HomeMy WebLinkAbout20143397.tiff , in observance of the
neendence Day liday,be closed at noon onlJulyp3rd &reopen onoMo day,rJuly, 7th.will CUSTOMER
Joseph D &Linda L Baker
Have a safe holiday!Payments can be made by mail or online at www.cwcwd.com. SERVICE ADDRESS
Please write account number on all payments and 7156 Maple St
correspondence.Thank you.
ACCOUNT NUMBER BILLING DATE
Water Consurrphon 07/01/14
000589-01 42 30 cDUE
3610 - 0 07/10/14
2.1— .
-
16
12 BILLING PERIOD
d 1
0 J J ASONDJFM A M J From 06/01/14 t0 07/01/14 = 30 Days
CENTRAL WELD COUNTY WATER DISTRICT
"35 2nd Avenue
m.CO 80631
•
Scanning Cover Sheet
for
Septic Permits
Permit # G19700501
Permit Type: Health I EHS History/EHS Conversion History
Situs Street Address 7156 MAPLE ST
Situs City, State,Zip
SeclTown/Range: 08-02N-67W Application Status: Finaled
Application Date: 03/11/1996
Parcel # (12 digits) 131108303004-R5379286
Owner Full Name: KEN B HOMES INC
Owner Address: P.O. BOX 837
LONGMONT,CO 80501
Owner Phone#: 303 7767041
Contact Name:
Contact Address:
Contact Phone#
Information above has been Verified in Accela by employee noted below
X May 07, 2009
Processed by: Date
Report ID: EHS00024v003 Page 1 of 1
Print Date-Time: 5/7/2009 1:52:19PM
L
"1QO50 %
. .; - mEmoRAnDum
1119 C To Planning Deu December 2, 1994
COLORADO
From Pam Smith, Environmental Specialist
Subject Joseph Baker Medical Hardship Zoning Permit
The Baker's currently have a septic system permitted under permit #G700501. The
system is sized for 3 bedrooms and will be adequate for the additional bedroom
that has been added in the garage for the hardship situation. I am aware that
the garage/home is and will be considered the permanent dwelling for this
situation and that the garage/home will be remodeled once the medical hardship
is no longer needed. As long as the remodeled home does not exceed 3 bedrooms,
the septic system will be adequate for the home.
Please feel free to call me at 353-0635 if you have any questions.
;:. Ilp.t. .. 1
v.
WELD COUNTY HEALTH DEPARTMENT
15th Street and 17th A ( , S O
• P. O. Box 1227 0.
•
Greeley, Colorado
Application for Permit to Install, Construct, Alter or Repair Individual Sewage Disposal System.
Ownifor Sponsor A ess
o B ..... O. Th 1k 7- �`- 7,7�- -7A CC/
Address of Si rs 4-•..7"•e14,4M, crA vpF Df 2.7 —o, ;Q
Mailing Address ® ,
General Information Septic Tank
1. Living Units 1 1. Liquid Capacity Gallons --
2. No. of Bedrooms J 2. Dimensions .40251____L L D
8. No. of Baths / 3. Material
4. Basement Drain /�-d 4. Type In!
5. Automatic Dishwasher ....2. -O Type Ou e
rnag
6. Garbage Disposal
7. Automatic Laundry Sec ary Tr ment
8. Size of Lot tie)
�
9. Type of Soil Field %U� 1' Bed
10. Percolation Test 1. No.of distribution lines
11. Water Supply / a 2. Trench: Widt n
12. Lot Grade
13. Water Table Depth 3. Type Filler Material ��/ /�
14. Other 4. Depth of Filler Mater3,al —a W'+'- --C�
5. Gravel Size a d. 7-
6. Type Tile. .. 7. Depth of Cover "VP-Zs 1!An
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.
/� / �' 7
Date: - 17 3 �I / 4 7;1 Applicant:. A'� L""'^
Thep and sphifications as shown are approved, pending payment of rmit
i r1�
Sanitarian: Q
Date: `� y D
The above system inspected and found to comply with a plan and description.
Installed by 70i> ,e /1- z, ®an ✓Date: r a
Sanitarian: _
PERMIT FEE $ RS-/-411-7/ 7—3� - 7 a
Received by Date
Please use reverse side for Plot Plan or u separate sheet of paper.
t.._.—
a
P
N •
- WILD COUNIY MALTS DEPARTMENT sos s &IMO/
tlIPIROIBfE TAL PROTECTION SERVICES • [AMP
1317 16th Avenue Court ISOS s
Oceele*, Colorado 60631 10*11 s
(303)333-0633 Weld County HeahhDepatsndu limn.
STATEMENT OF EXISTING FOR SEPTIC SYSTEM u�C
(PLEASE FILL OUT IN BLACK INK ONLY)
OWNER OF RECORD: Jos"I, a • j,,,,(, /, .7)a Kee PHONE:. csns) ess-Ion•
•NAILING ADDRESS: 7r SL a t atE Sneer ,A.,ig ..•ct C. JPotos*
City State Zip
SITE ADDRESS: y/eb MapLe S roe err L• nrsSf �o iosav
"tits State Zip
LEGAL DESCRIPTION: PTI PT: SECTION;. S TOWNSHIP:A_ RANGE: 6 T
SUBDIVISION: Eke/ae4ed II.Ltc LOT:A. IstoaCLatief FILING:
NUMBER of PEOPLE: 3 BATHROOMS: I LOT SIZE: 330 r LA0 BEDROOMS: 3
(10fSIDENTIAL3 or COMMERCIAL BASEMENT PLUMBING: Yes WATER SUPPLY:J:3 Afte
SYSTaI SIZE: Tank is constructed of doncr"'s and has /00o gallons capacity
(material)
FIELD: 'Bed R O o Sq. ft. or Trench sq. ft. DATE SYSTEM INSTALLED: Inc
Toe era required to draw a diagra of the system on the reverse side of this lots is
hied: ink only and indicate location. length. width. and distance from the duelling-
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 and further states that the system is in good
working order and to the best of his/her knowledge is not failing to function properly.
I further understand that any falsification or misrepresentation may result in revocation
of any permit granted based upon this information hereby. submitted and in legal action
for perjury as provided by law. (� /�
/I Ail q j ).01-rit LO_ Attila •
Date Owner
Subscribed and sworn to before me this day of A/0✓ , 199 f,
•
by
Witness my hand and official seal. NY e®issien expires: q - 19 -n:
/I- a.J -9* . i a
Q /42 � v tF,
Date • d`NNotary Public,
r.
:
STATQQNT OF LUSTING REVIEWED BY:
Environmental Protection Specialist
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