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HomeMy WebLinkAbout20170397.tiffBOARD OF DIRECTORS CHARLES ACHZIGER GENE STILLE GARY SIMPSON TODD BEAN ROBERT ARNBRECHT November 7, 2016 William N. & Rackel Ward 35640 WCR 43 Eaton, CO 80615 NORTH WELD COUNTY WATER DISTRICT 32825 CR 39 • LUCERNE , CO 80646 RICK PICKARD, DISTRICT MANAGER P.O. BOX 56 • BUS: (970) 356-3020 • FAX: (970) 395-0997 • EMAIL: A ';i=r RE: Meter Number 182 002, Located at 35640 WCR 43, Eaton. Owner: Willian N. & Rackel Ward To Whom It May Concern: North Weld County Water District provides domestic water service to the property located at 35640 WCR 43, Eaton. The current owners of the property are Willian N. & Rackel Ward, The current service provides a 3/4" meter with Water Allocation and Plant investment Allocation of 1 which yields 228,000 gallons per year without surcharge rates. Surcharge rates are detailed below. The District has reviewed the Owner's request for a dog boarding kennel with capacity for up to 30 dogs and up to 3 part time employees and have no conflict with this request. Water tap/service is placed on the physical property, defined by a legal description. In case of a Recorded Exemption, the water tap shall only serve the parcel that the water tap is located on. Service shall NOT cross the legal description of one parcel to serve the other parcel, unless an easement has been recorded for the water service and has been approved by the District. The District guarantees treatment and delivery of water purchased. All water that is delivered with surcharge is subject to water availability. Water purchased through the District shall be 70% delivery of an Acre -Foot of water (228,000 gallons), if the allotment for Colorado -Big Thompson (CBT) project water, which is determined by the Northern Colorado Water Conservancy District, is 50% or greater. North Weld County Water District will restrict the delivery as necessary when the CBT allotment is less than 50%. A portion of the Raw Water Fee is utilized by the District to construct storage reservoirs. The Plant Investment Fee pays for the infrastructure required to deliver 1 AFU (228,000 gallons). If usage exceeds the number of Plant investments that were purchased, an additional Plant investment Surcharge will be applied to your account. Plant investments may be purchased to increase the amount of water to be delivered and avoid the Plant Investment Surcharge. Refer to table below for current Plant Investment Surcharge schedule. Water Surcharfe Surcharge will be assessed when an account's year to date usage exceeds their annual allotment. Currently surcharge is $2.00 per 1,000 gallons. This fee is to recover the District's cost to obtain additional water rights for delivery. All water that is delivered with surcharge is subject to water availability. Plant Investment Surcharge When an account's year to date usage exceeds their Plant Investment Allotment (# of Equivalent Taps x 228,000 gallons), a surcharge will be assessed. The transfer of additional water will not remove this charge. Additional Plant Investments must be purchased to increase the allotment and reduce the Plant Investment Surcharges, 0 to 456,000 gallons above the Plant Investment Allotment (228,000 gallons) $3.95 per 1,000 gallons More than 456,000 gallons above the Plant Investment Allotment $1.95 per 1,000 gallons Respectfully, r Leann Koons Office Assistant NORTH WELD COUNTY WATER DISTRICT P.O. BOX 56 32825 CR 39 LUCERNE, CO 80646 PHONE: (970) 356-3020 • FAX: (970) 395-0997 • E-MAIL: water@nwcwd,org Board of Directors: Charles Achziger, Gene Stille, Robert Arnbrecht, Todd Bean, Gary Simpson Manager: Rick Pickard ACCOUNT NUMBER NAME AND SERVICE ADDRESS BILLING PERIOD WILLIAM N. & RACKEL WARD 182002 35640 CR 43 06/21/2016-07/20/2016 EATON, CO 80615 8 Water Class P (KGal) 70 % of 1.000 Acre Foot 228 Transferred Water 0 Allocation Adjustment 0 Less YTD Usage 33 Remaining Water Allocation 195 Plant Investment Class 70 9 of 1.000 Acre Foot 228 Less YTD Usage 33 Remaining PI Allocation 195 Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul District E -Newsletters enroll at www.nwcwd.org Prey. Read Curr. Read Usage Unit Amount Previous Balance 18.30 07/12/2016 Payment - Unknown -19.30 07/20/2016 Standard - Full 170 174 4 kgal 18.30 07/12/2016 Convenience Fee - Credit Card Payment 1.00 Current Amount 19.30 Total Amount Due 18.30 DETACH HERE NORTH WELD COUNTY WATER DISTRICT P.O. BOX 56 LUCERNE, CO 80646 PHONE: (970) 356-3020 • FAX: (970) 395-0997 • E-MAIL: water@nwcwd.org Any payment received after the 15th of the month may not show on this billing. Please note that all accounts are due by the 15th of the month. Return this stub with your payment Thank you. ACCOUNT NUMBER SERVICE ADDRESS AMOUNT DUE BY: 08/1 512 0 1 6 AMOUNT PAID 182002 35640 CR 43 EATON, CO 80615 $18.30 I IIulIuIIII !III IlI I II,I I„III.II !III I.IlulI I II 111II IIIIII IIIIIuI II AUTO**SCH 5 -DIGIT 80632 WILLIAM N. & RACKEL WARD 35640 COUNTY ROAD 43 EATON CO 80615-9205 2>1455 II III.II'II'IIIIIIIIIIIIII.IIIIIII,I IIIIII.I.IIuIIIIIIIIII.JIIII NORTH WELD COUNTY WATER DISTRICT P.O. BOX 778 Gretna, NE 68028-0778 000182002000182002000001830 Architecture Structural Geotechnical Job No. 155450 November 11, 2016 Bill Ward 35640 WCR 43 Eaton, CO 80615 Attn: Bill Ward Re: OWTS Evaluation 35640 WCR 43 Weld County, Colorado Dear Bill: RMG ROCKY MOUNTAIN GROUP Materials Testing Forensic Civil/Planning RMG — Rocky Mountain Group has completed the evaluation of the existing Onsite Wastewater Treatment System (OWTS) for use with 3 part time employees. The initial installed records from Weld County Department of Public Health and Environment for G19790090 show the septic tank to be 1250 gallons and the absorption bed to be 1080 square feet. A repair permit was obtained in 1995 under permit number G-950008 showing the 1250 gallon two compartment tank with an absorption bed containing 1272 square feet. See attached reports. RMG evaluated the house as a four bedroom house and included 3 day workers as full time employees. The workers are proposed to be part time. The daily flow was determined to be 570 gallons per day using the current code. The on -site soil Long Term Absorption Rate (LTAR) of 0.80 was used for the sand consisting of a percolation rate of 6.1 minutes per inch as shown on the Weld County records. This would require a septic tank with a 1250 gallon capacity and 855 square feet of rock and pipe absorption bed. See attached calculations. Please note both the size of the septic tank and the absorption field are over sized for the proposed use. Therefore, this system is capable of handling the proposed use. Southern Office: Colorado Springs, CO 80918 719.548.0600 Central Office: Englewood, CO 80112 303,688.9475 Northern Office: Evans, CO 80620 970.330.1071 www.rmeenelneers.com Monument: 719.488.2145 Woodland Park: 719.687.6077 Erbil/Kurdistan Iraq: 0750 192 99 44 35640 WCR 43 Weld County, Colorado I hope this provides the information you have requested. Should you have questions, please feel free to contact our office. Cordially, Thomas M. Cope, P.E. Sr. Geotechnical Engineer I�Qi' Mountain Group 2 Job No. 155450 1601 37th ST. • EVANS, COLORADO 80620 • 970-330-1071 • FAX 970-330-1252 PROPOSED ESTIMATED CALCULATIONS ON -SITE WASTEWATER TREATMENT SYSTEM DESIGN FLOW 35640 WCR 43 4 Bedroom house = 525 gpd 3 day workers = 3 x 15 = 45 gpd Total 570 gpd Table 30-6-1 Table 30-6-2 SEPTIC TANKS 48 hour detention = 1140 gallons INSTALLED: 1250 Gallon Tank OK ABSORPTION BED Soil Treatment Area (STA) Required = Design Flow (gpd) Soil Type = 1 LTAR (gpd/sf) LTAR=0.8 Table 30-10-1 = 570 0.80 Required Area = 712.5 sq. ft. Gravity - Bed x 1.2 Table 30-10-2 Adjusted Required Area Trench with Chambers INSTALLED = 855 sq. ft. = 1272 sq. ft. OK Scanning Cover Sheet for Septic Permits Permit # Permit Type: G19790090. Health / EHS History / EHS Conversion History Situs Street Address 35640 CR 43 Situs City, State, Zip Sec/Town/Range: 03 -06N -65W Parcel # (12 digits) 080303200001-R1365802 Owner Full Name: • GILBAUGH IVAN Owner Address: 1312 9TH. AVE GREELEY,CO 80631 Contact Name: Contact Address: Application Status: Finaled Application Date: 03/11/1996 ' Owner Phone #: 303 3527037 Contact Phone# Information above has been Verified in Accela by employee noted below January 23, 2009 Processed by: Date Report ID: EHS00024v003 Page 1 of 1 Print Date -Time: 1/23/2009 2:42:46PM L of • WELD COUNTY HEALTH DEPARTMENT 1516 Hospital Road Greeley, Colorado PH. 353-O540 Permit N. 90-7g Application for permit to install, construct,.an Individual Sewage Disposal System. Owner r(i'cl 1 t'71 /,hra O(iA Address/3/a -61Jde/C• y Directions to site: Hwy -1 Rd. N mi, E mi, S ml,'W mi 3 ( AO ak f 3 Legal Description: Ptn. Neti,Vd Sec. ;9 ,T lrt N, R 1 W, Sub. Lot Elk [General Information No. Bedrooms 4( No. Persons 6 No. Baths .'f2. Basement Plumbing A/o Size of Lot r7- PTeS H2O supply (If 'Well give depth) A/,still Weld New Home Mobile Home Modular_ Add'n Type of sewage disposal requested: � 1Y1 f/e ffif? Septic tank/".' Privy Other ` De t. Use Oni Perc rate (avg, of 3 Soil Type alik, H2O Table Depth _jp" Lot Grade .r.„307# Engineer Design Yes . Na If YES -reason: Comments: ( \ This is to certify that the system is NOT within 400 ft. of a public seRaertr- ti•-.,,• - installation instructions: Minimum Requirements) 1 Septic Tank 1256 Gals. Absorption Trenches War V Sq. Pt. Other or Special Instructions Seepage Bed % 0 6 0 Sq. Ft. Syria**. ria**. 0%44 4 ' fad wf' ful441 I _. This system will be constructed ind instal3_ed in accordance with the above specifications and regulations regarding individual sewage disposal systems in Weld County, Colorado. 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 constructi9n has not been commenced. L1 r Date: {- J Applicant: The plena and specifications as shown are approved pending payme em of it fee. Date: 4- i Sanitarian:i_ The above system inspe tad and found to comply with plan and d -s r pti.n� Systems Contractor. Date: —' Engineer Review: (Date) I't•rmtt Fee: Received by.:' J Sanitarian: (Signature) r, r Date: // ,•{,' , f , /r2'/ / / + y y 1 U6 SEW 6E :tf !:.t:'t.=sir'1L., SYSTEM FERKI'i' Vi1 ^'a--Y.'300oB WELD COUNTY HE rL.'1H DEPARTMENT EN.:'xr-fOrNMENTY i_.. HEAT.:TH SERVICES X. _, ,..,.,F :. #n•�J.r :ie:;'i'!•d �'-rvi=;�li-l�� �:�.�C?r.� "s!'il::i�'C_ .`Y�,, COt:.`i� .��}�'�'ti�353-0635 EXT=25 kEPAIR PERMI L'WNER HOWL=,, r ANDA1.-#,-. R. 1DI REBs 640 WCR 43 PH 003) 4:'4—.2s t:() ,,ADDRES2 oF I'''F Or sED 4,wYSVEN 35640 NCR 43 .1,•F t3A TES( 1.1iF; 'i[::3N (.) SITEN • iti N tt SEC N TNF 6 Haar. 6 1 D V C' Yr LOT 0 RLor.K 0 FILING f. ) :�C�d.7xl.i r :1:,SIL.i:riti� • i_ i-T6 - TYpF=u RESIDENTIAL HOUSE:: E R.BATHROOMS OT SIZE = 0 } r Ehi',�IC.",r r` F''E SCJ1�a�r ! .�h`t�s. `� Y3C:FiI: BEDROOMS 4 BASEMENT PLUMBING NO WATER SUF'RL.Y. Nwr;;Wn Appi.-It`.(1" 100..' FEE $ 54C).O0 RE :';. BY CHPD YOUNG DATE. 0:014/95 SIGNED). Irf E`INEHAWF .r,-, r: rV 01/11/95 F= EF coL! TIoN RATE ti .1 MIN PER INCH LIMITING ZONE B FEET E-i SOIL TYPE=: SUITABLE PERCENT GROUND SLOPE t:}% DIRECTION N 'HEOC!IkES E.NIMNEEN D.€"';G1G I• NO IN 100 YEAR FLOOD F I.r N ZONE NO THE . f - +'d I v "�� r';+.._'.f', J r•'rd JD THE ON —SITE ;-�C1i L I-' E,_I:,sr�l.li. ( I U tN rr,�rryl ti r•,�: r��F:�1=�.1�,,,'�'r�:ic_r!'�.: _�r;!���,-,'c� THE FOL_L_bWI'I f(�.F 7'{'_lr�!].MUM ..',NS I ( L.LAr T IOl.{ t F=•!<:CI;-:Et1A `• IONS ME RECAJI EDL. 1:: EPTIC TAW' stir; 1250 G LL,.UNS AFssURPT'1. ON TRENCH 5B SO. f s f"l R AB soHF T:r:r 1N ]Y :D 760 SO.• F „s . ' i i Rbz?r rr.oN, ,"!-HM PERMIT IS SUBJECT {.r,_f THE FOLLOWING NG ADDITIONAL TERMS AND co!Nn.I1TIOW THIS PERMIT. T $ '" a t 'l W CO IS. -'R 1 IoN! TO v" 4= ` 'tii�l I GRANTED �CE='111='Clr;.{};.rl._y -{�' ALLOW. i�:.•>'s -il,C''T....]r : � i_;CJIYf'1 _I'6C{:TH:Is pERr`r::T NAY SE a �rBY " WELD COUNTY s'r 'F`iL_Tk DEPARTMENT FOR REASONS SET ! ri1Y REVOKED cm SUSPENDED 'r: E THE i nI:(-;"!„1 iii THE WELD "oc:11.1N y1' INDIVIDUAL. SEHA€ E D SPDE(a!-_ SYSTEM REGULATIONS INCLUDING r iILuRE To i1EE1 ANY TERM OR CONDITION IMPOSED THEREON DURING 'r EMF'E`RARY OR F''INAL. ,'DEPARTMENT E 'kiiV'lr,..� THf. ISSUANCE E OF ' HIS PERMIT DOES NOT- CONSTITUTE ASSUMPTION BY THE DEI, A l rr fEN'r 1.`r a t ::s a APL ,� "S+ R S•' �.. ;f OF THE �� �' ', 's ." �'"'°'-'_SJYEE::�� OP L_'fFs ?Ii_J:"1 s FOR THE FAILURE .1F�, .T#'+rf�13i_:i�i#_1�1(_';rsi� SENA3!', DmpOSAL SY;_FTE!'4. WIels1'! ];i; JCaJ:s!a 0i,;!3/95 { Nv'wr o N ENTPL. sPECIALIT.J ..I.�,� Y IS NUT TRANSFERABLE A � ,y SHA I,;1EODM VEID Ir•' SYS'r Em :CJf�.!!::''_JL CT r° N HAS -1.#.�s PERMIT ,� : �r�" AND �..,�... ...-.: f' . {_ NoT CCi1"IMENCE:D- NiI\I ONE: YEAR OF ITS IssLJANCE:. g:rE-,,ORE'. IN:ss".1'.€i>.rs t:Iis.it?i_. APPROVAL L:iF_ THIS P'ERI„1IT THE WELD COUNTY HEALTH IDr P•Ar-;•'•r•- EN_}.. RESERVES THE RIGHT To IMPOSE , .. NDITI -, t , - MEET .., 1 t R :Bi • r.,t.1 S ON A �.r ,Yn TERMS AND �.r.";-1;.,s s l[_t#'v;~e f�.�-r�:LAIY:;;t.I7 � (.�,>.. F�' �t:.s_.t i:..r-, J.t:�i�l�! r_a J CONTINUING � r',--• •E FINAL. n .E�.WUT APPROVAL C CONTINGENT ,.,.� Ty..r� FI\ Y F':' "I t F t- _,.,r ;:�i.;'Y, ;�..,�10-til_. €-�.'._ ,I „� k , !. 1:.:i s..14 T,.� ,..Ir='f.sl}. THE lr.:_ FINAL I #F�.t.,. 1;1�rs-t cL;_s �$. Ai,... THE s,..s_.•.2_.. ,. T HE COUNTY L,+ E.. -,' �,,1 Y p SYSTEM r::: SY 7 WELD •._T�._r_JP#•i i' :�^:6 i._.!.• :)�!-��4F� s I it -;ti': . SYSTEM EF:NC:3'FAir;'_ 5' fKF.;:;,,UDyA'_. �' ' E OF SYSTEM INSTALLED E:NVIF`: NMIENTAL c F'EE:E•€..IE T THE ]:SE3MA:rte: CF ITEM rERNIT DOES tiC-.T. I,Yc COMPLIANCE wi"r'H 0 HE'=; STATq, COUNTY OR ,__r:1CYAI_ REGULATORY 0tH 'SL IL...OING !: E'.-r:'a:sE:::r lt' N' ;:i,, NOR s' - ALL X' A:_.. 77J N,R7IrY rt.ttj . a_ - . r..,..,. Cj WILL . i J.L I U "�Y C r E E— TE i t, i••'\i AND :.�ltl��s,.ls':i_.1�• {:i��_. r r:.."i G.a_..x._ #_)F''�::�i�� .E. �_: ;..r:1���s� �...If t11�',;!_:: ,d .. s•*r". .._:#:a_.r-�Lil_..., _. rl s r•.« ,..:JL:r�c r . sh.:..` { .( -1, - :.} F 'B`1- N -T APr.C _ w -+ _'r.'I-.._.I�' ..:}L� .,.i. .�._ .F.'. �.Y f,•rrry' .7I...., i._r i('�:.- 1-�#_. �lis'L..r--'- I-,�_ 14,"._ f..�}�.3 rr._ •r,. Jx� . _ .-s Y.41..L-. .- s ENE ,T r07.: THE r2lJ'ri:'-"".'a : ; :+ 1- 'I (C F1!-.IE-:'i: \ f u jr' _ Al' ,,....I J.! f._I.;.. IS,••`f I ENEE OF -,CA O 'C tst ,.„ PER ,,.r ,r-! t -.-� ,yr.• r', ,M �ns_,C••..0 r- t-- L.'t_. L ,_(' � 1••. fir,. / rf.:�;fv1.:.. 'l_1r, ..,.,,,. 1 ., ,.. ..... ,._ ..,.._ .., �I: '.•r t,1 X? _ ..} "•I, /a,.,{'r': fJtr�ti'• 61_ .v ff o d Lottl , Zit Yq3 B4O1 Iz7i 1 S .I.t O. SYSTEM a }{_ :r NO .,C l5O'.1OE} INDIVIDUAL �il_::�ri=i�I::= DISPOSAL 3s?�!._ ;7YLa �#�hs F ..:F'�:I'�la.]'" . If,. �' OWNER Ht".)1 l :•9 1:tif• NkDAL_L_, R. WELD OOLINTHEALTH DEPARTMENT ENVIRONMENTAL HEAL] H SERVICES 1717 !.6TH AVENUE COUR , L7REE-L..EY CO 130631 1 . 5ter--i 6^"5 ExT.2225 ,.. .25 R''T&E'AIl'i: F'E•- FCI II -1. ADDRESS ..::640 WOR 4: PH (03) 454-2960 60 EATON CO S0615 ADDRESS S OF PROPOSED SYSTEM 35640 w. R 43 EATON CO BC061 Lac IL .ipg::RIPT' TON OF SITE.: NW4• SEC 'r T WP 6 I=CI\IO 65 r: IJi«'�I?]`VI JrE=:N^ LOT 0 EL O 1< 0 FILING 0 1_ISF: TYPE . RESIDENTIAL HOUSE S IS 6 BATHROOMS 12:5 LOT SIZE O0 ACRES SrFlV1:1=:L=;�� PERSONS '•: BEDROOMS fry, BASEMENT PLUMBING NO WATER SUPPLY NWCWD c 'F• LI ATToJ'd'•. FF F $240,00 Fl ₹ p, BY C;F4Ab YOUNG DATE 01,111/ 95 SIGNED BY B1JCK<: RINE_E••IAR"1 DATE 01/11/(<<Ti . a_ PE CJIL rIC3N FATE'.:. Lai/IL MIN PER INCH LIMITING ZONE ).10_, FEET tOI:L TYPE czi,ajtGcw Ask_ ' PERCENT GROUND SLOPE Atii... DIRECTION __ , V;E()L.IRE' 3 ENLIlwai'.:ICFR 1.71..SION IN 100 YEAR FLOOD PLAIN ZONE ..4_.... FROM THE APPOCATION INFORMATION SUPPLIED ANL THE ON -SITE SOIL. PERCOLATION ION DATA f!'IL FVL.L.OWTNc rammLIh1 INST'AL...L_.AT"TLN b'J 1IF=:ECATIONS ARE REnums,llr, S'_F"TID TANK .i2Sc E 1..LONSt ABSORPTION TRENCH 5:940 _ SO. FT„ ABSORPTION BED 7j.FxO_ :On FT. DI. ADDITION, THIS ,PERMIT .,, .. ? )131.:T2_ :.� r_ , TO -_. � r-I�t_ f FOLLOWING_44[. C �`� ADDITIONAL. E. -TERMS AND THIS F'ER . {.. is GRANTED r TED TEMPORARILY TO ALLOW CONSTRUCTION TO COMMENCE.. THIS PERMIT � E...� r _,.. ,1 I.C . ,.... ,.sf�rlFwF s ..,.�., MAY EE REVOKED OR SUSPENDED s'' • i-11=_ WELD COUNTY HEALTH DEPARTMENT FOR REASONS SET FORTH IN THE WELD COUNTY INDIVIDUAL SEWAGE DISPO='sAL.. SYSTEM REGULATIONS INCLUDING FAA:LI E TO MEET ANY TERM OR CONDITION :1-IPOSED THEREON DURING TEMPORARY OR FINAL APPROVAL..-. THE ISSUANCE OF THIS F'aRMI.T DOES NOT CONSTITUTE ASSUMPTION BY THE O ITS EMPLOYEES -.S ;,_-�- {B IT 1'F T FAILURE O .. D ..1' J Y I DEPARTMENT . F4 .L . s E- �'�F':...i._ ' �; E:: � ,_.lr- �.,. _.. � FOR H. . I••; 11f9� L:.. -t' I••iL S i�!� THE SEIJF)C E !=a'f{'Y{'f:Y{,1{.. stir`STF_4'i lo' 4ti E t ., :E •i:INr• ,- NTAL SPECIALIST DATE: r THIS PERMIT IS NOT' TRANSFERABLE AND SHA1. L. BECOME vOID IF SYSTEM CONSTRUM ION HAS NoT COMMENCED WITHIN ONE YEAR OF 'ITS ISSOANCT,:. BEFORE ISSUING FINAL APPROVAL OF THIS PERMIT THE WELD COUNTY HEALTH DEPARTMENT RESERVES THE RIGHT TO IMPOSE ADDI- TIONAL TERMS AND CONDITIONS REOUIRED T3 MEET OM REGULATIONS ON A CONYINOING BA- SIS. FINAL PERmIT APPROVAL. I.':, CONTINGENT UPON THE FINAL. INSPECTION OF THE COM- PLETED SYSTEM DV THE WELD CCUNT'v HEALTH DEPARTMENT. ""'#R:E3II\IAL_--((::r c. :r'" ...,.. ';'.. rroJCL_') 'v'>C...`..'-- i;H ...IL.j'..,'. i.771w.'•, Tll"' ''.,..',...,, 1( b FOR I :. I I.. LJc•• S.. SEWAGE DISPOSAL YS T iEM NO. G -950005 WELD COUNTY HEALTH DEPARTMENT ENVIRONMENTAL. HEALTH SEFNICES 1517 Igrid AVENUE COUF0- GRE:EEL_'<:Y, CO 506631 :r :-• •- -r•: ..tip,_ ..�-�{�:a._ I:}�-1'n..-.�.�. OWNER HOWE, RAN!Dr LI_,. 'r .. ADDRESS 35640 WCR 43 x:'H (30:3 F3: ll..LL,s5,c}43 EATON CO 90eLd5 ADDRESS DRESS OF PROPOSED SYSTEM 35640 WJC:`R 43 EATON CO 80615 LEGAL rye='cif: RIr ..l:n1 i OF Sal'..1..D4 NW4 SEC , r , ... ,._A '� �, I~.� .. �1 iJt5�' 6 RNG 65 SU DI',1,"s :E'ON: LOT 0 BLOCK 0 FILMS 0 USE TYPE! RE S:l:DENS'1 I! 1... HOUSE E3E::RV=Ss PERSONS 6 BATHROOMS 2,50 LOT SIZE "f,D FiCFsE$ BEDROOMS 4• BASEMENT PL._uMBlI1(} NO WATER SUPPLY NWCWD APPLICAf~1"! A N4OWLEDBE=S THAT THE COMPLETENESS OF THIS APPLICATION IS CONDITIONAL UPON F'Ul=J-i'I-iEl . M NDATURY AND AD DI .ICi1JN_ 'TESTS AND REPORTS AS MAY BE REQUIRED BY 1H[ WELD. COUNTY HEALTH DEPARTMENT TO BE MADE AND F-URNIT :SFW D BY THE APPLICANT. -t:II• BY THE WELD COUNTY HEALTH DEPARTMENT FOR PURPOSES OF 'THL. EVALUATION OF THE APPL_]:cATI(:JN AND THE :Cls*;i ANC;i _ OF THE PEW' I T IS 8L.JBti3EOT TO SUCH TERNS AND CONDITIONS AS DEEMED. NECESSARY TO INSURE COMPLIANCE WITH RULES AND REGULATIONS ADOPTED UNDER - RJ1C.L.E TITLE 25, CRr. 1/97:, AS AMENDED, THE APPLICAN1:' CERTIFIES THAT THE PROPOSED SYSTEM WILL. NOT BE LDCATED WITHIN =!•J0 FI::E1 OF A COMMUNITY SEWAGE SYSTErt THE UNDERSIGNED HE :RL. EA' CERTIFIES THAT ALL STATEMENTS MADE INFORMATION AND -REPORTS ' SUBMITTED HERE W ; H AND REQUIRED . s o BE SUBMITTED BY THE: APPLICANT AF Ey OR WILL BE, F EPRE SE:1'd"I L_ L} TO ;E_:: '11-3E AND CORRECT TO THE T'il'_;-t'T' OFe. NY h'h(iiJ1.EHEE AND E!E:t.:i•.=:'.",,r AND ARE DEF3iLu Jt-:D To 142 HI:LI.ED ON BY THE WELD COUNTY HEALTH DT:PAFCiiA t=I IN E Vf1t_IJA'I i,Jc THE 18AMC ITUR PURPOSES OF' ISSUING THE PETIT APPLIED FOR HERE_ I.N. I O JRTHE:'F UNDER— STAND TF-IAT ANY FALSIFICATION ICA'T'ION OR MISRzEI REI8EN?AI1ON MAY RESULT IN THE DENIAL OF THE APPLICATION OR REVOCATION Dr ANY PEMIT i.t r Cis:: Alk TED BASED U,C7ON 8A1D AF" PLIC{•'iTION AND IN LEGAL ACTION FOR PE RJURy AS PROVIDED BY LAW. 1 AF'PL.,:i.C r ION FEE ;24 „0C; HAD DATE i::(0../1,U95 ../1, ..'�,UDATE 'II�t<.7 O.11l'.IE /AGi NT SIE:R.k101L __..,..__....... VELD CIUNTY HEALTH DEPARTMENT ENVIRONMENTAL PROTECTION SERVICES SITE EVALUATION OWNER: K).4...1-DpfuL APPLICATION NO.: G, S'S x 8 SITE: _35(vc(D u'7 .,ra. PT fdLOYu S 3 --- Tom_ R (r�S DATE: I - i:�j-45 SUBDIVISION: �+ I LT BLK_ FLG ep- PERCOLATION TEST DATA: Start Time; 3soc Hole No. Hole Depth H2o - min. min. 'sue min. min. -min, min, min. It3 Nits 4fha Mrxa C r~_.3 1-a a 3t no 2 r ” s - , }5 -3H 5 5 sc. So (15 $, a • A 5,{p 3 0e� 30 04 kSr �14�c� [�Z+T7 t.pao 3�-a -110 Ind R zi 6[ -: 111211110Pill ME 5 IIIIIII 3 4S Lto �MI � tioQS fit' » piii NNE FIN All measurements in .mm unless otherwise indicated. * - Add H2O Environmental Specialist. PLOT PLAN a min. min. min. THEE tam, cif Total Average Rate SOIL PROFILE Lrk+b {LT1Cow Hello