2014-05-12_PERMIT FILE - C2010089A

• 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

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