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Form„No. 3 <br /> '(Revised b/b4) C So 8 <br /> f COLORADO WATER CONSERVATION BO <br /> NOTIFICATION" OF INTENTION TO DRILL:❑, RED ILL ❑, <br /> RECASE ❑, OR DEEPEN X.A WATER WEL <br /> -District No.......:.............Name or Number of-Well----- ----- ---- ----- ---- - '.'�- Q. <br /> t <br /> Name of Driller.- - --- -- ------ -------- - --- ------Phone ------ <br /> Address------------------ --- -late <br /> , r 3--1 o a=--G - <br /> Well Drillers License No------- -----------•----------------- Start of Work.....__.- --------------- <br /> Land Owner's Name--------- ------- -------- - - <br /> Address---------------------------------------------- ----- <br /> - 9-------------------- - <br /> Estimated Depth of Well __r�" Ft. Location of Well <br /> 'Diameter of Well _ .__In. Section No. County------- _ -_ <br /> Diameter of Casing .In- . Twp...4091-------Range-... ----P.M....................... <br /> •, z <br /> Weight of Casing -_.1 406g! .bs./Ft. Please mark well loca on to nearest 40 acres 'F <br /> (small squ ) below. <br /> - N <br /> Type of WeII: Domestic ❑ <br /> Irrigation ❑ <br /> l - <br /> l <br /> Municipal ❑ <br /> Stock ❑ I I. W <br /> Other � I <br /> S' <br /> Method:to be used in drilling----------------------------------------- If above location is,ui iknown, complete the fol- <br /> lowing: <br /> ------------------------------------------------------------------------------------------- <br /> County----------------------------------------------------- <br /> Estimated Depth of Bottom and Top <br /> of Shutoff ............................------------------------------------------- City, Town or Subdivis'Dn------------------- <br /> - --------------------------------------- ---•--->------------------------------------- <br /> Type of Shutoff---------------------------------------------------------------- Street Address of Well Location-------------------------------- <br /> ---------------------------------------------------------------------------------------- -------------------------------------- ------------ ---------- <br /> RFPTWFN <br /> MAY 311955i. <br />