HomeMy WebLinkAbout20172921.tiffWATER CONSUMPTION SURVEY
To aid in the determination of water consumption for the water service you requested, it is of considerable
importance to know as much as possible about how the water will be consumed. Please answer all questions as
accurately as possible. If you have questions please call (970) 356-3020.
Customer Name:
(dab C)f\eiJ. le_
Current Mailing Address: Q o eXX 3c5
QwsKlawa PI
•Lt-i tt a,
Day "Lime Phone Number: 'fO1— q - t9 07 / Agent Phone: _
Customer E -Mail: h .N.o et S Q A -o I . c,bM Agent E -Mail:
Agent's Name:
Agent Address:
Which best describes your needs:
Residential Only
Industrial / Commercial
Usage Hours
Number of Employees
Livestock Operation
Number of Members in the Family:
How do you plan on irrigating your lawn?
North Weld County Water District
Pump Water From Irrigation Ditch
Pump Water From Well
Other (Specify)
Number of Livestock to be fed:
a Cattle
D Horses
O Sheep
Dairy
b
0
o
Hogs
Chickens
Other
What is the present source of water for your livestock? r1/6 -
Would you anticipate using the proposed water tap for watering livestock? Yes No X
If you are unable to complete the above, please complete one or more of the below:
Please base your design for our tap on a maximum usage of:
Gallons per minute
Gallons per day
1° Gallons per month
I
Applicant's`Signature Date
BOARD OF DIRECTORS
CHARLES ACHZIGER
GENE STILLE
GARY SIMPSON
TODD BEAN
ROBERT ARNBRECHT
February 23, 2017
Bob Christie
PO Box 355
Oakland, FL 34760
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
WWW.NWCWD.ORG • EMAIL: WATERWNWCWD.ORG
This letter is in response to your inquiry regarding water service to the following described property,
Approx 41360 WCR 15. Lot B RE -3685 in a portion of Section 5, T7N, R67W of the 6t^ Prime Meridian.
(See attached North Weld County Water District sketch)
Parcel 070505300018
1 Water Service is presently being provided to the abovo mentioned property through motor #
2. North Weld County Water District is able and intends to provide water service to the above -mentioned property, provided all
requirements of the District are satisfied. If contracts have not been completed with North Weld County Water District within one year from
the date of this letter, the District may refuse to supply water to the above -mentioned property, The District reserves this right to refuse
service, in the event that raw water is unavailable, and ror pipeline or Filter Plant capacity is not capable to provide additional service.
Before a water tap may be purchased, the applicant must provide a copy of a Warranty Deed, a Physical Address, and this letter.
3. As additional consideration for this Letter of Intent to provide service. Property Owner agrees to sign and execute any necessary
Easements and Rights -of -Way regarding specific locations, widths, size of pipeline(s) and descriptions for Water Lines as determined
by the District This Agreement is conditional upon execution and recording of the Easement and Right -of -Way Agreement. and until
such Easement and Right -of -Way Agreement is finalized to the satisfaction of the District and recorded, District shall not be required to
provide any services of any type.
4. The District recommends that based on the number of family members and livestock along with other information provided in the
Water Tap Request Form, your irrigated landscaping square footage not exceed approx. 6,000 square feet. The
recommendation is based on the Full Standard Tap allocation and should be utilized to optimize delivery without surcharge. Additional
allocation should be purchased for landscaping areas larger than the recommended area.
5. The District recommends that anticipated raw water be purchased through the District. The District guarantees treatment and delivery of
raw water purchased. All water that is delivered over the allocation (with surcharge) is subject to water availability Water
purchased through the District shall be 70% delivery of an Acre -Foot of water. if the allotment for Colorado -Big Thompson (COT) 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.
6. Tap Options and Requirements
Raw
Water
Raw Water
Storage Fee
Plant
Investment
Distance
Fee
Meter
Set
Fee
Water Allocation
(Annually)
i Plant Investment
Allocation
,Annually)
Full Standard
Tap
100%
100%
100%
100%
100%
228,000 Gallons
228,000 Gallons
Lot Size greater than 0.33 Acres (14,500 sq ft)
r
75% Tap
75%
75%
I 75%
75% 1100%
171,000 Gallons
171,000 Gallons
__
—1
Restrictions
Lot sizes greater than 0.20 acres (8,800 sq ft) but less than 0-33 Acres (14.500 sq ft) OR
landowners with verifiable irrigation rights or well permits for outside water use
50% Tap 1
50%
50%
50% I
50%
100%
114,000 Gallons
114,000 Gallons
Restrictions
Lot size less than .2 acres (8,800 sq ft) OR with a Board Approved Irrigation System OR a Board
Approved Commercial Enterprise
Conservation
Blue Tap
100%
100%
0
0
100%
228.000 Gallons'
L0 Gallons
Restrictions
If Qualified, taps may be used in combination with Conservation Tap (i.e. 50% Water with a
Conservation 0 Plant Investment)
'Gallons may vary depending on qualifying combination
r
A tap may be allotted more
228.000 gallons = Annual
Surcharge will be assessed
See Page 2 for Rates.
than 1 unit of Water and/or Plant Investment. In this case the allotment is the class X
Allocation (i e. Water Allocation 5 x 228 000 = 1,140,000 gallons Annual Allocation)
when an account's year to date usage exceeds the Water and/or Plant Investment Allotment.
Y Legal Ducumcnis Letter ul Inlets' 20 7 1201'-0I -18 13ub Christie. 41. no-- N CR (5'12017-02-23 'Letter or Intern Chuictic doc
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NORTH WELD COUNTY WATER DISTRICT
TAP REQUEST - CHRISTIE, 41360 CR 15
rha mat: , 1.s J tf geflef 1IM Qat'C output b y' ai rte net ;napping site and is fog
rFfNMK, ardy :am 'awn. Ihet Appeal on ten map may Ot may not be accurate
i tonsil x ]therwtse .el at4e
THIS MAR IS NOT TO RE USED FOR NAVIGATION
WATER SUPPLY INFORMATION SUMMARY
Section 30.28433A L C.R.S. requires that the applicant submit to the County,"Adequate 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
5,+
lontOt
2. LAND USE ACTION 5 t to 3)
a cans'', I Y
-re (,c,ic nil
3. NAME OF EXISTING PARCEL AS RECORDED
50R let I
g 4 a C -7,.p7
0 5 D 5 ?j cce l
g
J
SUBDIVISION FILING BLOCK LOT
4. TOTAL ACREAGE 55
5. NUMBER OF LOTS PROPOSED 1
PLAT MAP ENCLOSED J YES
6. PARCEL HISTORY - Please attach
copies of deeds, plats or other
to June 1, 1972? 0 YES
division of land action since June
evidence
or
documentation.
NO
A. Was parcel recorded with county prior
B. Has the parcel ever been part of a
If yes, describe the previous action
till NO
1, 1972?
0 YES Cif
7. LOCATION OF PARCEL ...Include .
114 OF 114
.............
SECTION
0
_ ....._.
________ — .. ........
..
5 TOWNSHIP
..._.
7 VI ON OS RANGE 1. 7 ❑ E a
PRINCIPAL MERIDIAN: 0 6TH
h.M. 0 UTE 0 COSTILLA
8. PLAT • Location of all wells on property must be plotted and permit numbers provided.
Surveyors plat 0 Yes 0 No If not, scaled hand drawn sketch 0 Yes C No
9. ESTIMATED WATER REQUIREMENTS - Gallons per Day or Acre Fat per Year
10. WATER SUPPLY SOURCE
❑ EXISTING 0 DEVELOPED
WELLS SPRING
WELL PERMIT NUMBERS
n /A-
NEW WELLS
PROPOSED *MRS ;cHEc* owe
Auuvut. C.: UPPER ARAPAHO(
J tarot DAwsa ._ (OWIA MIAMICOMMERCIAL
ai tit °A"rs°" - lARAMIE Fax wus
O OBfrER L. DAKOTA
iJ OTHER
HOUSEHOLD USE N I— of units QC0 GPD AF
USE # I O of S.F. GPO AF
IRRIGATION 440 of acres GPO AF
DECREE CASE NO.'S
STOCK WATERING # O of head GPD AF
NAME
LETTER
SERVICE
0 MUNICIPAL
D
WATER COURT
OTHER • GPO AF
0 ASSOCIATION
0 COMPANY
0 DISTRICT
In IOC W
TOTAL
GPO AF
FOR
G NO
OF COMMITMENT
❑ YES
11. ENGINEER'S WATER SUPPLY REPORT la YES 0 NO IF YES, PLEASE FORWARD WITH THIS FORM. (The may be reputed before ow reviews comol.I,dJ
12. TYPE OF SEWAGE DISPOSAL SYSTEM
*SEPTIC TANK1LEACH FIELD 0 CENTRAL
Li LAGOON 0 VAULT
C ENGINEERED SYSTEM (Attach a copy et anillannne distil 0 OTHER
SYSTEM - DISTRICT NAME
- LOCATION SEWAGE HAULED
TO _
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