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<br />f~~~,'_~5~:,~B Ol.ZCG /~~AT~ OF'~OL:RADO (/,~-t Aft/:..
<br />
<br />2U ~1-45' DIVISION OF WATEH HESOUHCES ItJUO:CIfr./i!iiiIJ";'llf/
<br />[ndl'", No, ":')7 OFFICE OF THE STATE ENGINI.:EH c V$LU!
<br />lD\\D , ; ffloUNfI ~~ 1968 f:V
<br />Use (, MAP AND STATEMENT FOH \VATER WELL FILING i' ...,,>{~i,; ~""f"
<br />
<br />Ilegistered PERMIT NUMI3EH 013630--1-- 1_ .. ~t"r. "I' -',.
<br />
<br />KIlO\\' ClII men by tllese Jll'esents: That the underSigned--L!.dt ~_ /"./;::' < -'- ( (' d ,2' ?,~' r:
<br />deli lllant(s), ":hose Clddrl's; is , City , (j t: Ll-
<br />stall'S: Cl:1im:11ll(s) is (Cll'l') the o\\'llL'r(s) ur \I'ell No. L lo,,~ted CiS ;\lO\\'n (1) tllli m?Jl belo\\'; the
<br />tutal number (If :1L:l'l'::).o( land o\\"ned by him (thel~l) to be irl'i~a~~c1 rl'Olllll~is \\cll is J S <:: _; work
<br />\\':lS eOlllllH'lleed Oil tllls \\ell by aetuClI eonstnletlon /.; c'7l lby o[ t< - , . " [OH t.ll~
<br />lL'::;ll...li c;l.p:lI:it.,; pI said \\'L'll is '/~- l' (gpm) (cfs), 1'01" which e]airy is herd) made for l t....:co rt (.,,~'.l.
<br />1'~iJ.I~")::;l'S; 1.i1;~1 the :1\.l'ra~L' annual amounl or waler tu IJe divl.'rted is--1 :)) (') aCl"l'-fl. ; anti (hal the
<br />afl.'I'CIllL'nlilJIlL'tl ::>tatL'JllL'nts an.: made ~lI1d thi.s map and slalellll'l1l are filed in eomplianee witlllhe law.
<br />) /; (I )(/ e . -, "
<br />l ~rtf .NI2!fA':<--t.'P"'-"'/7L~-^--'
<br />Claillwllt(S) J
<br />
<br />St~te o[ CulorCldo
<br />LUiUlt~. t.r _ [1 PJSO
<br />
<br />) ss
<br />)
<br />
<br />SU:JSCl'ilJcd and s\\'orn bl'fore me this
<br />
<br />30th
<br />
<br />December
<br />
<br />,10 68
<br />
<br />doy o[
<br />
<br />~r~' Commission L'xpires
<br />
<br />6/13/71
<br />
<br />J'
<br />Not"ry Puulie
<br />
<br />.' J.i. /""r,:
<br />
<br />MAP
<br />TltE \\'ELL SII.-\LL BE LOC.-\TED WITH HE FERENCE TO GOVEltNMENT SUllVEY COHNEj(S OJ(
<br />~1()"l':\IJ-:I\'TS, LlH SECTILlN UNJ':S BY DISTANCE AND J3EAIUNG.
<br />
<br />., ;".
<br />
<br />/1.
<br />(North or South) section line
<br />, (East or Wl'St) section I ille
<br />
<br />"
<br />
<br />feet fronl/:. -
<br />reet [l'UIll . ,
<br />
<br />IF \U~LL IS I-"tlll mlHGATION. THE A1tEA TO BE IRHIGATED MUST BE SHADED Ol{ C1tUSS-
<br />!lATC!lED,
<br />
<br />Thl' sCjuClrl' bl'lo\\ will be used to indieClte the location of the welt and the irrigClted land,
<br />
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<br />IIlli.
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<br />
<br />WELL LOCATION_:;!
<br />
<br />Count).
<br />
<br />Ali.I
<br />T. /0
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<br />: / . I
<br />/~ /.() Ill, see.
<br />,1;" ,<'/ fU
<br />
<br />1'1
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<br />l/~
<br />
<br />, It.
<br />
<br />P.M.
<br />
<br />Ground WClter nasin
<br />\Vater Manag:clllenl
<br />District
<br />
<br />Domcstie \",,11s mClY be located IJY the
<br />fullu\\illg: LOT I:lL~)c;l":
<br />
<br />___ S UBmVISIOt\
<br />
<br />No. GW (!?~M~'~
<br />
<br />.-\CCEI'TElJ 1'1l._H FlUNG II' TilE Ot'I'ICE OF THE STATE.', 9'NGINEEH
<br />r-' , ~ .
<br />nAY 01,' ". ,1(J-,-,---,--.
<br />
<br />,'" .
<br />...... '1
<br />
<br />OF COLOllADO
<br />, ,.)
<br />, :'
<br />......
<br />
<br />ON THIS
<br />
<br />C... ~
<br />State Eng-{l1l'YI'. '
<br />
<br />. ,
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