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2013-02-18_PERMIT FILE - M2012050
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2013-02-18_PERMIT FILE - M2012050
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Last modified
8/24/2016 5:13:18 PM
Creation date
10/16/2013 7:16:55 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M2012050
IBM Index Class Name
PERMIT FILE
Doc Date
2/18/2013
Doc Name
Signed 600 Foot Well Spacing Statements.
From
Oldcastle SW Group, Inc.
To
DRMS
Email Name
THM
Media Type
D
Archive
No
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GWS -38 600 FOOT WELL SPACING STATEMENT <br />I (we) M o,r , J b 6ncL A2- Co -rr� ci state as follows: <br />1. 1 (we) own real property described as /AA COMCkEW 32, l � in ipA' <br />the '/4 of the SE� '/4, Section 11 , Township I S , Range ( F <br />UrF P.M., ,MESA County, Colorado. We own the right and <br />easement to the following well: <br />Actual <br />Distance from <br />Permit # 1/4 1/4 Sec. Twp. Rng. N/S Sec. Line <br />68760 -F- 5' SE l4 1s 115 5o/ N ft. <br />2. 1 (we) have been apprised that 0LW,46= - -6 &R00P JUA titlt W <br />Actual <br />Distance from <br />ENV Sec. Line <br />Cp 1�a ft. <br />A <br />> �mpRN the � grY <br />present owners of a parcel of land in the NIE '/4 of the SE '/4, Section Iq , <br />Township 1$ Range "1 E , GQIE7 P.M., desire to drill a new well or <br />extend the use of an existing well. I (we) also understand that the purpose of such <br />well is set forth in the well permit application, and that I (we) have reviewed the <br />application that was submitted to the State Engineer and receipted by him under <br />receipt no. 3651903 <br />3. The proposed location for the subject well will be 600 feet or less from my (our) <br />well. <br />4. By this statement I (we) am (are) specifically waiving any objection to the issuance <br />of a well permit for the subject well, as set forth in the referenced application, and <br />would request that permit issuance not be postponed or denied because of any <br />concerns by the Division or others that the proposed well will materially affect my <br />(our) well or water right. I (we) am (are) also specifically waiving my (our) right I <br />(we) may have to participate in a hearing before the State Engineer pursuant to <br />Section 37 -90- 137(2), C.R.S. <br />Dated this day of <br />(�C r <br />JA <br />
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