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Form No. COLORADO DIVISION OF WATER RESOURCES For Office Use only <br /> GWS-27 DEF ARTMENT OF NATURAL RESOURCES <br /> 5/2012 1313 Sherman St,Ste 821.Denver,Colorado 80203 <br /> Pho ie,(303)866-3581 <br /> DWR Web:v mater.state.co.us Email:dwr rmitsonline state.co.us <br /> REVIEW N TRUCTIONS PRIOR TO COMPLETING FORM Ir1AR 2 3 241fi <br /> GRAVEL PIT W L PERMIT APPLICATION <br /> WAT Eft i ESoURC6b <br /> 1. TYPE OF PERMI G 1A1}-ENGINFER <br /> C01.0 <br /> NEW PIT(S) �� 3(��sag3 A <br /> PIT(S)EXIST.CONSTRUCTED AFTER DEC. 31, 1980 <br /> 2. APPLICANT INFC WATION <br /> NAME(S) Fremor t aving&Redi-Mix <br /> Mailing Address . Box 841 <br /> City, St.Zip Canc n City,Colorado <br /> Phone(w/area cc JO)(719)275-3264 Email:]odi@arycorp.com <br /> 3. CONSULTANT/A RNEY/OPERATOR CONTACT(If different than#2) ! <br /> NAME(S) Helton illiamsen, P.C. PIT NAME Mask Ranch No. 2 Pit <br /> Mailing Address 7 1,f 3 S.Alton Way,Suite A-125 <br /> City, St.Zip Cent n ial,Colorado 80112 DRMS NO._ /'1 "9Q(8 -0!S <br /> Phone(w1 area cc 10)(303)792-2161 Email:nphelps@helton-williamsen.com <br /> 4. GENERAL LOCA ION OF PIT(S): COUNTY Archuleta <br /> SE 114 NW 1/4, Sec.25 Twp. 35 N. ©S.,Range 2 ©E. (X W. NM P.M. <br /> DP s i <br /> 5. Estimated maxiML m water surface to be exposed:_y6 10,5• Acres. Number of Pits Al s41A <br /> 6. Estimated depth o pit(s)11 Ft. Estimated depth to groundwater 2 Ft. <br /> 7. Estimated date to xpose groundwater 05/01/2018 ;date to complete mining 09/30/2018 <br /> 8. ATTACHMEN S:I Check which have been attached.) <br /> i <br /> (a) N Scat d map of pit area with range,township, &section clearly identified(REQUIRED). <br /> (b) ❑Cop of the reclamation permit,if applicable. <br /> (c) ❑CopI of pre 1/15/89 water conservancy dist.or water user assoc.augmentation agreement, if <br /> g g applicable. <br /> (d) ❑Cop of proposed substitute water plan or augmentation plan application, if applicable. <br /> I <br /> (e) FICopifOf court approved augmentation plan, if applicable. Case No. <br /> (f) ❑Oth r 1 <br /> 9. Detailed descriptio of any use, other than evaporation, and method of diversion, rate of diversion, and annual amount of <br /> diversion of any water withdrawn from the pond. <br /> Pit evaporation anj water retained in the dewatered and�to�.7 hed mined material at 60,000 tons excavated during mining <br /> calculated as 2%1 0 by weight,or 0.88 acre-feet. Ev = 3/0.23 u•�'� <br /> 10. Will dewaterin cc u within the DR"- ermit bounda r Yes f No <br /> 11. 1(we)have read t statements made herein and know the contents thereof,and that they are true to my(our) <br /> knowledge. (PursLaht to Section 24-4-104(13)(a)C.R.S., the making of false statements herein constitutes perjury <br /> in the second deg a and is punishable as a class i misdemeanor.] <br /> Sign or enter name(s)of ubmitter If signing print name&title Date(mm/dd/yyyy) <br /> For Office Use only <br /> Court Case No. p Div. Co. /_� WD"1 Basin_MD Use <br />