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I I <br /> (5) THE LOCATION OF THE PROPOSED WELL and the area on (6) THE WELL MUST BE LQCATED BELOVIF <br /> which the water will be used must be indicated on the diagram below. by distances from section lines. <br /> Use the CENTER SECTION 0 section, 640 acres} for the well location. <br /> -I II II � Lt7O ft. from Sou7''H sec.line <br /> 11 T T — + — + — -4-— T 4 — + — + d&_fi. <br /> (north or south) <br /> I 14 1 MILE,5280F 1 from EA3TT _ sec. line <br /> (east or west) <br /> �i) � ( I LOT BLOCK FILING �► <br /> 1 <br /> + i NORTH SECTION + _ SUBDIVISION <br /> (7) TRACT ON_W1166H WELL WILL BE <br /> LOCATED Owner:11met for. } t <br /> �NORTH1 Z + D +TT J �, No. of acres - Will this be <br /> � 1 _ <br /> C l m ' the only well on this tract? 11 <br /> y , o (8) PROPOSED CASING PROGRAM <br /> l z l <br /> a r_- I Plain Casing <br /> Yt in.from ft.to /O ft. <br /> i ► � ,1 <br /> in,from ft,to ft. <br /> Perforated casing <br /> SOUTH SECTION LINE <br /> 1 _ _in.from� _ft.to 0 ft. <br /> -�- + + �- �-, -)- 4- in.from ft.to ft. <br /> (9) FOR REPLACEMENT WELL givedistance <br /> and direction from o{ well and pans for plugging <br /> The scale of the diagram is 2 inches= 1 mile K.,�/�� <br /> Each small.square represents 40 acres. <br /> WATER EQUIVALENTS TABLE (RountS�etfiFigures) <br /> An acre-foot covers 1 acre of land t foot deep <br /> 1 cubic tool per-second(cfs) . -449 gallons,pef minute lgpm) <br /> A family of 5 will,require$pprdxi(nitely,l,icre-foot of water per year. <br /> 1 acne-foot:.;-4�560 cub iic.. eet,,�,3?5,900"lions., <br /> 1,000 ppm pumped eoritinJously forone day produces 4.42.1.,de-feet. <br /> j10) 4ANQ�N WHICH--'GROUNQ W41`03 WILCAE USED: <br /> Owner 0: p <br /> ( Br.••tt,..ra_.{r �sftaPjs. LrS! No.of acres: �re1[_ �- <br /> Legal description <br /> (11) QETA LE DEmaIQW'of the.use of groltncf w ter: Household use and domestic wells must indicate type of disposal <br /> system to be used. 1 - <br /> s49O f SIVIt-e_ <br /> (12) OIHER WATER RIGHTS used on this land, including wells. Give Registration and Water Court Case Numbers. <br /> Type or right Used for(purpose) Description of land on which used <br /> (13) THE APPLICANT(S) STATE(S) THAT THE INFORMATION SET FORTH HEREON IS <br /> TRUE TO THE BEST OF HIS KNOWLEDGE. + " <br /> ZAP,& <br /> SIGNATURE OF APPL WAN TISI , <br /> Use additional sheets of paper if more space is required. <br />