2019-12-03_REVISION - M1977300 - Laserfiche WebLink

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(5) THE L"r1 T IOP4 OF -rHE PROPOSED WELL and the area on (6) THE WELL MUST BE LOCATED-BE OW which the water will be used must be indicated on the diagram below, by distances from section lines. Use the CENTER SECTION 0 section, 640 acres) for the well location 1776 ft. from SOUth sec. line + — i 4- ---- -4- �- --L -�- tnortn or south) I i 1379 ft. from East sec. line •4--�-�--1 MILE,5280 FEET—- (east or west) ' ! LOT N/A BLOCK N/A FILING a N/A i I f N/A NORTH SECTION LINE SUBDIVISION — — 1 I 4 I j (7) TRACT ON WHICH WELL WILL BE NORTH ` _ j LOCATED N/A I Owner: T T zi ; — T — y No.of acres N/A Will this be m the only well on this tract? N/A GI w Io (8) PROPOSED CASING PROGRAM ml z Plain Casing y i rn '_. i `— z 4 in. from 2.0 ft.to 8.0 ft. I i i I 4 in.from 14.0 ft.to 15.0 ft. Perforated casing SOUTH SECTION LINE i 4 in.from 8.0 ft. to 14.0 ft- -- — -�- -T — — in, from ft.to :t. I ' I j I {9} FOR REPLACEMENT WELLS give distance and direction from old well and plans for plugging The scale of the diagram is 2 inches= a mile N/A Each small square represents 40 acres. WATER EQUIVALENTS TABLE (Rounaed Figures) An acre-foot covers 1 acre of land 1 foot deep 1 cubic toot per second(cts) .. .449 gallons per minute(gpm) A family of 5 will require approximately 1 acre-foot of water per year 1 acre-foot. ..43,560 cubic feet .. .325,900 gallons. 1.000 gpm pumped continuously for one day produces 4 a2 acre-feet. (10) LAND ON WHICH GROUND WATER WILL BE USED: Ownedsf: N/A No. of acres: N/A Legal description: (11) ETAILED C IPTION of the use of ground water: Household use and domestic wells must indicate type of disposal system to be used. Water Quality Monitoring Well _ (12) QTHER WATER used on this land, including wells. Give Registration and Water Court Case Numbers. Type or right Used for(purpose) Description of land on which used Commercial Drinking/Sanitary Permit #64684 - Decree W6915 (13) THE APPLICANT(S) STATE(S) THAT THE INFORMATION SET FORTH HEREON IS TRUE TO THE BEST F HIS KNOWLEDGE. G TURE OF APP S/ f ANT(S) Use additional sheets of paper rf more space is required.