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WRJ-25-15 ~ <br />it, 4 <br />TYPE OR <br />PRINT IN B ACK INK. <br />COPS' OF ACCEPTED <br />STATEMENT MAILED <br />ON REQUEST. <br />RECEIVED <br />AUG 1 5 1989 <br />OUR RFSMURCtfi <br />r >fi1611i11rFi <br />COLORADO DIVISION OF WATER RESOURCES <br />818 Centennial Bldg., 1313 Sherman St. <br />Denver, Colorado 80203 <br />SS. <br />STATE OF COLORADO <br />COUNTY OF. <br />Weld <br />AFFIDAVIT <br />>r STATEMENT OF BENEFICIAL USE OF GROUNDWATER <br />AMENDMENT OF EXISTING RECORD <br />LATE REGISTRATION <br />PERMIT NUM LOCATION OF WELL <br />THE AFFIANT(S) Walter Mayer <br />whose mailing <br />address is 9704 Hwy 66 <br />City Platteville <br />COQ R0651 <br />{ 1 ' MP) - ' <br />County Weld <br />NW <br />y.. of the NE h, socrion <br />� ��7L PM <br />TWP 9• <br />t OR st RnE( OP -NI 6. <br />being duly sworn upon oath, deposes and says that he (they) is (ore) the owner(s) of the well described hereon; the well is <br />located as described above, at distances of 140 feet from the section line and 2'C10 feet from the <br />t,dCRTW nR Rat:+Mt <br />east section line; water from this well was first applied to a beneficial use for the purpose(s) described herein on the Z_ <br />(COOT OR 'NFU') <br />day of _July , 199; the maximum sustained pumping rate of the well is 900 gallons per minute, the pumping <br />rate claimed hereby is 900. gallons per minute; the total depth of the well is 53 . feet; the average annual amount• <br />of water to be diverted is 200... acre-feet; for which claim �s hereby made for iirrigate pn <br />purpose(s); the legal description of the land on which the water from this well is used is <br />Ne 1/4 Sect 33 Twn 3 N Rng 67 W <br />of which <br />160 acres are irrigated and which is illustrated on the map on the reverse side of this form; that this well was completed in <br />compliance with the permit approved therefor; this statement of beneficial use of ground water is filed in compliance with law; he <br />(they) has (hove) read the statements made hereon; knows the content thereof; and that the same are true of his (their) knowledge. <br />(COMPLETE REVERSE SIDE OF THIS FORM) <br />X Signature(s) <br />Subscribed and swarfl <br />to before rpe"'cin tJiisr•/MV. d4oy of , 19 <br />=._{ �� r OnY Comm!'n Win <br />My Co s_rratyrrri: yi — . <br />txRM t <br />• • S,. �,, r N"A" <br />rl <br />��;- 'r .� <br />ACCEP'TEP FDR FILE' i' HE. STATE ENGINEER OF COLORADO <br />PURSUAIWT"TO ,:i :OWING CONDITIONS: <br />Accepted that those conditions of approval as <br />Bbated on the permit are complied with.131a5/'9f <br />!1A 2 51991.: <br />OATF <br />OCT 2 7 1989 <br />Court Case No. <br />FOR OFFICE USE ONLY <br />W-[! <br />Prior. Mo Day Yr <br />Di•. Cty U22_ <br />Sec. <br />Well <br />Use . I <br />Dist. 2„, Basin ,_•_ Man Dis <br />