HomeMy WebLinkAbout20170660.tiffNORTH'
WELD Mil
COUNTY
WATER.
DISTRICT
NORTH WELD COUNTY WATER DISTRI
P.O. BOX 56
32825 CR 39
LUCERNE, COLORADO 80646
PHONE (970) 356-3020 • FAX (970) 395-0997 • E-MAIL: water@
ACCOUNT NUMBER
SERVICE ADDRESS
AMOUNT DUE BY
1195003
37046 NORTHWEST DRIVE
WINDSOR , CO 80550
$ 24
VICKI S. SWENSON
16705 RIST CANYON ROAD
BELLVUE , CO 80512
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not
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ACCOUNT NUMBER
NAME AND SERVICE ADDRESS
BILLINM
1195003
VICKI SWENSON
37046 NORTHWEST DRIVE
WINDSOR , CO 80550
07/24/2014
Previous Balance
08/14/2014 Payment - Electronic
08/22/2014 Standard - Full
Current Amount
Total Amount Due
Prey. Read Curr. Read Usage
170 178 8 k
You are currently paying this account with on --sin
banking — no return envelope will be sent.
District E -Newsletters enroll at www.nwcwd.org
Water Surcharge Rate Effective 11/01/2014
$2/Kgal
15
Water Class
70 % of 1.000 Acre Foot
Transferred Water
Allocation Adjustment
Less YTD Usage
Remaining Water Allocation
Plant Investment Class
WELD COUNTY HEALTH DEPARTMENT
1555 17th Ave.
Greeley, Colorado
No.
7/0 yam
a7i.7
Application for Permit to Install, Construct, Alter or Repair Individual Sewage Disposal System.
or Sponsor f Ad F x
Cf-
Address of Site
Mailing Addres
General Information
1. Living Units 1
2. No. of Bedrooms
8. No. of Baths
4. Basement Drain
5. Automatic Dishwas
6. Garbage Disposal
7. Automatic Laund
8. Size of Lot
9. Type of Soil
Percolation Test
Water Supply d —
I0. ---
11.
12. Lot Grade
12. Water Table Depth
14. Other
Septic Talc #)l Lf4✓
1. Liquid Capacity P'D Gallons
2. Dimensions W L D
S. Material
4. Type Inlet
Type Outlet
Secondary Treatment
Field _ Bed _--_
1. No. of distribution lines
2. Trench: Width Length
S. Type Filler Material
4. Depth of Filler Material — -
5. Gravel Size
6. Type Tile
7. Depth of Cover —_
8. Other
The Permit is to remain in full force and effect for six (6) months from date, until revoked for non-compliance.
This system will be constructed in accordance with the above specifications and regulations governing non -
municipal sewage disposal systems, in accordance with Regulation No. 1 of the Weld County Health De-
partment.
Date: it-- /G '
Applican
The plans and specifications as shown are approved, pending paymrefit of pe
Sanitarian:
Date:
C_
The above system inspected I found to comply with the plan and description.
/(7)
}vfl':)—. ‘
Installed by
PERMIT FEE $
Received by
Please use reverse aide
oG
Sanitarian:
Plot Plan o'use separate sheet of paper.
Da
c1-7‘2
Date /9- 4.- 7/
..,.....m..--
1
HSP1D6P INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT
WELD COUNTY HEALTH DEPARTMENT
EN IIIkONMENTAt HEALTH- SERVICES
1517 16TH AVENUE COURT, GREELEY, CO 80631
353-0635 EXT.2225
OWNER GARBOR, P. ADDRESS
3/ow NJI a. -t.
ADDRESS OF PROPOSED SYSTEM PENDING
0000(
00000
LEGAL DESCRIPTION OF SITE: SW4 SEC 29 TWP 7 RNG 67
SUBDIVISION: NORTHWEST ESTATES LOT 14 BLOCK 0 FIL
USE TYPE: RESIDENTIAL HOUSE)
SERVICES: PERSONS 1 BATHROOMS . J0 LOT SIZE 1.44 ACRES
BEDROOMS 5 BASEMENT PLUMBING YES WATER SUPPLY NWCWL
APPLICATION FEE $240.00
REC'D BY CINDY SALAZAR
DATE 06/01/95
SIGNED BY GERHARDT BRUNNEF
DATE 06/01/95
PERCOLATION RATE MIN PER INCH LIMITING ZONE FEET
SOIL TYPE PERCENT GROUND SLOPE V. DIRECTION
REQUIRES ENGINEER DESIGN y' IN 100 YEAR FLOOD PLAIN ZC
FROM THE APPLICATION INFORMATION SUPPLIED AND THE ON -SITE SOIL REF
THE FOLLOWING MINIMUM INSTALLATION SPECIFICATIONS ARE REQUIRED:
SEPTIC TANK GALLONS, ABSORPTION TRENCH SO.
OR
ABSORPTION BED _ SO.
IN ADDITION, THIS PERMIT IS SUBJECT TO THE FOLLOWING ADDITIONAL TER
CONDITIONS:
THIS PERMIT IS GRANTED TEMPORARILY TO ALLOW CONSTRUCTION TO COMME
MAY BE REVOKED OR SUSPENDED BY THE WELD COUNTY HEALTH DEPARTMEN'
FORTH IN THE WELD COUNTY INDIVIDUAL SEWAGE DISPOSAL SYSTEM REGULA
FAILURE TO MEET ANY TERM OR CONDITION IMPOSED THEREON DURING TEMP
APPROVAL. THE ISSUANCE OF THIS PERMIT DOES NOT CONSTITUTE ASSUMP
DEPARTMENT OR ITS EMPLOYEES OF LIABILITY FOR THE FAILURE OR INADE(
SEWAGE DISPOSAL SYSTEM.
ENVIRONMENTAL SPECIA
THIS PERMIT IS NOT TRANSFERABLE AND SHALL BECOME VOID IF SYSTEM C
NOT COMMENCED WITHIN ONE YEAR OF ITS ISSUANCE. BEFORE ISSUING FIN'
THIS PERMIT THE WELD COUNTY HEALTH DEPARTMENT RESERVES THE RIGHT
TIONAL TERMS AND CONDITIONS REQUIRED TO MEET CUR REGULATIONS ON A
SIB. FINAL PERMIT APPROVAL IS CONTINGENT UPON THE FINAL INSPECTIO
PLETED SYSTEM BY THE WELD COUNTY HEALTH DEPARTMENT.
. S p ocacirai n se -,(0,O(
t WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIR
1555 NORTH 17TH AVENUE
GREELEY, CO 80631
PHONE (970) 304-6415 FAX (970) 304-6411
Permit #:
Owner:
Applicant:
Permit Type:
Parcel #: 0705-29-0-03-002
Location: 37042 NW DRIVE
Legal Description: 1NW-14 L14 NORTHWEST
%37042-37044-371746 N
Installer:
SP -0200448 Sec/Twn/Rng:29 07 67
L14 WINDSOR, LLC
GARBER WARREN
RREP C=Commercial, R=Residential + NEW, REPair, VauLT
13)
Description:—TRPtEX- NAM.tLt`-c--tir't-S Lci "lam- �c-
Commercial: N Residential:Y Acres: 1.44
Statt
Appl
Issue
Final
ESTATES 1ST FILING
# of Persons:
# of Bedrooms:
6 Basement Plumbing: Y
3 Bathrooms - Full: 3 3/4: 0 1/2: 0
Water Public: Y
Water Private: N
Water Source: NWCWD
Cistern: N Well: N Well Permit #:
Percolation Rate: 21.7 Limiting Zone: 8 ft 0 in Description:
% Ground Slope: 0 Dir: Soil Suitable: (YIN) Y
Engineer Design Required: (Y/N) Y In 100 Year Flood Plain: (Y/N) N
Minimum Installation
Septic Tank: 1250 gallons Absorption Trench: 0 square feet
or Absorption Bed: 1490 square feet
Actual Installation Loy r SF' t v1,9
Septic Tank: o,COO gallons Absorption Trench: square fe
Absorption Bed: I S 50 square fe
Design Type: c4
NOTICE
The issuance of this permit does not imply compliance with other state, county or local regulatory or bi
shall it act to certify that the subject system will operate in compliance with applicable state, county anc
persuant to Article 10, Title 25, CRS as amended, except for the purpose of establishing final approval
issuance of a local occupancy permit persuant to CRS 1973 25-10-111 (2).
This permit is not transferable. The Weld County Department of Public Health and Environment rese
additional terms and conditions required to meet our regulations on a continuing basis. Final permit ap
the final inspection of the completed system by the Weld County Aepartment of Pu li Health and Envi
. VI.
COLORADO
WELD COUNTY DEPARTMENT OF PUBLIC
HEALTH AND ENVIRONMENT
1555 N. 17TH AVENUE
GREELEY, COLORADO 80631
PHONE: (970) 3044415
FAX: (970) 304-6411
SOB
ORG
REPO
LOA
ISM
STATEMENT OF EXISTING FOR SEPTIC SYST
(PLEASE FILL OUT IN BLACK INK ONLY)
PARCEL NO. c9 1 05090 O
PROPERTY OWNER . / L t
MAILING ADDRESS
City
DESCRIPTION OF BUILDING (ex. house, mobile/modularhome, shop,office
SITE/LOCATION ADDRRESS fi t IV Id D r `v e /4/ r l 1
_P70 tit
3 7 O city
LEGAL DESCRIPTION PT_ PT
SUBDIVISION if
CENCUS TRACT
PHONE NO.&Ui 7
cauAtre gdos
COMMERCIAL YES / NO
NUMBER OF PERSONS
BEDROOMS
WATER SUPPLY - PUBLIC
SECTION TOWNSHIP
tea LOT BLOCK
LOT SIZE/ACRES / ► 4 wei7
RESIDENTIAL £_ : / NO
BASEMENT PL �: ING NO
BATHROOMS - FULL /3/ :
NO NAME /lb r Mie'l Hof
PRIVATE YES/NO WELL YES/NO CISTERN YES/NO WELL
SYSTEM SIZE: Septic tank material is constructed of and has
FIELD: Trench square feet or Bed square feet YEAR INSTA
You are required to draw a diagram of the system on the reverse side of this form in black ii
location, length, width, and distance from the dwelling.
The undersigned property owner hereby certifies that the above described septic system is it
described, and exists at this time on the parcel of ground identified by the above legal descril
that the system is/is not in good working order and to the best of his/her knowledge is/is not I
I further understand that any falsification or misrepresentation may result in revocation of
upon this information hereby submitted and in legal action for perjury as provided by law.
p e to/ _Lirg
DATE OWNEIIGNA�'CTRE
Subscribed and sworn to before me this / Sf day of 0071-0,4-r
By /Miler zJ ' -
Witness my hand and official seat
My cAmmissio eTpires ` J1i " ' T
p'c. 5c+.51 -e176 -F-or
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