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2014-05-12_PERMIT FILE - C2010089A
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2014-05-12_PERMIT FILE - C2010089A
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Entry Properties
Last modified
8/8/2017 10:12:32 AM
Creation date
5/21/2014 9:50:57 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C2010089A
IBM Index Class Name
Permit File
Doc Date
5/12/2014
Doc Name
Approved Well Permits
Section_Exhibit Name
Appendix 2.05.6(3)-4
Media Type
D
Archive
Yes
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COLORADO DIVISION OF WATER RESOURCES <br />Office Use Only Form GWS -45 (04/2012) <br />DEPARTMENT OF NATURAL RESOURCES <br />1313 SHERMAN ST, RM 821, DENVER, CO 80203 <br />Main: 303 866 -3581 Fax: 303 866 -2223 dwr ermitsonline state co us <br />GENERAL PURPOSE <br />Water Well Permit Application <br />Review Instructions on reverse side prior to completing form. <br />The form must be computer generated, typed or In black or blue Ink. <br />1, Applicant Information <br />6. Use-Of Well (check a livable boxes <br />-- - ----- �p -- boxes) - - - - - - <br />Name of applicant - - - - - - - — __ ____- ______.___ <br />Attach a detailed description of uses applied for. <br />Western - Fuels- Colorado, LLC <br />- <br />® Industrial ® Dewatering System <br />address <br />❑ Municipal ❑ Geothermal (production or reinjection) <br />P.O. .O. Box 33424 -_. - <br />-- <br />-- � - - " -- <br />-Zip <br />ED Irrigation <br />I Stale cod <br />ary e <br />I <br />Dust suppression <br />®Other (describe): pP <br />Denver i CO i 80233 <br />❑Commercial <br />Telephone # (area code & number) __ -E -mall (online filing required) `}v " - <br />7, Well Data (proposed) <br />(303) 255 -5800 <br />Ntawmum mp-in rate -- -- — - i lviriiial amouru to b'a withdraHm - - -��- <br />(In comb`i'nation w/ 800 gpm !See Attachment B acre -feet <br />DW12 -2 & DW12 -3) <br />Total depth __Aquifer - <br />2. Type Of Application (check applicable boxes) <br />KI Construct new well El Use existing well <br />❑ Replace existing well ❑ Change or increase use <br />85 feet !Bedrock/Coal <br />❑ Change source (aquifer) ❑ Reapplication (expired permit) <br />8, Land On Which Ground Water Will Be Used <br />❑ COGCC Well ❑ Other: <br />- -_____ -• .---- --__ -- . -_ _.- <br />Legal Description of Land (may be provided as an attachment) <br />3. Refer To (if applicable) <br />wellperMit# waCercourt casee -- <br />West 1/2 of Section 25, Township 47 North, Range 16 West <br />N/A N/A <br />-. <br />Designated Bann Detem ination # Well name or-#,-,- <br />of the N.M. P.M. <br />DW12 -1 <br />4. Location Of Proposed Well <br />County i <br />(If used for crop irrigation, attach a scaled map that shows irrigated area ) <br />Montrose I SW 114 of the SW va <br />-� - - - - - - -- -_ _- <br />A. #Acres <br />Section Townsh; Nor 5 Ra <br />j p nge. "--'-E or.W Pnnupal Mendan <br />320 ;See Attachment A <br />25 :47 I� i 16 ❑ 0 N. M. <br />C. List any other wells or water nghts used on the land <br />-- -- - - <br />Distance of well from section lines (section tines are typically not property lines) <br />Others wells and water rights operated under Case Nos. <br />452 Ft from (- N (X S 301 Ft UorrLF]E JW <br />10CW209 and 09Cw171 and related SWSes. <br />9. Proposed Well Driller License # ci tional : <br />For re placement wellsonly - distanceanddirection framoldwelltonewwell <br />10. Sign or-Entered-Name Of Applicant(s) Or Authorized Agent <br />feet direction <br />Well location address (Include Gty Stale, Zip) . Check if well address is same as in Item 1 <br />The making of false statements herein constitutes perjury in the second <br />degree, which is punishable as a class 1 misdemeanor pursuant to C.R.S. <br />24 -4 -104 (13)(a). I have read the statements herein, know the contents <br />- - - <br />Optional: GPS well location mformabon in UTM format You must check GPS unit for <br />thereof 9 d state that they are true to my knowledge_ <br />- -(Y - u-'to -- -... -- <br />Signor t r n of per s submitting application Date (nWddlyyyy) <br />required setti ngs as follows: <br />j5 /� <br />j' <br />e U <br />Format must be <br />' <br />j -- Zone 12 orli-I Zone 13 <br />-- -- - - - -- - .. --- -- <br />It signing pent name and title <br />Easting <br />Units must be Meters <br />(�ItSt. ?iAC'i lChrtC(r�G i Ccvtur}GrF (Z, H njrCt.t't <br />Datum must be NAD83 Northing <br />Office Use Only <br />Unit must be set to true north <br />Was GPS unit checked for above? YES <br />❑ ! Remember to set Datum to NAD83 <br />- - - - - - - -- -- <br />USGS map name i DWR map no - Sudace elev <br />i <br />5. Parcel On Which Well Will Be Located <br />(PLEASE ATTACH A CURRENT DEED FOR THE S_ UBJECT PARCEL) _ <br />Receipt area only <br />A. Legal Description (may be provided as an attachment <br />West 1/2 of Section 25, Township 47 North, <br />Range 16 West of the N.M. P.M. <br />w <br />! <br />- - --- .._ .�- -- - -. <br />B. # of acres in parcel C. Owner <br />I <br />I <br />AOUAMAP - -- - ---- -- -- -- -- - - - - - --- - - -- - <br />320 i See Attachment A <br />WE <br />- - r- - - - - -- - <br />D. Will ttus be the oNy woM on the parcel') © YES x] NO (if no list other wells) <br />WR <br />Others wells operated under Case Nos. 10CW208 and <br />CWCB <br />09CW171 and related SWSPs. <br />TOPO <br />E. Stale Parcel ID# (optional) <br />MYLAR <br />SB5 DIV WD BA MD <br />
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