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Home My WebLink About20160340.tiff WATER SUPPLY INFORMATION SUMMARY Section 30.28 133,(d), 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 2. LAND USE ACTION 3. NAME OF EXISTING PARCEL AS RECORDED SUBDIVISION FILING BLOCK LOT 4. TOTAL ACREAGE 1g 5. NUMBER OF LOTS PROPOSED VI A PLAT MAP ENCLOSED ❑ YES 6. PARCEL HISTORY - Please attach copies of deeds, plats or other evidence or documentation. A. Was parcel recorded with county prior to June 1, 1972? 0-YES C1 NC B. Has the parcel ever been part of a division of land action since June 1, 1972? ❑ YES Ki--NO If yes, describe the previous action 7. LOCATION OF PARCEL - Include a map deliniating the project area and tie to a section corner. 1/4 OF 141/0114 SECTION ‘57 TOWNSHIP 124 s-N 0 S RANGE 7, 4 ❑ E 3 W PRINCIPAL MERIDIAN: 6TH ❑ M.M. ❑ UTE 0 COSTILLA 8. PLAT - Location of all wells on property must be plotted and permit numbers provided. Surveyors plat ❑ Yes 0 No If not, scaled hand drawn sketch 0 Yes 0 No 9. ESTIMATED WATER REQUIREMENTS - Gallons per Day or Acre Feet per Year 10. WATER SUPPLY SOURCE 0 EXISTING 0 DEVELOPED NEW WELLS WELLS SPRING PROPOSED AQUFERS • (CHECK ONE) HOUSEHOLD USE # of units GPO AF WELL PERMIT NUMBERS o ALLUVIAL ❑ UPPER ARAPAHOE ❑ UPPER DAWSON 0 LOWER ARAPAHOE COMMERCIAL USE # of S.F. GPD AF Li LOWER DAWSON 0 LARAMIE FOX sus D DENVER 0 DAKOTA o OTHER IRRIGATION # of acres GPD AF STOCK WATERING # of head 40P °° GPO AF ❑ MUNICIPAL ❑ ASSOCIATION WATER COURT DECREE CASE NO.'S OTHER - GPO AF 0 COMPANY Pratt 401 DISTRICT 'T'ut 1151 TOTAL a(10619 GPO -33 AF NAME C IUGL() b LETTER OF COMMITMENT FOR SERVICE E YES 0 NO 11. ENGINEER'S WATER SUPPLY REPORT 0 YES 0 NO IF YES, PLEASE FORWARD WITH THIS FORM. (This may be required before our review is completed.) 12. TYPE OF SEWAGE DISPOSAL SYSTEM sSEPTIC TANKILEACH FIELD 0 CENTRAL SYSTEM - DISTRICT NAME ❑ LAGOON 0 VAULT - LOCATION SEWAGE HAULED TO ❑ ENGINEERED SYSTEM (Attach copy of engineering design) ❑ OTHER Sep 171511 :04a Horseshoe Transport 559-627-4038 p. 1 ,.,, •csrs,w.Y•'j'.7--- t'. r ke Yi ' a..r Ni 3 1 V. L Li K• f,_..i.,r..? C. •..a 1•✓ IN T x WA"is 2 D S.vTi i;CI August 26. 2015 RE:. Water Service to 24804 CR 57 & 21938 CR 57: Kersey, CO Dear Sam Knevcibaard. This letter is in response to your request for increased water allotment to serve the following property described as follows: • W I_ NW '4 Section 35, Township 5, Range 64 Excluding pt within the high water contour in of the Loloff Res (2A M/L) Vest of the 6" P.M., County of Weld, State of Colorado Parcel 4109633 5000013 The property is currently being served by tap no. 61, a 5/8" meter with a current allotment of 300,000 gallons and tap no. 1157, a '/." meter with a current allotment of 750,000 gallons. Both taps are located on Weld Co. Rd. 57 between 50 & 52. We have current capacity to supply your requested 7.2 million gallons annually for phase 1 (20,000 gallons per day) with the existing taps if storage tanks are installed on your property to minimize peak flow demand. An additional 28 shares of CBT water will need to be transferred to the District before cater service can begin at phase I capacity. In order to provide 1 0.95 million gallons as requested for phase Il (30,000 gallons per day), the %" tap would need to he upsized to a 3 " tap at a current cost of S26, 100 along with an additional 16 shares of CBT water transferred to the District. While a tap upsize is not necessary to implement phase i, please keep in mind that unless the upsize is purchased within the nest 30 days, the cost 'Nil! be based on the tap fee schedule in place at the time of the upsize. The District has provided you with an alternative to purchasing the additional CBT shares in which you would transfer 4 CBI' shares to the District upfront for the first year. After that we would split the balance into 5 years until the requirement is fulfilled. Until all shares necessary to fulfill allotment requirement are satisfied you will need to lease CI3T to transfer to the District for this usage. YEAR SHARES 2nd 5 shares 3rd 5 shares 4th 5 shares 5th 5 shares 6th shares Total 28 shares Sincerely, CENTRAL WELD COUNTY WATER DISTRICT --• : ' Sts in er�strict Manager surg 22.75 td =_4 ^•-u:, a CrQ - 1 7f J„ .:...,- -:}', ._C�ht) .xL`U •Y�i: ° t�f":,�� ii: : .f i .t,�.,. -:?�.�•. 2 ;..*:-FT. : . rt>) ::.i_..r ,3t Ats ASSIGNMENT I FOR VALUE RECEIVED I/we hereby sell , transfer and assign to Lester A . Stroh and Margary A. Stroh, as joint tenants and not as tenants in common , One (1 , 5/8 " water taps in the CENTRAL WELD COUNTY WATER DISTRICT, on my/our property described as follows situate in Weld County, Colorado , to-wit : The V/est One -half (WI ) of the Northwest Quarter (NW4 ) of Section Thirty-five (35 ), Towsnhip Five ( 5 ) North, Range Sixty-four ( 64 ) West of the 6th P. M. It is understood that these taps were purchased for the above described lands and may not be transferred to other lands , without express , written consent , in addition to the below consent , of the CENTRAL WELD COUNTY WATER DISTRICT . I/we further authorize the Secretary of said District to do any and all things necessary to effectuate this transfer on the books and records of said District . I/we hereby state that all water rates and charges and other monies owned to the District have been paid and if not, shall be held out at the closing of the sale of my premises . INTESTIMONY WHEREOF, I/we have set my/our signatures this 24th day of November , 196 7 . Gble&rn2 Sam Herbs / a to hierbst I/we further agree to pay any and all charges hereinafter levied by said District for said taps and to abide by all regulations adopted by said District . ACCEPTED : l - Y 1 je ' / `1 z4 e , re" . Buyer 'Lester A . Stroh A x\r\a/L ( Buyer Marg� Js-.{,it.4y A .Stroh CONSENT TO ASSIGNMENT I, a.& tealutalanAlanager of the CENTRAL WELD COUNTY WATER DISTRICT, hereby consent to the above assignment on behalf of said District . M.A., as;_../tgar.} Manager F May 19 , 1977 ACTIVE TAPS TAP FEE AGREEMENT #1157 THIS AGREEMENT, made and entered into this 1O day of .T„ly 19 79 by and between the CENTRAL WELD COUNTY WATER DISTRICT , hereinafter called the District, and Stroh,L ,.ester A, and Stroh, Margary A. hereinafter called Customer, WITNESSETH : WHEREAS , District has been organized as a legal body and is known as the Central Weld County Water District , and WHEREAS , Customers are taxpaying electors within said District , or desiring tc join said District , or __ and , WHEREAS , Customers are desirous of acquiring one water tap of _ 5/8" inches in diameter from the said District , NOW , THEREFORE , in consideration of the premises and the terms of this agreeme• it is mutually agreed as follows : 1 . Customer agrees to pay the tap fee of $ _ ' Ann pp Dollars . -Ou -Dal -- 2 . In the event it is not economically feasible to extend the water to the property line of Customer , which matter is in the entire discretion of District , then all sums paid hereunder shall be returned to Customer and the agreement shall be null and void . 3. The description of the premises for which these taps are beira purchased is as follows : Wt NWT Section 35 T5 R64 - 75a Except pt within the high water contour line of the Loloff Res . 2a m/1 4 . This agreement, when approved by the Board of Directors , shall become a legal and binding contract upon all parties hereto . 5 . Customer further agrees to execute any and all easements needed by District at no expense to District , across Customer ' s property for the purpose of installing any pipelines constructed by District. District shall be responsible for restoring surface area back to reasonable condition at District cost . 6 . It is further mutually agreed that this agreement shall extend to and be binding upon the heirs , executors , administrators and assigns of the parties hereto 7 . Customer further agrees to the following special provisions : 8 . Customer further agrees to abide by the rates established and the rules and regulations of the District . IN WITNESS WHEREOF , the parties hereto have hereunto and hereunder set their si 'jnatures the day and year first hereinabove written CUSTOMER SIGNATURE CENTRAL WELD COUNTY WATER DISTRICT (ar ert Owner ) BY //172 ,) Stroh, Lester A. Paul Hoshiko , . Q a _ ATTEST Stuo , MWgary A Harry Andrews Secretary 4 ' Scanning Cover Sheet for Septic Permits Permit ## G19810072 . Permit Type: Health / EHS History / EHS Conversion History Situs Street Address 24804 CR 57 Situs City, State, Zip • • Sec/Town/Range: 35-05N-64W Application Status : Finaled Application Date: 03/11 /1996 Parcel # (12 digits) 096335000011 -R4175986 Owner Full Name: STROH LESTER Owner Address : 24804 WCR 57 KERSEY,CO 80644 Owner Phone #: 303 3534377 Contact Name: Contact Address: Contact Phone# Information above has been Verified in Accela by employee noted below x February 02, 2009 Processed by: Date Report ID: EHS00024v003 Page 1 of 1 Print Date -Time: 2/2/2009 1 :01 :03PM fr vat, VV APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM No. - no,'.` WELD COUNTY HEALTH DEPARTMENT ( I q S'I O&1 a New ENVIRONMENTAL HEALTH SERVICES Repair 181E Hospital Road, Greeley, CO 80831 383-0840 EXT. 270 BP OWNER / Sy' 5-774°171 - ADDRESS a e ie-/C ie -5'7 , Z e:6 57; PHONE 35 -4 �' ADDRESS OF PROPOSED SYSTEM ..2L,1O Zr etC e 5 7 , tr,PSC- ,- LEGAL DESCRIPTION OF SITE: PT s 35 , T S R ‘ 4( SUBDIVISION,__ -- LOT -- , .BLOCK , FILING .. USE TYPE: RESIDENTIAL X JX''S`e /e* INSTITUTION COMMERCIAL 9" ) k Tar1.E-T/eil'inye1sCO\THER .017A3 YA-A ,e' i/ &< 1144-ti2c' ._. , . SERVICES: PERSONS_ -2 BATHROOMS 07 ..__•LOT SIZE 4. BEDROOMS 3 - BASEMENT PLUMBING -- -• WATER SUPPLY TYPE OF SEWAGE DISPOSAL REQUESTED: . -,4OT7—C CA,vvainoWA 4 Applicant acknowledges that the completeness of this application Is conditional upon further mandatory and additional tests and reports as may be required by the Weld County Health Department to be-made and furnished by the applicant or by the i , Weld County Health Department for purposes of the evaluation of the application; and the issuance of the permit Is subject to such terms and conditions as deemed necessary to insure compliance with rules and regulations adopted under Article 10, Title 25, CRS 1973, as amended, The applicant certifies that the proposed system will not be located within 400 feet of a com- munity sewage system. The undersigned hereby certifies that all statements made, Information and reports submitted here- with and required to be submitted by the applicant are, or will be, represented to be true and correct to the best of my knowl- edge and belief, and are designed to be relied on by the Weld County Health Department In evaluating the same for purposes of issuing the permit applied for herein. I further understand that any falsification or misrepresentation jmay result in the denial of the application o revocation of any permit granted based upon said application and in legal action for perjury as provided by law. 7S0 SACS �Application fee � �� p Al,4, ". ' Recd by Date 4750 '� Owner/Agent Signature ( Date --.------- a a * * i* a a * * 0 * CI * * te * a a * * * * * a * * * * * a * a I* * a a If * V) * a * a * * * * * * * * - FOR DEPT. PERCOLATION RATE_ ' �i n 5. � `� '�n 'at n/ ' At WATER TABLE DEPTH / S / USE ONLY SOIL TYPE fr t arrel PERCENT GROUND- SLOPE ;`-' 411 t' REQUIRES ENGINEER DESIGN ( ) YES ( (No * * * a * .* * * * * * °a- * * a * * * * * * * a a a * * * * a * a * * * 0 * * * * a * * a '≥ * * * * * * * * INDIVIDUAL SEWAGE J ISP0SAL SYSTEM PERMIT From the application information supplied and the on-site soil percolation data, the following minimum installation specifi- cations are required: f - t _ � Z SEPTIC TAN Qn2 GALLONS, ABSORPTION TRENCH • SQ. FT. 3 � � el( or In a i I ABSORPTION BED SQ. FT. 1O5-#z_ SAr� . dd t on, this Permit Is subject to the following additional terms and conditions: S?o 4a This Permit Is granted temporarily to allow construction to commence. This Permit may be revoked or suspended by the Weld County Health Department for reasons set forth In the Weld County individual Sewage Disposal System Regulations, including failure to meet any term or condition Imposed thereon during temporary or final approval. The issuance of this Permit does not constitute assumption by the Department or Its employees of liability for failure or equacy of the sewage disposal system. Environ ntal Specialist Date • • This Permit is not transferrable and shall become void If system construction has not commenced within one year of its issuance. Before Issuing final approval of this Permit the Weld County Health Department reserves the right to impose additional terms and conditions required to meet our regulations on a continuing basis. Final Permit approval is ontingent upon the final in- . spection of the completed system by the Weld County Health Department. // itiv d ir`). eyvtadt een/ .44.1 SYSTEM CONTRACTOR Alel FINAL INSPECTION SYSTEM ENGINEER APPROVAL 17-3lJ/ f 7pt 'Q Enviro mental S cialist Date . • - , The issuance of this Permit does not Imply compliance with other state, county or local regulatory or building requirements, nor shall It act to certify that the subject system will operate in compliance with applicable state, county and local regulations adopted pursuant to Article ,10, Title 25, CRS 1973, as amended, except for the purposes of establishing final approval of an installed system for issuance of a local occupancy permit pursuant to CRS 1973 25. 10-111 (2). Original-Applicant; Copy-WCHD WCHD—EHS February, 1981 _ . . . (4-(<6 1)k- rAk,as,„ . ts Z• - tat 1.1 iv) 0 2( I e� if s F1 A 3 \ IP I . his rqs I i CUD • CG 0417:t (. 4C V-40 Scanning Cover Sheet for , Septic Permits Permit # SP-9700399 Permit Type: Health / Residential / New Situs Street Address 24804 CR 57 Situs City, State, Zip Sec/Town/Range: 35-05N-64W Application Status : PEND-LET Application Date : 09/04/1997 Parcel # (12 digits) 096335000011 -R4175986 Owner Full Name: STROH LESTER A Owner Address: 2208 27TH AVE CT GREELEY,CO 80631 -7714 Owner Phone #: Contact Name: Contact Address: Contact Phone# Information above has been Verified in Accela by employee noted below X July 08, 2008 Processed by: Date Report ID: EHS00024v003 Page 1 of 1 Print Date -Time: 7/8/2008 1 :57: 16PM • WELD COUNTY HEALTH . DEPARTMENT • ' 1517 16TH AVENUE COURT , GREELEY , CO 80631 ( 970 ) 353 - 0635 EXT 2225 FAX ( 970 ) 356 -4966 . Permit # : SP - 9700399 Sec /Twn/Rng : 35 05 64 Status : ISSUED Permit Type : RNEW C=commercial , R=residential + NEW, REPair, VauLT Applied : 09 / 04 / 1997 Parcel No : 0963 35 000011 Issued : 12 / 02 / 1997 Finaled : • Location : 24804 WCR 57 35 05 64 Legal Desc : 9557 W2NW4 35 5 64 EXC PT WITHIN THE HIGH WATER 24804 57 CR WELD OWNER STROH LESTER A 2208 27TH AVE CT , GREELEY CO 806317714 . SEPT -- INSTL UNRUH BACKHOE SERVICE - DUANE UNRU Phone : ( 970 ) 330 - 2494 3112 W 28 , GREELEY CO 80634 SEPT - ENGR MCRAE GERALD MCRAE & SHORT INC Phone : ( 970 ) 356 - 3101 1231 8TH AVENUE , GREELEY , COLORADO 80631 Description : HOUSE Commercial ( Y/N ) : N Residential ( Y/N ) : Y Acres : 80 . 00 Number of Persons : 4 Basement Plumbing ( Y/N ) : Y Number of Bedrooms : 3 Bathrooms - > Full : 1 3 / 4 : 1 / 2 : Water Public ( Y/N ) : Y Utility Name : CWCWD Water Private ( Y/N ) : Cistern ( Y/N ) : Well ( Y/N ) : Water Permit No : Percolation Rate : 63 . 0 Limiting Zone : 03 ft 06 in Desc : SEASONAL HIGH 96. Ground Slope : Dir : Sol ], Suitable ( Y/N ) : N Engineer Design Req ' d ( Y/N) : Y In 100 Yr Flood Plain ( Y/N ) : Minimum Installation Septic Tank : 1000 gal • Absorption Trench : sq . ft . Absorption Bed : 795 sq . ft . Actual Installation Septic Tank : leo-r gal Absorption Trench : . • sq . f t . Absorption Bed : v sq . ft . Design Type : m43 m43 s n' NOTICE The issuance of this permit does not imply compliance with other state , county or local regulatory or building requirements, nor shall it act to certify that the subject system will operate in compliance with applicable state, county and local regulations adopted persuant to Article 10 , Title 25 , CRS as amended, except for the purpose of establishing final approval of installed system for issuance of a local occupancy permit persuant to CRS 1973 25- 10-111 (2 ) . • This permit is not transferable . The Weld County Health Department reserves the right to impose additional terms and conditions required to meet our regulations on a continuing basis . Final permit approval was contingent upon the final inspection of the completed system by the Weld County Health Department . X �'' Nile) Env ' ronmental Specialist Date • t • 1 7 ., ( ' c tee-gs O e IN 1A f ( T raar4 -t % I 1A(C)4 / 61-7D Q .1) , 1 � ,L-4-.111 `aec- (1\ 4--- IC\a 6' ti Vt. 7 G\ • I WELD COUNTY HEALTH DEPARTMENT 1517 16TH AVENUE COURT , GREELEY , CO 80631 ( 970 ) 353 - 0635 EXT 2225 FAX ( 970 ) 356 - 4966 Permit # : SP - 9700399 Sec/Twn/Rng : 35 05 64 Status : ISSUED Permit Type : RNEW C=commercial, R=residential + NEW, REPair, VauLT Applied : 09 / 04 / 1997 Parcel No : 0963 35 000011 Issued : 12 / 02 / 1997 Finaled : Location : 24804 WCR 57 35 05 64 Legal Desc : 9557 W2NW4 35 5 64 EXC PT WITHIN THE HIGH WATER • 24804 57 CR WELD OWNER STROH LESTER A • 2208 27TH AVE CT , GREELEY CO 806317714 SEPT - INSTL UNRUH BACKHOE SERVICE - DUANE UNRU Phone : ( 970 ) 330 -2494 3112 W 28 , GREELEY CO 80634 SEPT - ENGR MCRAE GERALD MCRAE & SHORT INC Phone : ( 970 ) 356 - 3101 1231 8TH AVENUE , GREELEY , COLORADO 80631 Description : HOUSE Commercial ( Y/N) : N Residential ( Y/N) : Y Acres : 80 . 00 Number of Persons : 4 Basement Plumbing ( Y/N) : ' Y Number of Bedrooms : 3 Bathrooms - > Full : 1 3 /4 : 1 / 2 : Water Public ( Y/N) : Y Utility Name : CWCWD Water Private ( Y/N) : Cistern ( Y/N ) : Well ( Y/N ) : Water Permit No : • Percolation Rate : 63 . 0 Limiting Zone : 03 ft 06 in Desc : SEASONAL HIGH % Ground Slope : Dir : Soil Suitable ( Y/N ) : N • Engineer Design Req ' d ( Y/N ) : Y In 100 Yr Flood Plain ( Y/N ) : Minimum Installation • Septic Tank : 1000 gal Absorption Trench : sq . ft . Absorption Bed : 795 sq . ft . Actual Installation Septic Tank : lOC gal Absorption Trench : sq . ft . Absorption Bed : 1OO sq . f t . • Design Type : ta,a,tskkim NOTICE The issuance of this permit does not imply compliance with other state, county or local regulatory or building requirements, nor shall it act to certify that the subject system will operate in compliance with applicable state, county and local regulations adopted persuant to Article 10 , Title 25, CRS as amended, except for the purpose of establishing final approval of installed system for issuance of a local occupancy permit persuant to CRS 1973 25-10-111 (2) . This permit is not transferable . The Weld County Health Department reserves the right to impose additional terms and conditions required to meet our regulations on a continuing basis . Final permit approval was contingent upon the final inspection of the completed system by the Weld County Health Department . X ' Environmental Specialist Date f + �. WELD COUNTY HEALTH DEPARTMENT 1517 16TH AVENUE COURT , GREELEY , CO 80631 ( 970 ) 353 - 0635 EXT 2225 FAX ( 970 ) 356 - 4966 Permit # : SP - 9700399 Sec/Twn/Rng : 35 05 64 PERMIT Permit Type : RNEW C=commercial , R"residential + NEW, REPair, VauLT Applied : 09 / 04 / 1997 .Parcel No : 0963 35 000011 Expires : 08 / 30 / 1998 Location : 24804 WCR 57 35 05 64 Legal Desc : 9557 W2NW4 35 5 64 EXC PT WITHIN THE HIGH WATER 24804 57 CR WELD OWNER STROH LESTER A 2208 27TH AVE CT , GREELEY CO 806317714 Description : HOUSE Commercial ( Y/N ) : N Residential ( Y/N ) ': Y Acres : 80 . 00 Number of Persons : 4 Basement Plumbing ( Y/N ) : Y Number of Bedrooms : 3 Bathrooms - > Full : 1 3 / 4 : 1 / 2 : Water Public ( Y/N ) : Y Utility Name : CWCWD Water Private ( Y/N ) : • Cistern ( Y/N ) : Well ( Y/N ) : Water Permit No : - Percolation Rate : 63 Limiting Zone : -Etft 6 in Desc : Ground Slope : Dir : _ Soil Suitable ( Y/N ) : tj Engineer Design Req ' d ( Y/N ) : In 100 Yr Flood Plain ( Y/N ) : From the application information supplied and the on-site soil percolation data the following minimum installation specifications are required : • Chambers Septic Tank : 1,OCK) gallons , Absorption Trench sq . ft . or .,,� 0111Akie9 Absorption Bed 'a�'t5 s q . f t . In addition , this permit is subject to the following additional terms and conditions : C.( 4 1904LLasyttr° NOTICE This permit is granted temporarily to allow construction to commence . This permit may be revoked or suspended by the Weld County Health Department for reasons set forth in the Weld County individual sewage disposal system regulations including failure to meet any term or condition imposed thereon 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 not transferable . Before issuing final approval of this permit the Weld County Health Department 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 Health Department . X POM SAUK Environmental Specialist ate ' WELD r.OUNTY HEALTH DEPARTMENT ENVIRONMENTAL PROTECTION SERVICES SITE EVALUATION OWNER : S- 77?--DH- , Les '{-e1- APPLICATION NO . : ST 97 " 3 " SITE : Z '1 '2o tI Ii_JCy& & 7 PT S 3S- T S R 6 L/ DATE : / P h `� i ' SUBDIVISION : LT BLK FLG PERCOLATION TEST DATA : Start Time : la ' VQ Hole Hole H2O 3; 0 -3b min . No . Depth Remain min . min . min . min . min . min . Mn . min . min . inch S9S S3c r ( it Saa 5-IS- 16- , 115- 2'6 r _ 384 4 4 1 I O 44b 60.0 2yil .5 75- 5-4D 4 0 , I/ Ts- Sag"- l tf , - LAS' y`(5 3 3? /D 76 #1‘. I , 410 if $O Ii �f( trip 7 Z. • ♦ .4 .6 3011i ° 10 ' 4 no tits` o1 r f3o " / sea �' 1 , . Ssr sys" 6 15ct Car 515- 1 6 3O Jo - - Zsy All measurements in . mm unless otherwise indicated . 138 1 * - Add H2O Total Environmental Specialist r' Average Rate 603 PLOT PLAN SOIL PROFILE t "Lea- 1 0 se 3 . 5 --- ) (ier0 0 vi it M CCCellieW ifb"\sr, . ` 3ta ,,,,,d,„! 1,,,,,,Ls ... - � ,„,2a,,,a sn„,,,,,„k �. �1 7 I Yi 3_ 5- i rGagaS Qom, .4. dr./ ki 7 ' .._ ii,.42.c Fc4,...4,trit.,... u — feica„,...-,, na.,,...4, Rat./ • -,i-- inr, fn._ ,„. e • r McRAE & SHORT, INC. • 1231 8th Avenue Greeley,• Colorado 80631 Telephone (97Q 356-3101 Engineering, Surveying, Planning & Land Development November 7 , 1997 PROJECT NO . 97237 Environmental Health Services rRiRi957\11571 Weld County Health Department 1517 - 16th Avenue Court Greeley , CO 80631 I NOV i 7 199r tj+• c . , u t .i ) u L r' f . RE : ISDS NO . SP 9700399 - LESTER A . STROH LOCATION : Located in the West Half of the Northwest Quarter of Section 35 , Township 5 North , Range 64 West of the 6th P . M . , Weld County , Colorado . ADDRESS : 24804 Weld County Road 57 , GENERAL : Application was made to the Weld County Health Department under Permit No . SP 9700399 . The Weld County Health Department perco- lation. test dated October 10 , 1997 shows an average precolation rate of 63 mpi ( minutes per inch ) . Ground water was located at 7 feet below the surface , and the "seasonal " high ground water judged to be 3 . 5 feet below the surface . The "engineered design of this system is required due to the need for a minimum of 4 feet of suitable soil or a 4 foot distance above groundwater table . The most feasible and recommended design is to place the bottom of the leach field I foot above the exist- ing ground surface . The bed area shall be excavated 3 feet below the existing ground and replaced with 4 feet of "suitable" soil . The selected distribution system ( 24" depth ) should then be in- stalled . The surface of the bed , when completed , will be 3 feet above the existing ground . Overlot grading shall be placed around the raised leach field and extend a minimum of 6 feet beyond the b'ed area to provide contain- ment and slope protection . With the leach field being in a " raised " condition , care must be taken in considering the finished floor elevation of the house to pro- vide a gravity feed system to the septic tank and leach field . • I i Environmental Health Services November 7 , 1997 Weld County Hbalth ' Department PROJECT NO . 97237 RE : ISDS NO . 9700399 - LESTER A . STROH SEWAGE LOAD : 3 bedrooms X 2 people X 75 gpd ( gallons/day ) = 450 gpd Peak loading @ 150% X 1 . 5 Design loading 675 gpd SEPTIC TANK: 675 gpd X 30 hr . retention/24 hour flow = 845 gal . Use a standard 1000 gallon tank ( minimum ) . Mr . Stroh has indi - cated the existing tank will continue to be used . LEACH FIELD : STANDARD BED : Standard bed with perforated pipe distribution , selected gravel encasement , silt barrier and top soil cover . Q Xy' T X 1 . 30 BED AREA = 3 . 5 675 X 1/410 X 1 . 3 AREA = ' = 795 S 3 . 5 ALTERNATE BED SIZES : ( MINIMUM ) Width Length Area Description 18 ' X 45 ' = 810 SF ( 3 lines X 45 ' ) 24 ' X 34 ' = 816 SF ( 4 lines X 34 ' ) 30 ' X 27 ' = 810 SF ( 5 lines X 27 ' ) 36 ' X 23 ' = 828 SF ( 6 lines . X 23 ' ) LEACH FIELD - ALTERNATE WITH INFILTRATOR UNITS : Standard absorption bed = 795 SF Infiltrator System Factor X 0 . 50 • Infiltrator Bed Size = 400 SF INFILTRATOR UNITS : 400 SF = 25 . 6 Units . . . . Use 26 Un is ( Minimum ) 15 . 6 SF/Unit • -2- 1 • . Environmental Health Services November 7 , 1997 Weld County Health Department PROJECT NO . 97237 RE : ( SOS NO . 9700399 - LESTER A . STROH INFILTRATOR LAYOUT : ( One Unit is 3 ' X 6 . 25 ' long ) Leach Area Bed Area 4 rows X 7 Units = 28 Units = 437 SF 12 ' X 43 . 75 ' = 525 SF 5 rows X 6 Units = 30 Units = 468 SF 15 ' X 37 . 5 ' = 562 SF 6 rows X 5 Units = 30 Units = 468 SF 18 ' X 31 . 25 ' = 562 SF 7 rows X 4 Units = 28 Units = 437 SF 21 ' X 25 ' = 525 SF NOTES : The absorption bed area is to be fenced or barricaded to prevent large animals or vehicular use of surface above the bed . The attached General Notes and Design Specifications shall be used in conjunction with the standards established by the Weld County Health Department . McRae & Short , Inc . '��t+++++iu►�� tioitZtp ... ;11••41.14 c2C.,53;:a angr 6616-Gera l d B . McRae , Profess i ona I $ �ig neer and d Land Surveyor, Colorado Reg . 4.4416 . �gND ,��,. I/1f++++11+ttit Enclosures : Specifications and Detail Weld County Health Department Percolation date ( 10- 10-97 ) . -3- • . McRAE & SHORT, INC. CLIENT LESTER R . STROH PROJECT NO. 97237 Greeley, Cotorado .4 ISDS NO . SP 9700399 r>�OlECT Engineering, Surveying MADE BY OATE CHECKED Dv DATE SHEET I OF 4 GENERAL NOTES I . ALL CONSTRUCTION SHALL BE IN COMPLIANCE WITH THE WELD COUNTY HEALTH DEPARTMENT AND STATE REGULATIONS . 2 . ANY DEVIATIONS FROM THE PLAN MUST BE APPROVED PRIOR TO CONSTRUCTION BY THE WELD COUNTY HEALTH DEPARTMENT AND/OR THE DESIGN ENGINEER . 3 . ALL PARTS OF THE FIELD SHALL BE LOCATED A MINIMUM OF ID FEET FROM ALL i' PROPERTY LINES , A MINIMUM OF 20 FEET FROM ALL BUILDINGS , AND THE REQUIRED MINIMUM DISTANCES FROM ALL OTHER PERTINENT LAND FEATURES . 4 . THE SYSTEM SHALL BE INSPECTED BY THE WELD COUNTY HEALTH DEPARTMENT AND/ OR THE DESIGN ENGINEER DURING THE CRITICAL PARTS OF CONSTRUCTION OF THE SYSTEM. 5 . POSITIVE DRAINAGE SHOULD BE PROVIDED TO MINIMIZE. SURFACE RUNOFF WATER FROM ENTERING THE SYSTEM . , 6 . THE TOP OF THE FIELD AND FILL SLOPES SHOULD BE SEEDED OR SODDED WITH LAWN GRASS OR EQUAL TO CONTROL EROSION AND TO AID THE EVAPORATION-TRANS-- PIRATION PROCESS _ • THE PLANTING OF LARGE TREES , SHRUBS , OR ANY DEEP-ROOTING PLANT SHOULD BE PROHIBITED . 7 . NO PART OF THE FIELD SHOULD BE COVERED WITH PAVEMENT OR GRAVEL NOR SHOULD THE FIELD BE DRIVEN OVER . 8 . IT IS IMPORTANT THAT TRACTOR TREAD COMPACTION OF THE SOILS AT THE BOTTOM OF THE BED BE MINIMIZED SO THAT THESE SOILS DO NOT BECOME IMPERMEABLE FOR THE ABSORPTION OF THE EFFLUENT . IF THESE SOILS ARE CO;-�PACTED , IT IS RECOMMENDED THAT THE BOTTOM OF THE EXCAVATION BE - LOOSENED AND ROUGHENED PRIOR TO PLACEMENT Of THE SAND . - McRAE & SHORT INC. CLIENT LESTER A . STROH PROJECT NO. 97237 Greeley, Colorado I SDS NO . SP 9700399 rROJCCi Engineering, Surveying MADE BY OATE CHECKED BY _ DATE SHEET 2 or 4 DESIGN SPECIFICATIONS I . SEPTIC TANK : 1000 GALLONS ( MINIMUM ) PRECAST TANK CONSISTING OF 2 COMPART- MENTS . USE EXISTING TANK . 2 . ENGINEERED FILL MATERIAL: 4 FEET ( MINIMUM ) OF MATERIAL COMPOSED OF IMPORT- ED , WELL GRADED GRANULAR MATERIAL APPROVED BY THE ENGINEER . THE ENGINEERED FILL SHALL BE PLACED IN 6 " TO 8 " LIFTS AND MECHANICALLY COMPACTED TO 85 % OF STANDARD PROCTOR DENSITY ASTM D 698- 78 AND HAVE A PERCOLATION RATE OF BETWEEN 5 AND 10 MINUTES/ INCH ( SEE DESIGN ) . THE FILL SHOULD NOT BE OVER= COMPACTED . SUBMIT MATERIAL SAMPLE - FOR APPROVAL PRIOR TO CONSTRUCTION . FIELD DENSITY TESTS SHOULD BE PERFORMED IN THE ENGINEERED FILL AND SUB- MITTED TO THE WELD COUNTY HEALTH DEPARTMENT . 3 . STANDARD BED AREA : 795 SQUARE FEET ( MINIMUM ) WITH LEVEL BOTTOM & LAYERS . 3a . COVER - UNTREATED BUILDING PAPER. PLACED OVER THE ABSORPTION MATERIAL TO PREVENT THE BED FROM BEING CLOGGED DURING BACKFILLING OPERATION . 4 . ALTERNATE " INFILTRATOR SYSTEM" , USING 26 UNITS OF STANDARD DESIGN , FOR A TOTAL AREA OF 406 SQUARE FEET . THE UNITS SHALL BE PLACED ONTHE RE- PLACEMENT SOIL . THE INTERCES BETWEEN THE UNITS SHALL BE THE SAME AS THE REPLACEMENT SOIL , EXTENDING AT LEAST 2 " ABOVE THE UNITS . 5 . APPROVED BACKFILL MATERIAL : 10 TO 18 INCHES ( MAXIMUM ) OF SELECT SILTY SAND AND/OR SANDY SILT . SUBMIT MATERIAL SAMPLE FOR APPROVAL PRIOR TO CONSTRUCTION . 6 . DISTRIBUTION BOX : INSTALLED LEVEL TO PROVIDE EQUAL DISTRIBUTION OF THE EFFLUENT TO EACH UNIT . LESTER A . STROH PRosEcz moo. 97237 _ . '11cRAE & SHORT, INC. c�tFNT - " " Greeley, Colorado PhoJECT I SDS NO . . SP 9700399 •Engineering, Surveying MADE BY DATE CHECKED BY DATE SHEET 3 or 4 — ,d3 ° 7, cl it VCr Iv. \e‘D://://‘ , CI CCtS t iii 1 ts<\ r r .. L .. / / , , A / rLLJJ qp/ .61 • c . 7 • ! p • p . of . • . i ‘fri? l • ' o / "// 1...ti V O , O b • I ' O C } ' • // AM: " •( O C U O O /•O ` �7 --Q ' � 1 ' n k. V _ I ' o Cr T4 • / ( ^ } v ) J V • C., , •m " / , • l 0 ft V v . - - , - � ( , - 10 k.G, `' o oW - ra _, Zi 1 , &'n .. o•, O / (n . t A / alig, V0 p •\- • , I ,NA •mqG' ` WELD COUNTY HEALTH DEPARTMENT ENVIRONMENTAL PROTECTION SERVICES SITE EVALUATION .., OWNER : S TRa hi f Les '-(Z. APPLICATION NO :. 9 7 °°31 q sin : . 2. `f 70 '1 LiC t2- .s_ 7 PT -S 3 S- T - S R 6 L/ . J r DATE : / ° 1 (° t.`t SUBDIVISION : LT -BLK . FLG PERCOLATION TEST DATA : Start Time : 12 v . Hole Hole 1120 , 3 O 3 p . min . No . Depth Remain min . min . min . min . min . min . min . min . min . inch 5'15- S5C 1 ip : I if 11 Sea 5`;c 4 1(5- _ g'-. "0 , 6e0 , ;A., ii ..5 7.5-- Stip is ,ii II I 2.-d) _. , oc 4IS 50cr . SS" yt5 - . 76 A 3 3° ri 1 /O /Ai _ L( 70 , 430 _ / r,-6 ._y60 1« 07.4 4 3 �`t o p - 1 1 F a i , is I 1 fr5 yba • 1 S-2- 5 e SSA"' Ctir 6 5 30 )0 . 21/44 e I 1 , . All measurements in . mm unless. otherwise indicated . J8 1 „ * -- Add H2O To to l 6.2 Environment Specialist �' al Average Rate PLOT PLAN SOIL PROFILE N -------___tic ;. , ,... 1 ‘--- .., '4.0 . •vo n 3 - 5 r . 0 Ill i 61 a Q J _..-� �-p� 5 _ S _}- ._- _.. - i --.0 d.1;.c.. �.Ar � \ 1. .f_2G `r G'! 4) -)-"5- 1- 7 I rkw;vete- t_. 7l J / 1 r V 1 . ki 71 _ _rt .z,c. tr,,,b . 1.... 7 I_ ESTER A . • STROH ISDS NO . SP 9700399 4.42- , , , '. g. . _ r-, Al- 0 rnnflT tkin Don ' n77Z7 J ✓ • (art DEPARTMENT OF HEALTH 1517 16TH AVENUE COURT GREELEY, CO 80631 ADMINISTRATION (970) 353-0586 CI) HEALTH PROTECTION (970) 353-0635 • • COMMUNITY HEALTH (970) 353-0639 COLORADO - FAX (970) 356-4966 • October 13 , 1997 To : Applicant for Weld County Individual Sewage Disposal System Applicant : Lester Stroh Application No . : SP- 9700399 • Address of Proposed System : 24804 WCR 57 • Legal Description of Site : PT : 000 SEC : 35 TWN : 05 RNG : .64 Subdivision : N/A Lot : 000 Block : 000 Filing : 000 Date of Site Evaluation : October 10 , 1997 By : Troy Swain • • Dear Applicant : • Please be advised that the proposed Individual Sewage Disposal System for the above site must be designed by a Colorado Registered Professional Engineer as per Weld County I . S . D . S . Regulations 3 . 5 and/or . 4 . 6 , as follows in part : 3 . 5 . . . . Except as provided in 25 - 10 - 107 , CRS 1973 , no permits shall be • issued for the following systems unless they are designed by a Registered Professional Engineer and after they have been received • . and approved by the Board of Health . • D . Absorption fields for which the location cannot meet suitable soil or slope requirements . J October 1� , 1997 • Lester Stroh Page 2 4 . 6 A suitable soil shall meet the following criteria : A . A minimum depth of four ( 4 ) feet between the bottom of the proposed absorption field. and any limiting zone ( s ) . (Depth to limiting zone at above site : 3 . 5 ' Seasonal high groundwater ) . B . Has the capacity to adequately disperse the designed effluent loading as determined by a field percolation rate of between five ( 5 ) minutes per inch and 60 minutes per inch or by other approved soil tests ( Percolation rate at above site : 63 m . p . i . ) . C . Acts as an effective filter within its depth for the removal of pathogenic organisms . The engineer design must be approved by the Weld County Board of Health before a permit can be issued . The Board of Health meets on the fourth Tuesday of each month : therefore , the engineer design must be submitted to this office ten ( 10 days prior to the meeting . Should you have any questions concerning this matter , please contact this office . Sincerely , • Troy Swain Environmental Protection Specialist TS/ rb- 2946 • WELD .COUNTY HEALTH DEPARTMENT ENVIRONMENTAL PROTECTION SERVICES SITE EVALUATION OWNER : d\i' APPLICATION NO . : C1 SITE : �. q)1409----6T PT S T R DATE : A ok \\en SUBDIVISION : LT BLK FLG PERCOLATION TEST DATA : Start Time : Hole Hole H2O min . No . Depth Remain min . min . min . min . min . min . min . min . min . inch 1 ` - . - , ..._ .. 2 N . . 3 , I , • 1 \ r 4 4 H . . \ a All measurements in . mm unless otherwise ndcated . * - Add H2O Total CIVVEnvironmental Specialist O9.k Average Rate PLOT LAN SOIL PROFILE ..<-1 O\ -._._ ‘Iil 'cis. blei ' 642: 611 ---1:: \tasik :b' v,Irudivs---H.,thi,._, — - , , g i f Der - br - �1,1�i�. mss' bc}�,� - 0 Cx� J "m at .., nt it\ ti ??Mi9 - o -btu Cet Qjiackr eta : 0 :7 • • I ti: .. .. ;4. _ _ . ' 4 • , • I 4 1 4: • all I• • • •i • I` . • • . ' ry . ,• '.r• . .• 4 r,, .� g •', . • . r, ' I, ! �'• S 1::' !' \ ' ..�• •, t-t'raF' �.IC l�l�' - INDIVIDUAL. .:y1:.1t.,Jr'n:+#�. • >.� :1: ,:>. (:� >r�'sl.,. ':YY .:>'1"E::1 l 1�'iWl�-,iv!;1: , • I- '• 1'♦j�:l . (:�• ��#�C�-,...72,45-,N. ; W,J1:"L• 0 i::t::t.J1',#..I•''( I••i1:.:t"s1...•I1••I ')VII.:'(:.: ,,.,•1i"fril:::N1 1 - ,•:•►:I.'s-1 :1: R PEE MT•'r , • . t - I:::N1%VI1=:fal''II II 11. • L. f••#I:::ill•.• r'c••i ::31:11::."..1 1: , • •.. 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MEMORANDUM • • TO: File - - DATE: September 18, 1997 - - • "live FROM: Pam Smith, ISDS Program Coordinator COLORADO SUBJECT: Les Stroh NOV • • Mr. Stroh called me September 17, 1997 to tell me that the farmer to the south had not harvested potatoes yet, that they plan to harvest them next week (September 22, 1997). He has contacted Duane Unruh to help install the system and will call for a perc test when the field is ready. _ Tuuca secneoc- 9 ()A zkigote urces-4- euec 4c2A. e -iLedittista 6,(A • • • itit • MEMO.MEMORANDLJ M _ _ ____ . ._ . TO: File DATE: September 4, 1997 1111. o . • FROM: - Pam Smith, ISDS Program Coordinator COLORADO - . • SUBJECT: Lester Stroh NOV • • Lester Stroh came in today and applied for a repair permit (SP-9700399) and paid for a site evaluation for his property located at 24804 WCR 57, Kersey. He will schedule the site evaluation once the potato field to the south has been harvested (approx 1 -2 weeks, he will . . _ . .. . . . . . . . .• He is aware that a portion of the potato field will have to be taken out of production once the absorption field is installed and has agreed to this. • • • • . • • ' ' 1 ' tk li)l..i:ii:1”7.• 41° 61 6 • • a ' ` (493/4.10L ds Misit 1 cicienme2 • (iik,,0LAPc.9 1,.., UtCAl A ft5.1.° .. Y I. •.-4Lk s 'St'y.:'t' ' \, a.wig n(//' Ltnahft / 424{Antu:li, . . •.• J 411614 I le 4 • : - r d.L&..QFC\eknittii . .. . . - . . . it-ta.4 • , . , . • .• . •..• •. . . . IhU�I,�- .• ' a.: %%Pt "t.., . 1/411.).:j..- .• ... :' a til Wass (FL • . .- .- . . -. . 111 ��// . -•. ii.i.A. ithictututk....56i0LA, . • intkillAlteVLA nikLet: . . . • . • . . . vw.t. ik. ,cmaiti. . • . . - •YI[4 ;.! .Y' . 1 ) y igem Skil ilft,t1A.. eb • . ... .. . . - • • . . . . . • . . Wtkt n,�,...,„tc.,,s • — re) 'SAUL,: k sy.i.jiksQ,. Sots nu_ ,frui9 °AAA,. kiss . Q ba , . . . • . • t Vail" (PA stioc • b . . .• . . . . r•. ..pol .;, ' .• 2 : .- ;.‹.2i..Cta • e''. 2 gele [air::k d OW:C. (-) [(JO...41:d <410 . - .1, • • ( (1111/4 or •• 5CCD AI e 4.41.1t 94 frilLti, 2cJur") ,� S p • • • • • • • . . t!) t • • `. . , -.M�'� ••pis' ' :''• • .- . 't' • 'i . • • • •• •• .r}. ,tom . :f.' •�,;'• • 't . . .__.. ____. __-. ..._.. _ _ • • ' t- •-•' „ ° , • • ; ..&-•.•• C P:.., •i . ,,.r` •T� . ' • • . • :t✓•. • •., A .1 • • • r • •C:�YY yc.:• • ti:. . till' • T. - • . ar, .•.jf.r '�.)♦r'.' ' `` N• skr ?q '•.• .'r• �$a • ti• ++-: _ .:.1 '� n . Firr. . ... 0._ 414‘41:? . • (� oci,c0 3 pU c°v t \ DEPARTMENT OF HEALTH 1517 16TH AVENUE COURT GREELEY, CO 80631 Willie ADMINISTRATION (970) 353-0586 HEALTH PROTECTION (970) 353-0635 COLORADO COMMUNITY HEALTH (970) 353-0639 - FAX (970) 356-4966 . .-. July 16 , 19 9 7 , .1�{ l�� .. . . . _ �J Ll . Certified Letter No . : P 414 598 919 . Legal Action No . : 97 - 023 SyMLAA rt ' 'c c0 f 6hy Lestr A . Stroh 5G - OC e 2208 27th Avenue Court �� Greeley , Colorado 80631 Dear Mr . Stroh : In response to a complaint , your property located at 24804 Weld County Road 57 , Kersey, was investigated on June 27 , 1997 , by Pam Smith . The inspection revealed sewage surfacing and draining through a pipe into the field to the east . . Please be advised that the above described situation is in violation of Weld County Individual Sewage Disposal System Regulations , as follows in part : Sec 3 . 1 "General Sanitation Requirements : The owner of any structure where people live , work, or congregate shall insure that the structure contains an adequate , convenient , sanitary toilet and sewage disposal system in good working order . Under no condition shall sewage or effluent be permitted to be discharged upon the --- - - surface of the ground , . . . . " - Also be further advised that : Colorado Revised Statute Section 25 - 1 - 613 provides the following : "The Board of Health shall examine all nuisances , sources of filth , and causes of sickness , which , in its opinion , may be injurious to the • 6 Lester A . Stroh June 16 , 1997 Page 2 of 2 health of the inhabitants , within its own town , city or county . . . , and it shall destroy , remove , or prevent the same as the case may require . " Be advised that you have five ( 5 ) days from receipt of this notice to correct the aforementioned violation ( s ) . Failure to comply with the above , shall result in further legal actions as specified in Weld County Individual Sewage Disposal System Regulations , as follows , in part : 3 . 24 Penalties Any person who commits any of the following acts or violates any of the provisions of the regulations commits a Class I petty offense , as defined in Section 18 - 1 - 107 , CRS 1973 . A . Constructs , alters , installs , or permits the use of any individual sewage disposal system, without first having applied for and received a permit as provided for in 25 - 10 - 106 , CRS 1973 or 25 - 10 - 105 ( 1 ) ( f ) , CRS 1973 . If you should have any questions concerning this matter , please contact this office at 353 - 0635 . Sincerely, -QU\AcY\WR 911.4b1.50- at a Pam Smith - Jeffrey L . Stoll , M . P . H . Environmental Protection Specialist Director Environmental Protection Services PS/jh- 2413 . cc : John S . Pickle , M . S . E . H . , Director , Weld County Health Department Lee Morrison , Assistant County Attorney _ WELL) CUUNTY HEALTH DEPARTMENT . ••,..c.:: :,.. . .• FORMAL COMPLAINT RECORD /-� - --• 4, - . .---73197 1 ('''`-•. (*) 1 ) /. . R3 Complaint No . : t m' / ' ( •„_ . 6---c Date/Time : Complainant : • . Address Phone : ,_._. �/ _ Lokr A" S* ch-Owner : - - •/-1(1- Z-,..2 Address Jl/ Ou ele al i.e (�'-. oriP .e Phone : iv . ... Address /Location : i �% - ,?•--=:,�� /;. 7 l7-�t'/ �1� • - • --..... __. • _ Complaint : ( 4 ( -� l _ti _xiy_ . . r .it .1 , 1. eLinaJ iti .i 4.<. , / 1- • 11: .,./le / 1.://:/// . ...1-*) 1,2 .-cy-ti till..1-10 4 -.-( al L. ilfril/e /7‘-^01 -2 / (7 Di// idyee4 /Ia.,/ / A e I /,/"del N 71--e-1 (f7 ,- S 2 / . .•1 Li 1q0 Received by : /X Investigation : A BY : jfif W2M11-fr Date : Action : (*.)( t ; . r . . A,)00 S iii 'C `f �,(..�\ ptopu ,-1. e _ By : Date : Follow-up : By : Date : Final Disposition : By : . • Date : • • • .♦ ....a.._..__....w•..Y•.JC..•..'.. ..4L.M*4.,Mi.. . .N..L..Y1.L-.+..MrW_.J1r.Nfr•IMa\L. yfrLWa_\�-\r You_+1\Y.M1�..r\•.rr.I...NW./J\:.\uti...�........., _,r'_... :. .:r.�.. .J4 ••..l •.••..• .. . ..\ •. .. _. .. • • , • tTjZt; . DEPARTMENT OF HEALTH 1517 16TH AVENUE COURT GREELEY, CO 80631 ADMINISTRATION (970) 353-0586 0 HEALTH PROTECTION (970) 353-0635 • COMMUNITY HEALTH (970) 353-0639 COLORADO FAX (970) 356-4966 • December 4 , 1997 • Lester Stroh 2208 27th Avenue Court Greeley , Colorado 80631 RE : Individual Sewage Disposal System Permit No . : SP - 9700399 Location : 24804 Weld County Road 57 , Kersey , Colorado 80644 Dear Mr . Stroh : This is to inform you that your Engineer Designed Septic System has been reviewed by the Weld County Board ofTHealth and approved . A copy of the Weld County I . S . D . S review Form and your I . S . D . S . Permit are enclosed PLEASE NOTE THAT THE SYSTEM MUST BE INSPECTED BY A REPRESENTATIVE OF THIS DEPARTMENT AND BY THE DESIGNING ENGINEER BEFORE THE SYSTEM CAN BE APPROVED FOR OPERATION . THE ENGINEER MUST BE CERTIFY TO THIS DEPARTMENT . IN WRITING, THAT THE SYSTEM HAS BEEN INSTALLED ACCORDING TO HIS /HERS SPECIFICATIONS . Should you have any questions regarding your septic system, please contact this office at your earliest convenience at 353 - 0635 . Sincerely , 9/#1 • -SC( Jeff Stoll MPH , Director Environmental Protection Services JS/rb- 3141 cc : Gerald McRae , McRae & Short , Inc . • WELD COUNTY BOARD OF HEALTH ENGINEER DESIGNED SYSTEM REVIEW PROPERTY OWNER: Stroh, Lester PERMIT NO.: SP-9700399 (New) LEGAL DESCRIPTION: PT: SECTION : 35 TOWNSHIP: 05N RANGE: 64W SUBDIVISION : N/A LOT: 000 BLOCK: 000 FILING: 000 SITE ADDRESS: 24804 WCR 57, Kersey, Colorado 80644 FACILITY: Residential 3 rxelkr t . v► ied ACRES: 80.0 PERC RATE: 63.0 SOIL: Unsuitable WATER SUPPLY: Central Weld SLOPE: LIMITING ZONE: At-grade-Clayloam, 3.5ft-groundwater Yes ENGINEER DESIGN (3.5) No EXPERIMENTAL DESIGN (3.14) ENGINEER: McRae & Short ADDRESS: ESTIMATED FLOW: 675 G.P.D. PRIMARY TREATMENT: Standard tank (existing) CAPACITY: 1000 GALLONS DISPOSAL METHOD: Mounded Absorption bed SIZE: 795 SQUARE FEET REQUEST FOR VARIANCE: N/A STAFF COMMENTS: The system is adequately sized for the proposed load. The system will be mounded 1ft above existing grade. STAFF RECOMMENDATION: Approval ENVIRONMENTAL PROTECTION SPECIALIST: Pam Smith 211 1qq- REVIEWED BY BOARD: November-25;11997 B.O.H. DECISION: APPROVED: -E DENIED: TABLED: g. sThies, Ben Slater, Chairperson Weld County Board of Health PS/rb-3061 • r� • I y • * * * * * * * * Ry * * * * * * * * * * * * * * * * * * * * * * * * * * * * Ay * * * * * * * * * * * * * * * * * * * * * * * * * * * Ky * * * * * * * * * WELD COUNTY HEALTH DEPARTMENT ( 970 ) 353 - 0635 RECEIPT * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * •* * * * * *• * * * * * * * * * * * * * * * * * * * * * * * * Receipt Number : 97001983 . Amount : 115 . 00 09 / 04 / 1997 09 : 35 . .Payment Method : CHECK Notation : 1833 Init : RBUSTILL Owner Name : STROH LESTER A Applicant Name : Permit No : SP - 9700399 Parcel No : 0963 35 000011 4175986 Site Address : 24804 WCR 57 WEL Location : 24804 WCR 57 35 05 64 Total Fees : 240 . 00 This Payment 115 . 00 Total ALL Pmts : 240 . 00 Balance : . 00 * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *•* * * * * * * *• * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Account Code Description Amount 256041400 - 4221 - 400 New Septic Permit . 00 256041400 - 4221 - 400 Repair Septic Permit 125 . 00 256041400 - 4221 - 400 Vault Permit . 00 256041400 - 4221 - 400 Site Evaluation 115 . 00 256041400 - 4730 - 400 Potable Water Sample . 00 Description : HOUSE Commercial ( Y/N ) : N Residential ( Y/N ) : . Y Acres : 80 . 00 Number of Persons : 4 Basement Plumbing ( Y/N ) : Y Number of Bedrooms : 3 Bathrooms - > Full : 1 3 / 4 : 1 / 2 : Water Public ( Y/N ) : Y Utility Name : CWCWD Water Private ( Y/N) : Cistern ( Y/N ) : Well ( Y/N) : Water Permit No : NOTICE Applicant acknowledges receipt of the individual sewage disposal system guide and that the completeness of this application is conditional upon further mandatory and additional tests and reports as may be required by the Weld County Health Department to be made and furnished by the applicant or by the Weld County Health Department for purposes of the evaluation of the application; and the issuance of the permit is subject to such terms and conditions as deemed necessary to insure compliance with rules and regulations adopted under article 10 , title 25 , CRS as amended . The applicant certifies that the proposed system will not be located within 400 feet of a community sewage system . The undersigned hereby certifies that all statements made, information and reports submitted herewith and required to be submitted by the applicant are, or will be, represented to be true and correct to the best of my knowledge and belief , and are designed to be relied on by the Weld County Health Department in evaluating the same for purposes of issuing the permit applied for herein . F further understand that any falsification or misrepresentation may result in the denial of the application or revocation of any permit granted based upon said application and in legal action for perjury as provided by law . X /49- - 4 --sie/iT 7 OWNER/APPLICANT Date 7 t * * * * * * * 4 * * * * * * * * * * * * * * * `aC * ?i X *" * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * :F * * * * * * * * WELD COUNTY HEALTH DEPARTMENT ( 970 ) 353 - 0635 RECEIPT * * * * * * * * * * * * * * * * * * * * * * * * A * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Receipt Number : 97001980 Amount : • R125 . 00 09 / 04 / 1997 09 : 12 Payment Method : CHECK Notation : 1832 Init : KLOERA Owner Name : STROHJLESTER. A Applicant Name : Permit No : SP - 9700399 Parcel No : 0963 35 000011 4175986 Site Address : 24804 WCR 57 WEL Location : 24804 WCR 57 35 05 64 Total Fees : 125 . 00 This Payment 125 . 00 Total ALL Pmts : 125 . 00 Balance : . 00 * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Account Code Description Amount 256041400 - 4221 - 400 New Septic Permit . 00 256041400 - 4221 - 400 Repair Septic Permit 125 . 00 256041400 - 4221 - 400 Vault Permit . 00 256041400 - 4221 - 400 Site Evaluation • 2 . 00 256041400 - 4730 - 400 Potable Water Sample . 00 Description : HOUSE Commercial ( Y/N ) : N Residential ( Y/N ) : Y Acres : 80 . 00 Number of Persons : 4 Basement Plumbing ( Y/N ) : Y Number of Bedrooms : 3 Bathrooms - › Full : 1 3 /4 : 1 / 2 : Water Public ( Y/N ) : Y Utility Name : CWCWD . Water Private ( Y/N ) : Cistern ( Y/N) : Well ( Y/N ) : Water Permit No : NOTICE Applicant acknowledges receipt of the individual sewage disposal system guide and that the completeness of this application is conditional upon further mandatory and additional tests and reports as may be required by the Weld County Health Department to be made and furnished by the applicant or by the Weld County Health Department for purposes of the evaluation of the application; and the issuance of the permit is subject to such terms and conditions as deemed necessary to insure compliance with rules and regulations adopted under article 10, title 25 , CRS as amended. The applicant certifies that the proposed system will not be located within 400 feet of a community sewage system. The undersigned hereby certifies that all statements made, information and reports submitted herewith and required to be submitted by the applicant are , or will be, represented to be true and correct to the best of my knowledge and belief , and are designed to be relied on by the Weld County Health Department in evaluating the same for purposes of issuing the permit applied for herein . I further understand that any falsification or misrepresentation may result in the denial of the application or revocation of any permit granted based upon said application and in legal action for perjury as provided by law . X 21Ar ( s),? ;• � �T OWN R/APPLICANT Date r , • ♦ ot�t Health i3 WELD COUNTY HEALTH DEPARTMENT pa~tom) 1517 16TH AVENUE COURT GREELEY, COLORADO �� ,r 970-353-0635 970-356-4966 (FAX) r • SEPTIC INFORMATION • • • PROPERTY OWNER is re - A, Stir 01k MAILING ADDRESS °� o- U ir °Q ? A "� C' T 6:420:€6er CITX ST .ZIPS' 0 6 3 / HOME PHONE 33o71 tf WORK PHONE FAX SITE ADDRESS • `944"8- ° 1iv a f2 7 DIRECTIONS TO SITE / 5 2 , 2 v F /r'.�vc3j o - j2 )2 (N LEGAL DESCRIPTION PT 1111 4pT $SEC3S'C TWN ;dRNG 6 ' ACRES re" SUBDIVISION LOT BLOCK FILING PARCEL NO CALL ASSESSOR AT 353-3845 EXT 3650 THIS NUMBER IS DIFFERENT FROM LEGAL,DESCRIPTION 100 YEAR FLOOD PLAN? CENSUS TRACT RESIDENTIAL? COMMERCIAL? DESCRIPTION A7v EX: HOUSE MOBILE/MODULA/, SHOP. BUSINESS NUMBER OF PERSONS 4/ BASEMENT PLUMBING ACTS NO OF BEDROOMS _a BATHROOMS: FULL / 3/4 1/2 PUBLIC WATER Y / N _ WATER SUPPLIER iC G- l•- ,- WATER PRIVATE Y /N CISTERN Y/N WELL Y/N WELL PERMIT # NEW PERMIT REPAIR PERMIT PERC TEST FAX SI50 st2s SITS Si. • IF THIS IS A REPAIR PERMIT, PLEASE LIST PREVIOUS OWNERS OF THIS PROPERTY ! ( I APPLICANT NAME SA- M'1ie As A- /34, ter_ MAILINGADDRESS CITY ST ZIP HOME PHONE WORK PHONE FAX e ' DEPARTMENT OF HEALTH • 1517 16TH AVENUE COURT f & t\t ‘ t? 44111IlDGREELEY, CO 80631 O • DADMINISTRATION (970) 353-0586 HEALTH PROTECTION (970) 353-0635 • COMMUNITY HEALTH (970) 353-0639 COLORADO 1=AX (97O) 356-4966 • October 14, . 1997 Lester A. Stroh 2208 27th Avenue Court Greeley, Colorado 80631 Dear Mr. Stroh : . As per our meeting yesterday, with Pam Smith , we discussed the options for replacing your Individual Sewage Disposal System located at 24804 Weld County Road 57, Weld County. In Legal Action No. 97-023, you were required to repair this system because at the time of the complaint investigation it appeared to show signs of failure. In our meeting you indicated that the system recently appeared to resume proper function. You indicated that there may have been extenuating circumstances which may have temporarily impaired the functioning of the system this summer. Those circumstances included a prolonged visit by a family and extra washing of dairy equipment and rags. After the meeting I visited the site to observe the condition of the system. As you had indicated , there were no remaining signs of failure. The Division will continue observing the system for six months to assure that the recent improvement is permanent. Your septic permit will remain active during this time. In the event that failure should recur, you will be required to repair the system at that time. A repair will consist of total replacement of the field in accordance with the Weld County Individual Sewage Disposal System Regulations. If you have any questions regarding this matter, call me at 353- 0635 , Ext. 2229. • Sincerely, • 9vt , Jeffrey L. Stoll, MPH , Director Environmental Protection Services cc: Pam Smith , ISDS Program Coordinator • Lee Morrison , Weld County Assistant Attorney �" V • 0 €. H • COLORADO STAFF APPROVAL OF ENGINEER-DESIGNED SYSTEM The engineer-designed-Individual Sewage Disposal System proposed for the property located at 49j-1104 W CL SicN- LIA1/4( , and designed by 1 '- ,--4 SIN,4is hereby approved subject to the - following conditions: (cY6kflkCk QGtideL J C I , , applicant for I .S. D.S. Permit No.: SPC 0 19 under the provision of the Weld County Individual Sewage Disposal System Regulations, do hereby understand and agree that after approval by the Director of Health Protection Services, I may proceed with the construction of my engineer-designed sewage disposal system prior to approval by the Weld County Board of Health, but that the Board of Health reserves the right to disapprove any or all parts of the system design when it considers my application. I understand and agree that I proceed at my own risk and that I may be required by the Board to remove any or all of the system installed prior to Board of Health consideration of my application. • PamSratittksgivam too(c )©Y" ,8 M ( 41 Director-Environmental Plaotection Services Applicant \1�1 °t`k [/ 'vv Date Date ES32 • Scanning Cover Sheet for Septic Permits Permit # G19940396 Permit Type: Health / EHS History / EHS Conversion History Situs Street Address 24804 CR 57 Situs City, State, Zip Sec/Town/Range: 35-05N-64W Application Status: Finaled Application Date: 03/11/1996 Parcel # (12 digits) 096335000011-R4175986 Owner Full Name: STROH LESTER Owner Address: 2208 27TH AVE CRT GREELEY,CO 80631 Owner Phone #: 303 3300994 Contact Name: • Contact Address: Contact Phone# Information above has been Verified in Accela by employee noted below X August 14, 2008 Prose d by: Date Report ID: EHS00024v003 Page 1 of 1 Print Date -Time: 8/14/2008 8:36: 13AM . 1 t . :+i 0 I 15•ISiP :1O6F:' • INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT T NO . G-940396 WEL.J) COUNTY( HEALTH DEPARTMENT REPAIR F:'I:::RIIJ: T ENVIRONMENTAL I••IEAI...'TH SERVICES (1166. 2y; l 1517 16TH AVENUE COURT „ GREELEYv CO 80631. 353-06 35 I f'T ., c:'•4...4.115. OWNER S'TROH 0 L.ESTER AD:DRESS 2208 27TH AVE CRT PH ( 303 ) 330- '0994 '. RE::EL.EY CO 80631 ADDRESS OF PROPOSED SYSTEM 24804 WC:R 57 KERSEY Co 80644 < e) LEGAL.. DESCRIPTION O1:= SITE : W2 NW4 SEC 5 TWE 'K 1: NC 64 SUBDIVISION : ' LOT 0 BLOCK. 0 FILING ING 0 USE TYPE : RESIDENTIAL H(:Il.It3E '/Sa(:JI"' 94 9113 ii. :L ;'a SERVICES : PERSONS 4 BATHROOMS 1 . 00 LOT SIZE 80 . 00 ACRES BEDROOMS 2 BASEMENT PLUMBING NO WATER SUPPLY CWCWD APPLICATION FEE $240 . 00 RE::C ' I) € Y CINDY SALAZAR SIGNED BY LES3TER STROH DATE 08/08/94 DATE 08/08/94 PERCOLATION RA'T'E 9 ., 6 MIN PER INCH LIMITING ZONE:: 43 FEET T SOIL TYPE SUITABLE A*. I.NE:: PERCENT E :PIT GROUND ND SLOPE 0% DIRECTION C:T :1: (:IN REQUIRES ENGINEER DESIGN NO IN ''100 YEAR FLOOD PLAIN ZONE:: NO FROM '1'1•'11::: APPLICATION INFORMATION SUPPLIED AND THE ON-SITE so:E:L. PERCOLATION DATA THE:: FOLLOWING MINIMUM INSTALLATION SPECIFICATIONS ARE:: REQUIRED : SEPTIC TANK 1000 GALLONS„ ABSORPTION TRENCH 348 SO , FT . OR ABSORPTION BED 474 SO . F T ,. IN ADDITION„ THIS PERMIT IS S LJE TECT TO THE: FOLLOWING ADDITIONAL. TERMS AND C:t:It,1Z) 1: 'T' :I t:I1-1Sa NN..0 5555 NN•55 54 NM N..wu uu N.1..55 55-•5........41..4.Nw Nu uu N...•44 N.•..1.•....N..w.N..5555..N NI.N.........•N....N.M N•\......4 N.......u.N..Nu.N.NN.•N.N.•N.MN.N.N..u......u••u...... ..uN.N..1..5.1•..41..N.M..... THIS PERMIT IS GRANTED TEMPORARILY TO ALLOW CONSTRUCTION TO COMMENCE .NC;E . THIS PERMIT MAY BE REVOKER) OR SUSPENDED BY THE WELD COUNTY F'lEAL.LT1'•I DEPARTMENT FOR REASONS SET FORTH I IN THE WELD COUNTY INDIVIDUAL SEWAGE DISPOSAL SYSTEM REGULATIONS U INCLUDING FAILURE TO MEET ANY TERM OR CONDITION I: 'TION IMPOSED THEREON DURING TEMPORARY OR FINAL APPROVAL . THE ISSUANCE OF THIS PERMIT DOES NOT CONSTITUTE ASSUMPTION DV THE DEPARTMENT OR :ITS EMPLOYEES OF LIABILITY FOR THE FAILURE:: OR INADEQUACY OF THE SEWAGE DISPOSAL SYSTEM . STEVE WIATROSKI 09/02/94 ere /o 'lP- .-- 7V a ENVIRONMENTAL SPECIALIST DATE THIS PERMIT IS NOT TRANSFERABLE RALtLE::: AND SHALL BECOME VOID IF SYSTEM CONSTRUCTION N HAS NOT COMMENCED WITHIN ONE YEAR OF ITS ISSUANCE , BEFORE ISSUING FINAL APPROVAL.. OF THIS PERMIT THE WELD COUNTY HEALTH DEPARTMENT RESERVES THE RIGHT TO IMPOSE ADDI - TIONAL TERMS AND CONDITIONS REQUIRED TO MEET OUR REGULATIONS ON A CONTINUING BA- SIS , FINAL DIAL. PERMIT APPROVAL IS CONTINGENT UPON THE FINAL INSPECTION OF THE COM- PLETED ETE ) SYSTEM BY THE. WELD COUNTY HEALTH DEPARTMENT . SYSTEM INSTALLER , r' FINAL :I: I�ESai::'I' ('`'T ' `' �I DA'1'E~� l0 "Nil •III.. •. • N..w.u...M..N....Nw uw wu uN..w Mw....555500 SYSTEM ENGINEER ,� _ Al F'I CIVAL.. ,4•„N1, .4.......w.......4......N.. N1. NM..4. ..•MI\...5 'T'YI::'I": CII:: SYSTEM :1: NSa'1ALL.EI)4 . �, ,,{;l ENVIRONMENTAL N'T'AE... {af ' :C: :I: A ... :E: ti'1' THE ISSUANCE OF THIS PERMIT DOES NOT IMPLY COMPLIANCE WITH OTHER S'TA"f E v COUNTY OR LOCAL. REGULATORY OR Liii :I: L.I) :l: NG F:IE:OUIREMEI+I'rs NOR S1.1AL.1... IT ACT TO CERTIFY THAT THE SUBJECT SYSTEM WILL OPERATE IN COMPLIANCE WITH AF:PL.. :ICABL..E:: STA'TI v COUNTY AND I...00AI... REGULATIONS ADOPTED PERSt.lANT TO ARTICLE 10v TITLE 25 , CRS 1973 ., AS AMENDED v EXCEPT FOR THE: PURPOSE OF ESTABLISHING FINAL APPROVAL OF AN INSTALLED SYSTEM FOR ISSUANCE: OF A LOCAL.. OCCUPANCY PERMIT PURSUANT TO CRS 1. 973 :'. 5- :I. 0-1. 1. 1. 1. ( 2 ) . ORIGINAL-APPLICANT ; COF Y•.•.WCHD WCF•1O-••EF•1S MAY , 1984 1 it ...- -e.e.- \ ite I \45 I P\ 301/ ________A L \___e__. 2.t .e____------A 6 ' � std" \AC) V.-4 k (2‘ 3' ?? \ °, (49 °C C: - --- 1. 3' r , ky `..iii 25'err 0, \& b(R GOO- OA & C � �nok \via ..y(� Is w�-fenavv"`-, ,o • \ . ,,Q),:itube ---$ „ jnierj I fp . t. ett;kk -a wo- Lr A•co • Ste ' 1 I••IS"F' :i. cF' • INDIVIDUAL. SEWAGE DISPOSAL. SYSTEM PERMIT NO .. G_ -9t40396 WELT) COUNTY HEALTH DEPARTMENT REPAIR PERMIT ENVIRONMENTAL HEALTH SERVICES 1517 16TH AVENUE COURT „ (7E• E: ELEY ;. CO 806:3 :L 353-0635 EXT . 2225 OWNER STROH , LESTER ADDRESS 2208 27'rt••I AVE CRT PH ( 30 3 ) 330-0991 GREEL..EY CO £106%:d. ADDRESS OF PROPOSED D SYSTEM 24804 WCR 57 KERSEY CO 80644 LEGAL DESCRIPTION OF s :i: 'T# : is W2 NW4 SEC 35 TWP 6 RN(3 64 SUBDIVISION; LOT 0 BLOCK 0 FILING 0 USE TYPE g RESIDENTIAL HOUSE/SUE 949113 SERVICE:.•.Sg PERSON 4 BATHROOMS 1 , 00 LOT SIZE 80 . 00 ACRES BEDROOMS ; BASEMENT PLUMBING NO WATER SUPPLY CWCWD • APPLICATION FEE $240 . 00 REC ` I) BY CINDY SALAZAFt SIGNED BY LESTER STROH DATE 08/08/94 DATE 08/06/94 PERCOLATION RATE 9 N :I: hi PER INCH LIMITING ZONE ?...le:L FEET SAO :I: I... TYPE . 2 PERCENT GROUND SLOPE: 0• •� DIDIRECTION ..I .... REQUIRES Et`I 3s:E C. NE:.E:: DESIGN _4p,,.. . IN 100 YEAR FLOOD PLAIN ZONE t4 FROM THE APPLICATION .FNFC)RMA'TION SUPPLIED AND THE ON—SITE ?C) :E1... PERCOLATION DATA THE FOLLOWING MINIMUM I: NSTALI...AT :I: (Thi SPECIFICATIONS ARE i aiu :I: RE::I) u SEPTIC TANK E< •1OOO GALLONS .. ABSORPTION TRENCH 3.q.lr SQ .. FT . „ OR ABSORPTION BEI) SQ . FT . .. IN ADDITION , THIS PEF' I T � :I: �S ;. t.m :it :c r .T'C) THE FOLLOWING ADDITIONAL TERMS a AND C(:)NI) I T :EON y :. _............_........... 4-..__1 4, .__ { .... 'r5aisc....7.P a .0 i o.4...�.....&? WL.....C js:t4 ... ...... .. ._..... .i•i••IIS PERMIT IS GRANTED TEMPORARILY TO ALLOW CONSTRUCTION TO COMMENCE .. THIS PERMIT MAY BE REVOKED OR SUSPENDED BY THE WELD COUNTY HEALTH DEPARTMENT FOR REASONS SET FORTH IN THE WELD COUNTY INDIVIDUAL SEWAGE DISPOSAL SYSTEM REGULATIONS:EONS INCLUDING FAILURE TO MEET T ANY TERM C)R CONDITION IMPOSED THEREON DURING TEMPORARY C)R FINAL APPROVAL . THE ISSUANCE OF THIS PERMIT DOES NOT CONSTITUTE ASSUMPTION BY THE DEPARTMENT OR ITS EMPLOYEES OF LIABILITY Y'Y FOR THE FAILURE OR INADEQUACY OF THE SEWAGE DISPOSAL SYSTEM ... ,6 e r ' ! c�-zeta oiNe �� ____ ___ _ ._____________ _________ ___o-p-irpap 9 - ENV I Ath +� NTAL_ SPECIALIST DATE: - THIS PERMIT IS NOT TRANSFERABLE AND SHALL BECOME VOID IF SYSTEM CONSTRUCTION HAS NOT COMMENCED WITHIN ONE YEAR OF ITS ISSUANCE . BEFORE": ISSUING FINAL. APPROVAL.. OF THIS PERMIT THE:: WELD COUNTY HEALTH DEPARTMENT RESERVES THE RIGHT TO IMPOSE ADDI - TIONAL TERMS AND CONDITIONS REQUIRED TO MEET OUR REGULATIONS ON A CONTINUING BA- SIS . FINAL_ PERMIT APPROVAL IS CONTINGENT UPON THE FINAL INSPECTION OF THE COM- PLETED SYSTEM BY THE: WELD COUNTY HEALTH DEPARTMENT . OR 1 (3 :E NAL..•-AF'F'I.. I CANT COPY - WOHI:) WCHD-EHS MAY , 1984 A 'It WELD COUNTY HEALTH DEPARTMENT ENVIRONMENTAL PROTECTION SERVICES • • , , • SITE EVALUATION , OWNER : La: 4E .. '5=- W APPLICATION NO . : c49gciz%, SITE : en SOLI LOC-a 61 PTw /L 535 To<oR ( ( DATE : -c2 -9Y SUBDIVISION : rJR LT gs BLK FLG 0 PERCOLATION TEST DATA : Start Time : ap `. Hole ` Hole H2p a�`5 3 as.5 -CD min . No . . Depth , Remain man . , man. min . min . 0 min . _ min . _ min . min . min . �n fi 320 32.0 31c e. t0 4.Qo� ru. 190 abs e 1 / vS 30 rap 6P , .D1 355 So ;NO 'bt0 5IS •t 305 i 23c,oit y5 35 BS ?. 3 400 - • a -390 f 355 _K 355 a 355 3 5'1 7 445 35 sS . _`?-a 3 5'. .34 , zb5 Zso 2 4 31,/ y' , ' 5 ' s / 0 : O.5-V n.,. Ea '17-o , 4th 930 it 5 3� 5�� 33S e2 zc5 ( • -] 1tS / ' 114? 67Z) p(7417P el , a . 510 5o® Litaic ,i state e. yC 5 - 4160 6 Lis 35 "SS • 3 Cgto _ 0-1.1) (34 ) All measurements in . mm unless otherwise indicated . * - Add HZO Total 5 7> 7- Environmental Specialist A(Oa2 Average Rate g /0 4 PLOT PLAN SOIL PROFILE yi f a I 4.414 ,Q,� b ato4S) I i : a 40 at ...4._ ,1/2 (4,......„6. . . .„,„) ,, , i Qo1 . o II V o �- lea` to a a tk% rt ksi i . d k' / uto 129 - q� 1 . I a 1••ISF' :1. 06f•' ' ' APPLICATION FOR INDIVIDUAL SEWAGE DISPOSAL SYSTEM NO . C3"••940;a9w WELD COUNTY HEALTH DEPARTMENT REPAIR APPLICATION ENVIRONMENTAL HEALTH SERVICES 1517 16TH I•'I AVENUE COURT ,n GI F EL„EY „ CO 80631. 353-0635 Mry! 225 OWNER STROH ., LESTER ADDRESS 2208 27TH AVE CRT PH ( 303 ) 330..-099'1 GREEL E.Y CO 80631 ADDRESS S OF PROPOSED SYSTEM 24804 WCR 57 KERSEY CO 806414 LEGAL DESCRIPTION OF SITE : W2 NW4 SEC 35 TW1:' 6 RNG 64 SUBDIVISION : L-.C)T 0 BLOCK 0 F :I: LING 0 USE: TYPE : RESIDENTIAL HOUSE E }ERV I DES % PERSONS 4 BATHROOMS 1 . 00 LOT SIZE 80 . 00 ACRES BEDROOMS 2 BASEMENT NT PLUMBING NO WATER SUPPLY p(::.j ..Y CU,ICWD APPLICANT CrANT ACKNOWLEDGES THAT THE COMPLETENESS OF THIS s APPLICATION IS CONDITIONAL UPON FURTHER T1••IE:R MANDATORY AND ADDITIONAL TESTS AND REPORTS AS MAY DE REQUIRED BY THE WELD COUNTY HEALTH DEPARTMENT TO BE:: MADE AND FURNISHED BY THE: APPLICANT OR BY THE:: WELD COUNTY I•-IEAI._'TH DEPARTMENT FOR PURPOSES OF THE EVALUATION OF THE APPLICATION ; AND THE ISSUANCE OF THE: PERMIT TS SUBJECT TO SUCH TERMS AND CONDITIONS AS DEEMED NECESSARY TO INSURE COMPLIANCE . WITH RULES AND REGULATIONS ADOPTED UNDER ARTICLE :I. 0 „ E I. TI...E :' ', CRS :1. 973 ,, AS AMENDED . 'n •w APPLICANT CERTIFIES THAT THE PROPOSED SYSTEM WILL NOT BE LOCATED WITHIN 400 FEET OF A COMMUNITY SEWAGE SYSTEM . -TH•'IIE. UNDERSIGNED HEREBY CERTIFIES THAT ALL... STATEMENTS MADE , INFORMATION AND REPORTS SUBMITTED HEREWITH AND REQUIRED TO BE SUBMITTED BY THE APPLICANT ARE ., OR WILL I:sI: REPRESENTED TO BE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF AND ' ARE: DESIGNED TO BE RELIED ON BY THE' WELD COUNTY HEALTH DEPARTMENT IN EVALUATING THE SAME FOR PURPOSES a OF ISSUING •n••lE::: PERMIT APPLIED FOR HEREIN . :I: FURTHER UNDER— STAND THAT ANY FALSIFICATION:[ CATION OR MISREPRESENTATION MAY RESULT IN THE DENIAL OF THE APPLICATION L :I: CATION OR REVOCATION OF ANY PERMIT GRANTED BASED UF:'C)N SAID APPLICATION AND TN LEGAL ACTION FOR PERJURY AS PROVIDED BY LAW APPLICATION FEE $240 . 00 LEsTE=R: STROH FCC ' D BY CINDY SALAZAR e. 08/08/94 DATE:: 00/08/94 6 NI. 'f/AGEEENIT SI6NA'TUrtL. DATE ORIGINAL—APPLICANT ; COPY.-•W01-ID WCHD•'••EHS MAY „ :1984 ci •�. ' COUNTY HEALTH DEPARTMENT ;.. t em4N SOE 0 9 `i'i 3 tNVIRCNMEi rra PROTECTION SERVICES 1.517 16th Avenue Court I ' ' LOAN g iSDS Greeley, Colorado 80631 _ REPAIR Q ' Q� (303) 353-0635 Weid (ountyi"�P ith - PERMIT • STATEMENT OF EXISTING FOR SEPTIC SYSTEM ( PLEASE FILL OUT IN BLACK INK ONLY ) OWNER OF RECORD : Us 7T iz 4 Sre PHONE MAILING ADDRESS : 02v ° °z 7 ad r frE City State Po Zip SITE ADDRESS : . '2 1(6 ° a -S~ 7 /cei?S- o�i Co 06cC C City state Zip LEGAL. DESCRIPTION : PT : 147 2— PT : Nive{. SECTION : 3cr TOWNSHIP : 6 RANGE : SUBDIVISION : LOT : • BLOCK: FILING: NUMBER OF PEOPLE : 2t BATHROOMS : , / LOT SIZE : re Gam.¢- . BEDROOMS : v9--- aC RESIDENTIAL or COMMERCIAL BASEMENT PLUMBING : Yes No WATER SUPPLY : C 4. 13 2TApe as n. SYSTEM SIZE : Tank is constructed Of CtMtrier and has o2G1-‘) 6C & gallons capacity (material ) FIELD : Bed gt°"n sq . f t . or Trench 4 sq . f t . DATE SYSTEM INSTALLED : P160 o -car 6o L, 6 A-( PeACE i n-- 7967 You are required to draw a diagram of the system on the reverse side of this form in black ink only and indicate location. length . width , and distance from the dwelling. 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 of ground identified by the above legal description, I further understand that any falsification or misrepresentation may result in revocation of any permit granted based upon this information hereby subcsitted and in legal action for perjury as provided by law. e 6__ 9 la-abo . Date • Owner • Subscri 'di and sworn to before me this .7day of A4Ai b99 9r by Witness my hand and official seal . My ission expires : 94 ge/ /99 • Date Notary Pub ;► STATEMENT OF EXISTING REVIEWED BY: Environmental Protection Specialist • ♦ :at h � •`Z 1 A_, O • A • • • 1 1 ;-) C 0 (a- I'L tic-le-4°14\4---i3S---4---E. „....---)0„.,.., i 6.1 r let O • . . ler . ro iv, •...5 Le. A- S S Tag LeJtc �rn wt rn d AI t N 1. S eft /3 t- SA nfri 161Kr{ 6 .S 7 ;else ° 'i— w r+i r i LB �e ye.7 as n- t�. r % rite 13R ("L 'A- 1O 1 , 601 o nv . � �� k. � eh Act F� larn SA pin w / `T 7t T o ea ) ? Ark u vti 74 I T 2..a r"O lair ridgy • • j . • , . . • A ,. . _ ill....• '1 •'' . BLACK INK ONLY ! Si E • S • Hello