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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 /> 388 <br /> WELL PERMIT NUMBER 246992 - - <br /> APPLICANT DIV. 2 WD 11 DES. BASIN MD <br /> Lot: 5 Block: Filing: Subdiv:BEARD RANCH TRACT 5 <br /> APPROVED WELL LOCATION <br /> LAKE COUNTY <br /> NE 1/4 NE 1/4 Section 28 <br /> FRANK M NICKLE Township 9 S Range 80 W Sixth P.M. <br /> 7437 S WASHINGTON ST DISTANCES FROM SECTION LINES <br /> LITTLETON, CO 80122- 494 Ft. from North Section Line <br /> 4885 Ft. from West Section Line <br /> (303) 797-1742 UTM COORDINATES <br /> PERMIT TO CONSTRUCT A WELL Northing: Easting: <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 assure the applicant that no injury will occur to another vested water right or preclude another owner of a vested <br /> water right from 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) Approved pursuant to CRS 37-92-602(3)(b)(II)(A)as the only well on a tract of land of 35.018 acres described as parcel 5, <br /> tract 5, Beard Ranch division of land, Lake County. <br /> 4) The use of ground water from this well is limited to fire protection,ordinary household purposes inside not more than <br /> three(3)single family dwellings,the irrigation of not more than one (1)acre of home gardens and lawns,and the watering <br /> of domestic animals. <br /> 5) The maximum pumping rate of this well shall not exceed 15 GPM. <br /> 6) The return flow from the use of this well must be through an individual waste water disposal system of the <br /> non-evaporative type where the water is returned to the same stream system in which the well is located. <br /> 7) This well shall be constructed not more than 200 feet from the location specified on this permit. <br /> NOTICE: This permit has been approved subject to the following changes: the quarter/quarter and quarter section were <br /> determined from distances from section lines. You are hereby notified that you have the right to appeal the issuance of this <br /> permit, by filing a written request with this office within sixty(60)days of the date of issuance, pursuant to the State <br /> Administrative Procedures Act. (See Section 24-4-104 through 106,C.R.S.) <br /> 4o,13,200 Z <br /> APPROVED <br /> MPS t <br /> State Engineer By <br /> ,,Receipt No.0503875 DATE ISSUED 01-13-2003 EXPIRATION DATE 01-13-2005 <br />