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Form No, OFFICE OF THE STATE ENGINEER <br /> GWS-25 COLORADO DIVISION OF WATER RESOURCES <br /> 818 Centennial Bldg., 1313 Sherman St., Denver,Colorado 80203 <br /> (303)866-3581 <br /> EXST <br /> WELL PERMIT NUMBER 76166 -F <br /> APPLICANT DIV. 1 WD 7 DES. BASIN MD <br /> APPROVED WELL LOCATION <br /> CLEAR CREEK COUNTY <br /> SE 1/4 NE 1/4 Section 32 <br /> CITY OF BLACK HAWK Township 3 S Range 72 W Sixth P.M. <br /> PO BOX 68 DISTANCES FROM SECTION LINES <br /> BLACK HAWK, CO 80422- 2313 Ft. from North Section Line <br /> 1229 Ft. from East Section Line <br /> (303) 582-1324 UTM COORDINATES (Meters Zone:13,NAD83) <br /> PERMIT TO USE AN EXISTING WELL Easting: Northing: <br /> ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT <br /> CONDITIONS OF APPROVAL <br /> 1) This well shall be used in such a way as to cause no material injury to existing water rights. The issuance of this permit <br /> does not ensure that no injury will occur to another vested water right or preclude another owner of a vested water right from <br /> seeking relief in a civil court action. <br /> 2) The construction of this well shall be in compliance with the Water Well Construction Rules 2 CCR 402-2, unless approval <br /> of a variance has been granted by the State Board of Examiners of Water Well Construction and Pump Installation <br /> Contractors in accordance with Rule 18. <br /> 3) The well shall be constructed and maintained in accordance with variance no. 2012-004 and 2012-016A, granted by the <br /> Board of Examiners of Water Well Construction and Pump Installation Contractors on February 8, 2012. <br /> 4) Approved pursuant to CRS 37-90-137(2)on the condition that this well is operated in accordance with the City of <br /> Blackhawk substitute water supply plan approved by the State Engineer on June 12, 2012. This well shall not be operated <br /> unless it is included in a substitute water supply plan approved by the State Engineer or a plan for augmentation approved <br /> by the water court. The subject water supply plan is valid through May 31, 2013, and if not extended or if a court approved <br /> plan for augmentation is not in operation,diversion of ground water from this well must cease immediately. <br /> 5) Approved for the use of the Additional Hidden Valley Division point constructed under well permit no. 287498. Issuance of <br /> this permit cancels permit no. 287498. <br /> 6) The use of ground water from this well is limited to municipal use. <br /> 7) The pumping rate of this well shall not exceed 800 GPM. <br /> 8) The annual amount of ground water to be appropriated shall not exceed 1291 acre-feet(as requested). <br /> 9) The annual amount of ground water to be withdrawn through this well shall be limited to the quantity approved under the <br /> substitute water supply plan or court approved augmentation plan. <br /> 10) The owner shall mark the well in a conspicuous place with well permit number(s), name of the aquifer, and court case <br /> number(s)as appropriate. The owner shall take necessary means and precautions to preserve these markings. <br /> 11) A totalizing flow meter must be installed on this well and maintained in good working order. Permanent records of all <br /> diversions must be maintained by the well owner(recorded at least annually)and submitted to the Division Engineer upon <br /> request. <br /> 12) This well shall be located at least 600 feet from any existing well, completed in the same aquifer,that is not owned by the <br /> applicant. <br /> 13) This well shall be located not more than 200 feet from the location specified on this permit. <br /> 14) This well is subject to administration by the Division Engineer in accordance with applicable decrees, statutes, rule , and <br /> regulations. �j <br /> %PPROVED <br /> JMW <br /> State Engineer <br /> ,Receipt No. 3654841 DATE ISSUED 06- 4-2012 EXPIRAYIION DATE 06-14-2013 <br />