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2021-04-02_REVISION - M1980131
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2021-04-02_REVISION - M1980131
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Entry Properties
Last modified
4/19/2021 2:42:41 PM
Creation date
4/2/2021 1:24:29 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1980131
IBM Index Class Name
Revision
Doc Date
4/2/2021
Doc Name
Documentation of Well Application Submittal
From
Ben Langenfeld
To
DRMS
Type & Sequence
TR4
Email Name
RAR
JLE
Media Type
D
Archive
No
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GWS-38 600 FOOT WELL SPACING STATEMENT <br />(we) J-Fc— VE�- T 914 <br />9 <br />3 <br />I (we) own real property described as <br />Deakins Pit <br />state as follows: <br />in <br />the 1/4 of the NE '/, Section 6 , Township 6N ,Range 90W , <br />Sixth P.M., Moffat County, Colorado_ We own the right and <br />easement to the following well: <br />Actual Actual <br />Distance from Distance from <br />Permit # 114 1/4 Sec. Twp. Rng. NIS Sec. Line EA/V Sec. Line <br />80664-F NE 6 6N 90W <br />(we) have been apprised that Elam Construction, Inc. , the <br />present owners of a parcel of land in the NE '/ of the SE %, Section 6 , <br />Township 6N ,Range 90W Sixth p M., desire to drill a new well or <br />extend the use of an existing well. I (we) also understand that the purpose of such <br />well is set forth in the well permit application, and that I (we) have reviewed the <br />application that was submitted to the State Engineer and receipted by him under <br />receipt no. Pending <br />The proposed location for the subject well will be 600 feet or less from my (our) <br />well. <br />4. By this statement I (we) am (are) specifically waiving any objection to the issuance <br />of a well permit for the subject well, as set forth in the referenced application, and <br />would request that permit issuance not be postponed or denied because of any <br />concerns by the Division or others that the proposed well will materially affect my <br />(our) well or water right. I (we) am (are) also specifically waiving my (our) right I <br />(we) may have to participate in a hearing before the State Engineer pursuant to <br />Section 37-90-137(2), C.R.S. <br />Dated this day of h , Zr-'- / <br />Print <br />�� Sign <br />
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