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C O L O R A D O Application for Livestock Water Tank <br />Division of Water Resources and Erosion Control Dam <br />Department of Natural Resources DRS-11 (01/2o2o) <br />Application Instructions <br />For Livestock Water Tank Applications: For Official Use Only <br />This application is required per Section 35-49-106, Receipt/Priority WDID; <br />C.R.S. and must be submitted electronically to the Number: <br />State Engineer's Office Online Form Submission Email <br />account DWRPermitsOnline@state.co.us a minimum Payment Reference Number: <br />of 45 days prior to construction. A filing fee of $15.00 <br />is required for Livestock Water Tanks unless the dam Date Received: Date Approved: <br />vertical height does not exceed 5 feet and the <br />structure impounds less than 2 acre feet of water. Approvers Signature: <br />After submitting this form to <br />DWRPermitsOnline@-state.co.us, you'll be provided Approvers Name: <br />with the payment options. <br />Livestock Water Tanks are regulated and subject to the authority of the State Engineer consistent with sections 35-49-101 <br />through, 116, C.R.S. <br />For Erosion Control Dam Applications: <br />This application is required per Section 37-87-122, C.R.S. and must be submitted electronically to the State Engineer's <br />Office Online Form Submission Email account DWRPermitsOnline_@state.co.us a minimum of 45 days prior to construction. <br />A filing fee of $15.00 is required for Erosion Control Dam and after submitting this form to DWRPermitsOnline@-state.co.us, <br />you'll be provided with the payment options. <br />Erosion Control Dams are regulated and subject to the authority of the State Engineer consistent with section 37-87-122, <br />C.R.S. <br />Additional Information: <br />Additional information, including beginners guides to Livestock Water Tanks and Erosion Control Dams, is available at <br />www.colorado.zov/wate <br />1. Application Type <br />QLivestock Water Tank <br />Will the structure be used for livestock watering use and no other use? (�) Yes Q No <br />QErosion Control Dam <br />Will the structure be used to control erosion with no use of the water Yes Q No <br />stored or detained behind the dam? <br />2. Responsible Parties <br />First Name Middle Initial Last Name Suffix <br />Miranda IL FKawcak <br />Name of Company (if applicable) <br />Peabody <br />Phone Number Email Address <br />1970-870-2718 lmkawcak@peabodyenergy.com <br />Mailing Address City State Zip Code <br />29515 RCR 27 Oak Creek CO *467 <br />A�" <br />1313 Sherman Street, Room 821, Denver, CO 80203 P 303.866.3581 www.colorado.gov/water <br />