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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 1367 <br /> WELL PERMIT NUMBER 297250 - - <br /> APPLICANT DIV. 1 WD4 DES. BASIN MD <br /> APPROVED WELL LOCATION <br /> LARIMER COUNTY <br /> NE 1/4 NE 1/4 Section 21 <br /> LOVELAND READY MIX INC Township 5 N Range 69 W Sixth P.M. <br /> C/O LANDMARK ENGINEERING LTD DISTANCES FROM SECTION LINES <br /> 3521 W EISENHOWER BLVD 77 Ft. from North Section Line <br /> LOVELAND, CO 80537- 183 Ft. from East Section Line <br /> (970)667-6286 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) Approved pursuant to CRS 37-92-602(3)(b)(1)for uses as described in CRS 37-92-602(1)(f). Use of this well is limited to <br /> monitoring water levels and/or water quality sampling. <br /> 4) Approved for the use of an existing well acknowledged for construction under monitoring hole notice MH-53388, and <br /> known as Well#2. <br /> 5) This well must be equipped with a locking cap or seal to prevent well contamination or possible hazards as an open well. <br /> The well must be kept capped and locked at all times except during sampling or measuring. <br /> 6) Records of water level measurements and water quality analyses shall be maintained by the well owner and submitted to <br /> the Division of Water Resources upon request. <br /> 7) Upon conclusion of the monitoring program the well owner shall plug this well in accordance with Rule 16 of the Water <br /> Well Construction Rules. A Well Abandonment Report must be completed and submitted to the Division of Water <br /> Resources within 60 days of plugging. <br /> 8) The owner shall mark the well in a conspicuous place with the well permit number and name of aquifer as appropriate, <br /> and shall take necessary means and precautions to preserve these markings. <br /> 9) This well must have been constructed by or under the supervision of a licensed well driller or other authorized individual <br /> according to the Water Well Construction Rules. <br /> 10) This well must be located not more than 200 feet from the location specified on this permit. <br /> NOTE: Issuance of this permit does not guarantee that this well can be converted to a production well under a future <br /> permit. Additionally, pursuant to Rule 14.2 of the Water Well Construction Rules(2 CCR 402-2), monitoring holes <br /> constructed pursuant to a monitoring hole notice shall not be converted to a production well. (Upon obtaining a permit from <br /> the State Engineer, a monitoring hole may be converted to a monitoring well, recovery well for remediation of the aquifer, or <br /> a dewatering system for dewatering the aquifer.) <br /> APPROVED � s <br /> JB4 <br /> State Engineer By <br /> ,.Receipt No. 3668735B DATE ISSUED 04-03-2015 EXPIRATION DATE N�p <br />