Weld County Environmental Health Services Department 1555 N. 17th Avenue Greeley, CO 80631 Phone: (970) 304-6415 Fax: (970) 304-6411 Web: weldhealth.org ISDS Field Inspection Form Application Number: ISDS-1600001 FLATIRON MORTGAGE LENDING LLC Owner Name: Site Address: App Type: Parcel #: Legal Desc: EHS ISDS Reseach: Septic Search Septic Permit Recorded Septic Permit Reference Number Septic Tank Size Absorption Trench Size Absorption Bed Size Year Installed Public Water Supply Public Water Supply Utility Other Public Water Supply Utility 1132 HWY 66 WELD, CO 80504 Health\Residential\ISDS1na DAVID HOSKINS FLATIRON MORTGAGE LENDING LLC 12656 WATERSIDE LN LONGMONT, CO 805045252 120729000031-R4770986 25622C PT W2NW4 29 3 68 BEG 89D47'E 660' FROM NW COR S1405' S89D47'E 668.8' MIL N1405' N89D47'W 671.26' M/L TO BEG EXC BEG S89D47'E 971.26' FROM NW COR S89D47'E 360' SOD06'b 302.5' N89D47'W 360' NOD06'E 302.5' TO BEG (.25R) Application Status: Applied Applied Date: 01/13/2016 Intake Person: MSWAIN Yes Yes SE -1600001 1000 UNKN UNKN UNKN Yes Other LONGS PEAK WATER EHS ISDS Currant Flow: Current Flow Description Current Flow Number of Persons Current Flow Number of Bedrooms Current Flow Basement Plumbing Current Flow Full Bathrooms Current Flow 3/4 Bathrooms Current Flow 1/2 Bathrooms HOUSE 1 2 No 1 0 0 EHS ISDS Research Chances: Additions Description RE ISDS Field Inspection Form EHS046 Print Date Time. 1/13/2016 12.39:04PM Page 1 of 2 Application Number: ISDS-1600001 Owner Name: FLATIRON MORTGAGE LENDING LLC Site Address: 1132 HWY 66 WELD, CO 80504 )!HS ISDS Proposed Total: Proposed Total Number of Persons Proposed Total Number of Bedrooms Proposed Basement Plumbing Proposed Total Full Bathrooms Proposed Total 3/4 Bathrooms Proposed Total 1/2 Bathrooms Addition Comments 1 2 No 1 0 0 HOUSE The existing septic system is REQUIRED / RECOMMENDED to have the following alterations made to accomodate th proposed alterations to the structure(s) served. NOTICE This permit is granted temporarily to allow construction to commence. This permit may be revoked or suspended by the Weld County Department of Public Health and Environment for reasons set forth in the Weld County Individual Sewage Disposal System Regulations including failure to meet any term or condition imposed theron during temporary or final approval. The issuance of this permit does not constitute assumption by the department or its employees of liability for the failure or inadequacy of the sewage disposal system. This permit is non -transferable and non-refundable. Before issuing final approval of this permit 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 is contingent upon the final inspection of the completed system by the Weld County Department of Public Health and Environment. K Environmental Health Specialist Date ISDS Field Inspection Form EHSO46 Page 2 of 2 Print Date Time: 1/13/2016 12:39:04PM OWTS EVALUATION APPLICATION PARCEL NO.: _ 124:).--) 29 0 CAD 03 1 (12 DIGITNUMBBER) LEGAL DESCRIPTION: SECTION TOWNSHIP 3 RANGE 60 ACRES SUBDIVISION Atil- LOT BLOCK FILING _ THIS INFORMATION CAN BE OBTAINED FROM THE ASSESSOR'S OFFICE AT (970) 353-3845 EXT 3650 �} N.;)s NO: ! ( OOOOi I3.`. IT.. RLi VD: RECEIVE!) FEE:_ SITE ADDRESS a et, PROPERTY OWNER: re--AZL)� �. 7-eL (,...64-3,„caf? (�t-- MAILING ADDRESS: (245 6 - i,l, ,5 Co.) CITY ,,36„4,,1- STATE ZIP _ HOME PHONE: ) 933,-5-69.43 WORK PHONE 9v-5-44, FAX (_),A441 - EMAIL ADDRESS: IMA L1Ll. e. ynve_, e.-0 A7 ,� , [may,, APPLICANT NAME: ''"'L` AS %," LIP-- ,p,i:3 - 5/L r. MAILING ADDRESS: CITY STATE ZIP HOME PHONE: ( ) WORK PHONE ( ) _ FAX ( ) EMAIL ADDRESS: DESCRIPTION OF STRUCTURE CURRENT FLOW (House, Modular, Shop, Rec Exempt): f e.,.rS‘24 NUMBER OF PERSONS _ / NUMBER OF BEDROOMS 2--- BASEMENT PLUMBING YES / BATHROOMS: FULL / 3/4 Y2 PUBLIC WATER SUPPLY NO NAME 4,a1,( R.64,„ c..',.��t__ PRIVATE WATER SUPPLY YES / NO WELL /CISTERN PERMIT # PROPOSED CHANGES (House, Modular, Shop, Rec Exempt): NUMBER OF PERSONS NUMBER OF BEDROOMS BASEMENT PLUMBING YES / NO BATHROOMS: FULL PROPOSED TOTAL (House, Modular, Shop, Rec Exempt): NUMBER OF PERSONS ( BATHROOMS: FULL / % St NUMBER OF BEDROOMS 2---- BASEMENT PLUMBING YES /(S `/2 I HEREBY CERTIFY THE ABORMATION IS CORRECT AND ACCURATE TO THE BEST OF MY KJ4OWL DGE: B SIGNATURE OF APPLICAN DATE 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. Company Name: Customer Name: S --u ,~ 54 i . Aioi. 1:44, Address of Pumping: / J L. Pumping Date: / / ' . / 1. Tank Size: /vim ,Y[ Gallons Pumped: /04" f" 1 2. Lift Station: Yes No ✓ If yes, functioning: Yes No 3. Excessive water running back into, tank from field? Yes No dsV Phone number: 36,3-22/ - 7 If yes, estimate in gallons: id 4. Liquid level in tank over inlet line? Yes 5. Tank Constru ion (check one) Concrete i" Metal Brick Cesspool or Seepage Pit Other Plastic or Fiberglass 6. Tank Construction Obs ed: One Compartment Two Compartment 7. Inlet/outlet tees and/or baffles in good condition? Yes /No 8. Filter on outlet cleaned and inspected (if applicable)? Yes No� 9. Access to clean -out 1i within 8 inches of grade? Inlet: Yes No / Outlet: Yes No / 10. 20 ml. plastic replaced and sealed over tank lid (flood plain only)? Yes No_i 11. Tank/lid structurally sound and water tight? Yes /No 12. Obvious cracks/leaks observed? Yes No If yes, explain area: 13. Other conditions noted which may affect proper functioning of system? 14. Reason for Service: Maintenance Real Estate Sale Emergency/Backup Other l i" 15. Notes: PI? VISUAL INSPECTION SNAKING = LIFT PUMP* *ONE YEAR FACTORY WARRANTY ON OH PUMP. WARRANTY DOES NOT INCLUDE LARD -R. CUSTOMER'S SIGNATURE PAYMENT DUE AT TIME OF SERVICE ESTIMATES ARE GOOD FOR 3 MONTHS FROM DATE GIVEN Hello