Laserfiche WebLink
WRJ-s-Rev. 76 COLORADO DIVISION OF WATER RESOURCES <br /> 818 Centennial Bldg., 1313 Sherman St., Denver, Colorado 80203 <br /> PERMIT APPLICATION FORM <br /> Application mus FI)J[D <br /> be complete where _Ci Y 1.E { ) A PERMIT TO USE GROU <br /> applicable. Type or (Y) A PERMIT TO CONS <br /> print in BLACK AUC 2 4 ti96%0R: (V) A PERMIT TO INSTA— <br /> INK.No overstrikes CCCCP v 1 <br /> or erasures unless WATER Rj6WRM { ) REPLACEMENT FOR PU <br /> initialed. So,ENGINEER ( )OTHER <br /> 210. WATER COURT CASE <br /> oft <br /> (1) APPLICANT - mailing address FOR OFFICE USE ONLY: DO NOT WRITE IN THIS COLUMN <br /> NAME Sr-aftC tri-w` c L- Receipt No. V <br /> STREET_4.e- t7ox 1-'1 Basin Dist. <br /> CITY L:6�*Mgs C*10 80-4 QNDITIONS OF APPROVAL <br /> TELEPHONE NO, (1103) _{.70-/7oZ This well shall be used in such a way as to cause �X <br /> no material injury to existing water rights. The <br /> (2) LOCATION OF PROPOSED WELL issuance of the permit does not assure the applicant gv?,L V, <br /> that no injury will occur to another vested water Plfl <br /> right or preclude another owner of a vested water <br /> County C/[&,p &ee f right from seeking relief in a civil court action, <br /> hi Y. of the S E '/., Section 32- ISSUANCE OF THIS PERMIT DOES NOT <br /> Twp. J! .5. Rng.�,�. G P.M. 1) APPROVED PURSUANT TO CRS 37-92-602(3)(b)(II) <br /> IN,SI IE,W (A) AS THE ONLY WELL ON A RESIDENTIALSITE OF <br /> (3) WATER USE AND WELL DATA APPROXIMATELY 9 ACRES DESCRIBED AS THAT PORTION <br /> OF THE N 1/2 OF THE NE 1/4 OF THE SE 1/4 OF <br /> SECTION 32 T3S R72W OF THE 6TH P.M. , CLEAR <br /> Proposed maximum pumping rate (gpm) IS CREEK COK+Y RING MORE PARTICULARLY DESCRIBED <br /> ON THE ATTACKED EXHIBIT "A". <br /> AaJA <br /> Average annual amount of ground water 2) THE USE OF GROUND WATER FROM THIS WELL IS <br /> to be appropriated (acre-feet): '� LIMITED TO ORDINARY HOUSEHOLD PURPOSES INSIDE A <br /> SINGLE FAMILY DWELLING AND THE WATERING OF THE <br /> Number of acres to be irrigated: 0 USER'S NONCOMMERCIAL DOMESTIC ANIMALS. THE <br /> GROUND WATER SHALL NOT BE USED FOR IRRIGATION <br /> Proposed total depth (feet): 60 OR OTHER PURPOSES. jj�g .j.g� �T$j�L <br /> Aquifer ground water is to be obtained from: LOW <br /> MUSTHE ET ATURN N �(]iTWASTEOgi]ATB$sDzIMSAL <br /> SYSTEM OF THE NON-EVAPORATIVE TYPE WHERE THE <br /> WATER IS RETURNED TO THE SAME STREAM SYSTEM IN <br /> Owner's well designation s(M1 <br /> WHICH THE WELL IS IACATED.yG/-- "•2/� <br /> TH 1 <br /> GROUND WATER TO 6E USED FOR: <br /> { X) HOUSEHOLD USE ONLY - no irrigation (0) <br /> ( ) DOMESTIC (1) ( ) INDUSTRIAL (5) <br /> { ) LIVESTOCK (2) ( } IRRIGATION (6) <br /> ( ) COMMERCIAL (4) ( ) MUNICIPAL (8) <br /> ( ) OTHER (9) APPLICATION APPROVED <br /> DETAIL THE USE ON BACK 1N (11) 1 5 2 a A ,1 <br /> PERMIT NUMBER -�f`� <br /> (4) DRILLER LICENSED <br /> DATE ISSUED_- SEP 2 2 T9 <br /> Name EXPIRATION DATE SEP 2 2 1990 <br /> Street <br /> City ST TE ENGIN ) <br /> (state) (Zip) <br /> Telephone No. Lic. No, BY <br /> I.D. l C)aL COUNTY <br />