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2018-05-18_HYDROLOGY - P2017008
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2018-05-18_HYDROLOGY - P2017008
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Entry Properties
Last modified
1/23/2021 10:33:29 AM
Creation date
5/18/2018 11:02:45 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
P2017008
IBM Index Class Name
HYDROLOGY
Doc Date
5/18/2018
Doc Name Note
FINAL
Doc Name
Abandonment Report
From
Brandon Heser
To
DRMS
Email Name
TC1
Media Type
D
Archive
No
Tags
DRMS Re-OCR
Description:
Signifies Re-OCR Process Performed
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COLORADO DIVISION OF WATER RESOURCES Office Use Only Form GWS-46(1112011) <br /> DEPARTMENT OF NATURAL RESOURCES <br /> 1313 SHERMAN ST.,Ste 821,DENVER CO 80203 <br /> Phone: 303)866-3581 dwr ermitsonlineastate.co.Js <br /> MONITORING/OBSERVATION <br /> Water Well Permit Application <br /> Review instructions on reverse side prior to completing form. <br /> The form must be typed,completed online or In black or blue Ink. <br /> 1.Well Owner Information <br /> Name of well owner 6. Use Of Well <br /> Transit Mix Concrete Co. Use of this well is limited to monitoring water levels <br /> Mailing address and/or water quality sampling <br /> 444 E. Costilla St. 7.Well Data (proposed) <br /> Cry 5ta'n Zip;x r Total depth Aquder <br /> Colorado Springs CO 80903 <br /> 395 feet Granite <br /> Telephone fa FEiMail tIf fling online iris+equ•edl 8.Consultant Information (if applicable) <br /> (719)475-0700 rald.Schnabel@Transitmix.co <br /> 2.Type Of Application (check applicable boxes) Mike Day <br /> ❑Use existing well ❑Replacement for existing monitoring well Compary name <br /> *Construct new well Permit no Hydro-Logic Solutions, Inc. <br /> 0 Other 56847-MH Mailing address <br /> 3.Refer To (if applicable) 6100 Montview Blvd <br /> Momtonng hole acknowiedgment Well name or# City State Zip Corte <br /> MH- 56847 LTC-GW-5 Denver CO 80207 <br /> 4. Location Of Proposed Well (important! See Instructions Te03)5 <br /> County (303)570-9527 <br /> El Paso NW '"of'he NW 14 <br /> 9. Proposed Well Driller License#optional : <br /> Section Township Nor S Range F or W Pnncapal Mandan 10. Name of Well Owner or Authorized Agent <br /> x x The making of false statements herein constitutes perjury in the second <br /> 16 16 67 6 degree which is punishable as a class 1 misdemeanor pu*suant to C.R S <br /> 24-4-104(13)(a) I have read the statements herein,know the contents <br /> Distance of well from section lines�secaon lines are!ypicaev no,proper..l:nes� _ __ thereof and state that the are true tom knowledge <br /> Ft from`_ N, S rt '-cn: E W Sign or error full name here Date Imm'dd'yyvyi <br /> For replacemert wells only-distance and dxaction from old well to new"it Jerald Seh nabel 10/12/2017 <br /> feet direction If signing prirt name Prnt title dome'than land owner <br /> Well location address(Include City State Zip) Checl•i'well address is same as Item t President, Transit Mix Concrete Co. <br /> 2485 Hitch Rack Ranch Rd, Colorado Springs, CO 80926 Office Use Only <br /> Optional: GPS well location information in UTM format <br /> You mist check GPS unit for required settings as follows USGS map name DWR map rva Surface elev <br /> Format rust be J'M <br /> Zone 12 or,:Zone 13 Easing 508873 Receipt area only <br /> Umts must be Meters <br /> Datum must be NAD93 Northing 4278664 <br /> Uni!must be set to true north <br /> Remember to set Datum to NAD83 <br /> Was GPS unit checked for above? e YFS <br /> 5. Property Owner Information <br /> Name of properly owner <br /> RMBC Group, LLC <br /> Mailing address <br /> t � <br /> 712 Kris Ct. <br /> Ciy State Zip Code <br /> Los Alamos NM 87544 <br /> Telephone p <br /> DIV WD t3A MD <br />
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