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Home My WebLink About20161953.tiffWATER SUPPLY INFORMATION SUMMARY Section 30.28•133,Id4, C.R.S, requires that the applicant submit to the Counly,"Adognato evidence that a water supply dial Is sufficient in terms of quantity, quality and dependahilify wilt he available Lo ortsuro an edo hate su I of teeter 4 PPY • I. NAME OF DDEEVEOLOPMENT`11AS PROPOSED —, , J )() 11t�tciULS ,'T\��1L\clr�lA 'U� La �• 2. LAND USE ACTION :�\ n- 3. NAME OF EXISTING PARCEL AS RECORDED SUBDIVISION FILING BLOCK LOT 4. TOTAL ACREAGE I I G. NUMBER OF LOTS PROPOSED PLAT MAP ENCLOSER 0 YES C, PARCEL HISTORY • Ploaso attach topics of deeds, plats orother evidence or documentation. A, Was parcel recorded with county pilot to Juno I, 10727 YJ YoES I7 NO B. Iles the parcel over boon part of a dwislop ofAnd action since Juno I, 1972? I] YES 0 NO If yos, describe the previous action _. I S'O�r.o tki'.. • 7. LOCATIONOF PARCEL - Include la map doliniaiInp the project area and tie to a section tooter, I�' I 1/4 OF -SW 1)44 SECTION .�(c TOWNSHIP (e LIYN t7 ±49 Co S RANGE 0 E XXW PIIINCIPAL MERIOIAII: • 1411-D h.M. 0 UTE O COSTILLA 0. PUT • Location of all wells on property must he plotted mid permit numbers provided. Surveyors plat 0 Yos 0 No If not, scaled hand drawn sketch ID Yes ❑ No O. ESTIMATED WATER REQUIREMENTS - Gallon per Day or Acre nit par Year `I HOUSEHOLD USE 7l y of wills GPO AF 10, WATER SUPPLY SOURCE VA - 0 EXISTING O DEVELOPED WELLS SPRING WELL PERMIT NUMBERS �� , n S l' �I l 0 IlEV! WELLS • njutm AMMO-WV(k Gm inAVaen OM AaAPAAPX a Willi o1N4al O (OM ARAPAH0E asouwaAxna oourorsPDXKIPS COMMERCIAL USE p_I of S.F. GPO AF IRRIGATION /I of acres CPO AF 0 own O MUNICIPAL ❑ ASSOCIATION O COMPANY WATER COURT DECREE CASE NO.'S STOCK WATERING t/ of head GPO AF OTHER GPO AF TOTAL GPO AF ❑ DISTRICT NAME LETTER OF COMMITMENT FOR SERVICE D YES ❑ NO II, ENGINEER'S WATER SUPPLY REPORT 0 YES U NO IF YES, PLEASE FORWARD WITH THIS FORM. 17th my La rrau4ed balms our review lc corolned7 12, TYPE OF SEWAGE DISPOSAL SYSTEM SEPTIC TANK/LEACII FIELD O CENTRAL SYSTEM • DISTRICT NAME D LAGOON ❑ VAULT • LOCATION SEWAGE HAULED TO O ENGINEERED SYSTEM Much I telly it enotaurog detain O OTHER THIS FORM MUST HE sUOMITTEO PRIOR TO TI(E EXPIRATfON OF THE PERMIY. TYPE OM PRINT IN OLACK INK. V COLORADO DIVISION OF WATER RESOURCES 101 Columbine Bldg„ 1045 Sherman St, / Denver, Colorado 80203 __('STATEMENT OF BENEFICIAL USE OF GROUND WATER .._.___AMENDMENT OF EXISTING RECDRD STATE OF COLORA,D,�OI. Y/' COUNTY OF weid d PERMIT NUMUER.n 4 •.0 . SS. RECEIVED atis17so D'AITA RESOURCES STATE MINER CO20. THE AFFIANT(S) / a±1 �a 4:11.±4211 whose address Is.. _ R Ak J iLT____,g4 S� y_ e4 /�J _} Q sus' being duly sworn upon oath, deposes and says that ho (they) Is (are) the owner(s) of the well described hereon; the well Is located in tiled)/ • W 1/A of the_tSi4%._TIA of Section —__S, :._.—, Township 1,' IN. fa 13.IRange FI �i PM. at distances of1.121t.feat from the-S-0-ancation line (E. or VI) (North or South) and /0-0 O feet from the.__" ,t't _section line; the total depth of the well Is_ ...__feet; water from this well gait or Waal) was first applied to a beneficial use for the purpose(s) described herein on the_dayof19..; the maximum sustained pumping rate of the well Is_�.C__galions per minute, the pumping rote claimed hereby Is._/._ Awl gallons per minute; the average annual amount of water to be diverted is. acrefeet; for.which claim Is hereby made for ,[LA_inp it,f f Lc purpose(s); the legal description o1 the land on which the water from this well Is to be used Is which totals_._.% __acres and which Is Illustrated on the map on the reverse side of this form; that this well was completed In compliance with the permit approved therefor; this statement of beneficial use of ground water is filed in compliance with law; he (they) has (have) read•the statements made hereon; knows the content thereof; and that the same are true of his ..(tile).O know Ivie8................... _. . . SI noh)re(s)a Subscrihed and sworn to before me on this _1?� _.day of 19,4 Notary P,hllc ACCEPTED FOR PILING -IN HE OFFICE OF THE STATE ENGINEER OF COLORADO ON THIS___:DAY OF , 19 , My Commission expires_. (Seal) STATE ENGINEER WHITE COPY FOR DIVISION OF WATER RESOURCES PINK COPY FOR WELL OWNER FOE OFFICE Oa ONLY Prior. Date , Well Use , 19. Sec. —_.._..___, T. Yield W.n /" S Co (� 2 Index THE 1.0CATION OF THE WELL MUST BE SHOWN AND THE AREA ON WHICH THE WATER IS USED MUST SE SHADED OR CROSSHATCHED ON THE DIAGRAM BELOW, - ' This diagram re resents nine (9) sections, Use the CENTER SQUARE (one section) to Indicate the location of the well, if possible. 1 MII¢ -- -sl NORTH N A 1 + - + r - !- - + - T + r -. 4- + -. + .. } + NORTH BECTON - + - LINE ! + .- I + .. + -. { + H• I ti T — 1 E;II + .- + d . i + .' { -R I ......_. Li N ! I + - + -• SOu11H SE01io11 -I• -- LIfNE + + - + + -. -I. .. + ._ + - + - + THE SCALE Dr THE OIAHHAM IS TWO INC.UES EQUALS ONE•MILE. Meter Serial No. ❑ Flow Meter ❑ Electric Meter O Fuel Meter Owner of land on which water Is being used WATER EQUIVALENTS TABLE (Rounded. Figures) An acre-foot covers 1 acre of land l fool deep. 1. cubic toot per second (cts) , , , 449 gallons per minute (gpm). 1 acre•loot . , . 43,660 cubic feet ... 325,900 gallons. 1,000 gpm pumped continuously for one day produces 4.42 acre-feet. 100 gpm pumped continuously for one year produces 160 acre-feet. tati COLORADO DIVISION OF WATER RESOURCES 101 cafumb[ne ldg„ 1045 Sherman Street, Dgrrer, Colorado 80208 TYPE DR PRINT IN BLACK INK. APPLICATION MUST PE COMPLETED BEFORE ACCEPTANCE, APPLICATION FOR: * A PERMIT TO USE (BOUND WATER x A PEINCET TO CONSTRUOT A WELL REPLACEMENT FOR NO. x A PERMIT TO INSTALL A PUMP OTHER APPLICANT Elmer Elliott Street Address Rt..2 Box 181 City & State Greeley, Colo, Telephone No. 3636111 NAME OF AQUIFER GROUND RATER IS TO BE OBTAINED FROM; Atuvial PROPOSED TOTAL DEPTH OF WELL CO Ft. ESTIMATED MAXIMUM PUMPING RATE 16 GPM AVERAGE ANNUAL AMOUNT OF GROUND WATER TO BE .APPROPRIATED ANTICIPATED GROUT PROGRAM Material Cement Intervals 6 25 Placement Method humped PROPOSED CASING: Acre-feet' Plain 6 in. from 0 ft, to 60 ft. in, from ' ft. to ft. Perf. 6 in, from 60 ft. to 80 ft. in, from ft. to ft. Driller ,3,.nsh Drill3na Co. No. _ 21 Address Ault. Colo: :.80910..: IF WELL IS USED FOR IRRIGATION, BACKSIDE OF THIS APPLICATION MUST BE COMPLETED. 62-0 �1Pau`i PONAITIONS of A TNovAL FOR OFFICE USE ONLY APPLICATION APPROVED: VALID FOR ONE (1) YEAR AFTER DATE ISSUED UNLESS EXTENDED FOR GOOD CAUSE SHOWN TO THE ISSUING AGENCY. PERRIT N0. 51654 dpj RECEIVED FED 22'72. GROUND WATER TO BE USED FOR: %yATER RESOURCES DOMESTIC (1) COMIILo. 4`R LIVESTOCK (2) INDUSTRIAL 5 MUNICIPAL (8) IRRIGATION 6 OTHER WELL LOCATION COUNTY Weld Iof the SW > of Section 35 IN ADbITIO 0 THE ADOVE, THE WELL Reif BE P �I LOCATED WITIE REFERENCE TO 00VERNMENT SURVEY CORNERS, MONUMENTS OR SECTION LINES BY DISTANCE AND BEARING (DOMESTIC WELLS MAY BE LOCATED BY LOT, BLOCK, & SUBDIVISION.) ft. from section line -(North or South) ft. from section line (East or West) LOT BLOCK PILING # SUBDIVISION Ground Water Basin Water Mgmnt, Dist, Anticipated drilling date April 19 82 Owner of land on which well is located: Elmer Elliott Other water rights on this land Nono 7iY1G.iL_ , U Fe -1u V Signature of Applicant DATE ISSUED FEB 2 4 197 STATE ENGINEFD4 } Y ` BY eq.a�+ha- 9, fvee.E.,+ THE IODATION OF THE PROPOSED 1TELL MUST ]3E SHOWN ANS THE AREA TO BE IRRIGATED MUST BE SHADED OR CROSS -HATCHED ON THE DIAGRAM BELOW This diagram represents nine (9) sections. Use the CENTER HQUARE (one section) to indicate the location of the well, if possible. Mile N M -----I + I -- + •- -r _ -- + - -1-. .1. .1. I ----f -I. -. NOR'T'H SECT i _I- (ON LINE �. .. I (- I - • + I- + f - - .f. .. t -I. I I + .. I ti (7 -h . - —t M NHI .. c WWW -b {v�71- .� + -• i + I soU'LN SECT 3- I LON LINE .1- _ I + .. I. + -1. •• 4- -. -f. _. 1 1- -- f 4 -. I 4. THE SCALE OF THE UTAGOAM IS TWO INCHES EQUALS ONC-MILE • Owner of Number of acres irrigated land Legal description of irrigated land to be irrigated t^' WATER EQUIVALENTS TABLE (Rounded Figures) ;,I An acre-foot covers 1. acre of land 1 foot deep. 1 cubic foot per second (efs) „ 449 gallons per minute 1 acre-foot .. 43,560 cubic feet . 325,900 gallons. 1,000 gpn pumped continuously for one day produces 4.42 acre-feet, 100 gpm pumped continuously for one year produces 160 acre-feet. WRJ-2G-72 THIS FORM MUST BE SUBMITTED WITHIN 60 DAYS OF COMPL@TION OF THE WORK DE6CRI BED HERE- ON. TYPE OR PRINT IN BLACK_.. INK. LLL COLORADO DIVISION OF WATER RESOURCES 101 Columbine Bldg., 1845 ShormanSt, (1"R Denver, Colorado 00203 •WELL COMPLETION AND PUMP INSTALLATION REPORT PERMIT NUMBER 51654 Ttl7k?'Y: cicfdanln:,• Aim joy WELL OWNER Elmer Elliott Si v,, of the MD/V2,, i r7! SW %ofSec. __35 ADDRESS Route 2 Box 181 Greeloy, Colo, 8043f1•_ 6 North, R, 66 West DATE COMPLETED Fobruary 26 WELL ,19.2. From To Type and Color of Material Water Loc. 0 2 Topsoil z 8 Clay a 18 Gravel and boulders 18 52 Shale with sand» stone etrealce TOTAL DEPTH 52! Use additional pages necessary to complete log, HOLE DIAMETER In from ...—v in, from . to ft 0 to ft. In. fronl,, to ft 6 P,M CASING RECORD: Plain Casing Sin __"& kind . PVC from 0 to 15 ft Size _,".& kind . PVC from ,25 to lip ft Size & kind Size 51' & kind from Perforated Casing PVC Size rn & kind PVC Size & kind GROUTING RECORD Material to ft from. _f-5 to _25_ft. from to 52 ft from CemePl Intervals _1L IQI Placement Method to _ft. GRAVEL PACK: Size . i/11• X Interval lea 10-,521 TEST DATA Date Tested February 26 Static Water Level Prior to Test , l , 1072. it Type of Test Pump Bai]or Length of Test One Bonn Sustained Yield (Metered' 15 GPl4 Final Pumping Water Level 161 PUMP INSTALLATION REPORT T---UNHN041M—,� Pump Make Typo Powered by Pump Serial No, Motor Serial No. Date Installed Pump Intake Depth Remarks HP,.^_ WELL TEST DATA WITH PERMANENT PUMP Date Tested Static Water Level Prior to Test Length of Test Sustained yield (Metered) Pumping Water Level Remarks _ Hours GPM e 6 H WATER TABLE GORE OF DEPRESSION CONTRACTORS STATEMENT The undersigned, being duly sworn upon oath, deposes and says that he is the contractor of the well or pump installation described hereon; that he has read the statement made hereon; knows the content thereof, end that the s e of his own led Signature, —�License No. _ 21 Stale of Colorado, County of CG Subscribed end sworn to before me this rU day of 4LLL // /CJ ,19.,2Z.. • My Commission expires: Notary Public • .—.21 SS , 192 Fonts TO DE MADE OUT IN QUAonUPLICATE: WHITEFFpnM must be an migInnl copy on both aides and cloned. WHITP ANO GREEN copies must bo tiled with the Stele Engineer, PINK COPY 4s lot 1116 Owner end YELLOW COPY Is for the Driller. J. atig.;-e6/Pee • WELD COUNTY HEALTH DEPARTMENT 15th Street and 17th Avenue • - 7� 3° P. O, Sox 1227 No, ✓/% Greeley, Colorado Application for Permit to Install, Construct, Alter or Repair Individual Sewage Disposal System. Ownsr or Spone r. Address of Site Mailing Address 1. Living Units 2. No. of Bedrooms 8, No. of Baths 4. Basement Drain 5, Automatic Dishwasher 6, Garbage Disposal 7, Automatic Laundry 8. Size of Lot 9. Type of Soil 10, Percolation Test /3 _ 11. Water Supply T�-/ 12. Lot Grade 18. Water Table Depth 14, Other Addre s Phone ..ar.rs'/'I LS' -Pyl/lAili s, ega,,$4G /,tn4'.o try39au.,36-a-ua General Informotlop I -61.49.A4,,•1.z Septic Tan t' `'"' A' y`�ie 1. Liquid Capacity .)off 1 Gallons 2. Dimensions W L D 8, Material • e. 4. Type Inlet Typo Outlet Secondary Treatment , Field -.Bed 1280 ro.all/t,_ 1. No, of distribution lines 2, Trench: Width i Length 8. Type Filler Material 4. Depth of Filler Material 6. Gravel Size 6. Typo 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: Applicant: The plans and specifications as shown are approved, pending paymfnt- f pert fee. Sanitarian:CC /i.fi. a A o (/ (//1 Date: , 17, )q 7 1 The above system inspected and found to comply with the plan and description. Installed by PERMIT FEE L c7 DO. Received by Please use reverse side for Plot Plan or use separate sheet of paper, Sanitarian: Date is. yens, ,,pN.l .7UH~04.4999 02139 • COLORADO PAR CUR PROPERTY OSNE WELD COUNTY DEPARTMENT OP PUBLIC~ HEALTH AND ENVIRONMENT 1595 N. 17TNAVENUE GREELEY, COLORADO 80631 PHONE: (970) 304-6415 FAX: (970) 3044411 P,Bi SE IS ORG PERMITC REPAIR # _ LOAN 4 iS05 #t ,3 ,,terzrirED STATEN'' OF EXISTING FOR SEPTIC SYSTEM JOIN Q (PLEASE L OUT IN I3LA, z � ONLY) 15 9 �EIlti7,�aN��lEh7�l Num emus PHONE NC). ( 9 5 MAILING ADDRESS, en t& 5- ' pLef,4 . fro.45.5;/ _ep .e 411-02 E7 Dec 9.. • Cit} S Zip bESC1APPTION OF BUILDING (ex, house, mobile/modular home, shop, office) SrrizoCATION ADDRESS pr 2r/ er a��e, / City State Zip LEGAL DI✓SC'ION PT PT . _. SECTION TOWNSHIP__ RANGE_ _ _ SUBDIVISION LOT__ BLOCK J4'lI,f1VG CENCII'S TRACT LOT SIZE/ACRES COMMERCIAL YE/8/14O RESIDENTIAL, YES / NO NUMBER OF PERSONS BASEMENT PLUMBING YES / NO BEDROOMS BATHROOMS FILL 314 It2 WATER SUPPLY Fumes NO minty NAME PRIVATE ES / NO CISTERN 'E S / NO WELL YES /NO WELL PEST # SYSTEM SIZE; Septic tank material is constructed of _ and has gallons rapacity. FIELD: Trench _ • square feet or Bell , square feet YEAR INSTALLED You an required to drafts, a diagram of the system on the reverse side of this form in black iqk only and indicate location, length, width, and distance from the dwelling. The nadersigned property owner hereby certifies that the above described septic system is in fact installed, as described, and exists at thb time on the parcel of ground identified by the above legal description and further states that the system islls not in good working order and to the best of his/her knowledge Wis not falling to function prujperly, 7-C17 IC' I further' understand that any falstflcntion or misreproeutntion may result in revocation of Roy permit granted based upon this information hereby submitted nod in legal action for perjury AS provided by law. DATE OWNER Subscribed and sworn to before me this bF day of Witness my hand and,official seal. DATE STATEMENT OF EXISTING REVIEWED DY 1 My commission expires.,. NOTARY PUBLIC ENVIRQNMMZNTAL PROTECTION SPECIALIST F % • t 4 TOTAL P.01 C I Ii k 0 IC dG co' fig" I all, ca.01)6R191° No- 7o 5cA Le. :texte-r Hang 4 ATT. • an RI:)6C- -699 t IAl is- Sr . P/6515 -41,e6-40 ,O,6tito/z) e--57-99 • ,. T te-rte✓' fivp xceP 5:sea 7 ` " c csa 24:err—area 4- 7e4 4 fled: Ail relit/a-Al 14e.57ec-727 l44 Ane 1-e d 747 gone- Z i Zes-ee-cr� ,/jam/f( /es /7:41/4c,_, 51,106'44&" b ra f �j ltot ,., left • ` ,W IiD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVTRONNENT 1555 NORTH 17TH AVENUE, GREEL,EY; CO 80631 PHONE (970) 304-6415 FAX (970) 304-6411 SEPTIC LOAN. APPROVAL . Closing Date: New Loan : Y Re -Financed : . TO WBUI i' TT' MAY CONCERN: Review and inspection report for an existing dwelling: SEND TO: ELMER ELLIOT 4785 TOPAZ DRIVE COLORADO SPRINGS,' CO 80918 . • Request No : 99-039 Date Received: 06/15/1999 It regarding water and the 'sewage 'disposal '4rstem ' Realt(*•Phone•:•. Owner' `Phone (U) : Oc'iher Phone.(W) : • • ,. ��c�ta=��=csY- c=^Pi�d==tit == =Eat;==c=: INFORMATION: Address: 4699 WEST,. F STREET' GREELEY CO 80631 Legal; 18020-A PT N2SW4 35 '6 66 •BECK" SSA) 'S'ec/Tin/Range; 5' • Subdivision/Legal: 35 06 66 Property Owner: ELLIOT, ELMER .. • Tank Pumped On: 02/06/1998 By: SLIM'S SANITATION• PERMIT ON .RECORD : Permit No 619710930 SOE ,(Y/N) : Original Owner; ELLIOTT ELMER ' Bath: 1 Bed: 2 Acres: 41.00 Water Supply .- • Public : N Utility Name: Private: Y Cistern; N Well: Y Permit Number: Wank Capacity; 750 gallons Field Size: 380 square .. 4 tat =t tts=c=======G=eta=tae ==csm=====tad =.=.e=== —._a—_.. w • • Licensed: .y Year Installed : ,1971 . Date of ,.B'inal Insp: 05/28/a.r73. • feet CCR L3t=====n=om====F===f=== INSPECTION FINDINGS: Date -of inspection: JUNE 151;999 ' Soil Conditions - Dry; X Saturated: Snow-covered: Residence -- Occupied: X Vacant: Sewage Disposal System - Satisfactory: •X Other•: Bacteriological Water Test Acceptable: X .Other: COMMENTS: . Date: Signature; tivSnen.4\--. • .• Environmental Protection Specialist ' • Neither the county of Weld, nor any of its agents or employees undertake or assume any liability to the minor of. the above property, to any purchaser of the above property or to any lending agency making a loan on the above Roperty in conrtactfon'with either its examination of the property or in the report. This inspectiaci was conducted solely for the purpose of detecting health hazards 'obaezvable At the ttme'pf :yy!sr t C`A'I" 'constitute a warranty that the eyetem is without flaw or that it will continue to function'in the.future. Tnt,pe--'_. _,y 'c %4 O. during periods of snow cover and high soil saturatjon may be of'quedtionable value to potenti©l'buyera,dde to.advcrso conditions: ..% Hager sample report. reflect the bacteriological quality of the water nupply et the time the people use taken. Evaluation, 'onset:non. Statexente of Existing {boeJ relies on information the property Owner providco,.unor doath`, indicating current otatus cif (he nyotcm and representing to the best of his/her knowledge the system is not failing to. :function properly. ' • • • I . ••,•• I. Hello