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<br />W~J.B.70
<br />
<br />;.
<br />
<br />S1ATE OF COLORADO ...
<br />OIVISION OF WATER RESOURCES '~
<br />OFFICE OF THe STATE ENGINEER
<br />
<br />MAP AND STATEMENT FOIl WATER WELL FILING
<br />PERMIT NUMBER --Ll..:.'" "7
<br />
<br />looelt N<" _ - ,-
<br />IDWO __" - --'"
<br />ComfJltl(lon__, -
<br />Yield --
<br />Checked By__ ..4_'
<br />
<br />STATE or COLORADO I SS
<br />
<br />CLAIMANT (sl'-::'l.~ 2ll-L" ,:,.':r,t
<br />
<br />ooinu (luly ~wOrtl upc1n oclth rlcposes ann says thar he (they) is (are)
<br />the owner (51 o( Ihe well describoo hereon; the total number of acres
<br />
<br />of lalld irrigated frnm this well is ,-.
<br />'NOrk was CCI-r.r~'el\CCc1 on this well by actui'll constructit'Jn all the
<br />
<br />I' , ...t ",,)onr'
<br />__...L_.. _day of ,... "',- "
<br />
<br />1911: the suslnined
<br />
<br />yield (ro," snid well is ~ gpm. lor which claim is hereby rnado
<br />
<br />lor_ ' . ~",::" 1.1"",___
<br />
<br />. pUf'Ilose (51;
<br />
<br />thr. aV~lagc i1nlluDI omollnt to be divmlt'ld is . ,-- .-'-
<br />ocre--fect: tl1l$ m,1!) Hnd :Hi'ltmnent is filnd in compljilnc" with lilW;
<br />he (!'ley) t,O$ i havel rend the statements made hereon; knnws the
<br />cont(lrlt tIH~rl:"(')f; anrl that the ~c:1tI9 are t(UP. of his (their) own
<br />kllOwlt'ldgc,
<br />
<br />SqJIl,llU/,(lI: r.l_ .---. ~.' ,_.
<br />
<br />Aclt!r',,;~s; _ ._- ~-- .
<br />
<br />----
<br />
<br />Sull!iL:riLJ.::d and 5Worn to u~(oro me on this___cfay
<br />
<br />01_,,--.- ,,--, ,19
<br />
<br />My COlllrnl5.Sioll C!-XlJjfCS:~ - --...
<br />(Scali
<br />
<br />Notary PUbliC - -
<br />
<br />BEST COpy'
<br />
<br />Date Coml1l(;tC:d~.-.tt!..::~~r~: "''7L_
<br />. -
<br />
<br />WfLL ClATA
<br />
<br />Slatlc Waler Lewl 1 'J
<br />
<br />'"
<br />, a
<br />
<br />Totnl Depth of Wull :,,~. "'t"
<br />
<br />.-..--' --~...-
<br />
<br />WELL LOCATION
<br />
<br />, 1 . ',' ......
<br />
<br />Co
<br />
<br />"f < I
<br />___..'4 0 ~_ .
<br />
<br />Yo, see, ,1
<br />
<br />T. "7 'I
<br />
<br />R. 73 '-I
<br />
<br />1\."
<br />
<br />INDICATE WELL LOCATION ON DIAGRAM
<br />
<br />NCIlTH
<br />
<br />I I I
<br />I I I
<br />I I I
<br />- - -1- -, - + - - - r - --
<br />I I I
<br />I I ,
<br />t3 ---t----~---~--
<br />;: I I I
<br />I I I
<br />__..1_ __L___l.~__
<br />I I I
<br />I I I
<br />I I I
<br />_.__L- I
<br />SOUTH
<br />
<br />m
<br />';> ;::
<br />!:4 i"
<br />m
<br />
<br />,
<br />I
<br />-~
<br />
<br />WELL SHALL BE LOCATED WITH REFERENCE TO
<br />GOVERNMENT SURVEY CORNERS OIl MONUMENT
<br />OIl SECTION LINES BY DISTANCE AND 8EARlNI
<br />
<br />.It. from seclion II
<br />(NtXth Or South I
<br />
<br />It, from seclion II
<br />lEast 0' Wnll
<br />
<br />Ground Water Basin
<br />
<br />Wate, Management
<br />District
<br />
<br />Dome,lic wells may be located by the followin
<br />
<br />LOT
<br />SUBDIVISION
<br />FILING H
<br />
<br />. BLOCK
<br />
<br />ACCEPTED FOR FILING IN THE OFFICE OF THE STATE ENGINEER OF COLORADO ON THIS
<br />
<br />OF
<br />
<br />__.19_.
<br />
<br />DAY
<br />
<br />STATE ENGINEER
<br />
<br />FORM TO 8E M~OE out IN l'U~DRUP\.ICA1~: WHiTE FORM ."1U1I be an original copy on both tid.. and Ilgned.
<br />WHITI ANU ~"f,~tI. l",wC'" 'm~.t IA hi"", ""'""' rhtl StiHI~ 1::.,..,,11"'''''' Wlthm 30 .JflY4 .1\1t the weill .1 compl.ted or wir.nlft 1'..
<br />.It., ...r,ltf't1.:", .,"\11 H' the PUtl'li', ""hh;I,,,v,,r q; S~I:",,<Jr. ~:Nt. C()P'l' i~ :'Hf" tnl! OIlro.'tH enr. YELLOW CO" I. for.... 0.111_.
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