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Sent By: TUTTLE APPLEOATE INC U; 3034522759303452B811;Jun-5- <br />' F o R M COLORADO DIVIS1vIG OF WATER RESOURCES ~ <br />Na. DEPARTMENT OF NAYURAL RESOURCES <br />0WS-77 1311 6harmut 6t., Mn ale, Damar, Colorado 8t120i <br />12/a6 Phone: p0a- a66•ab87 <br />PRIOF! TO COMPLETING FORM <br />~ GRAVEL PIT WELL PERMIT APPLICATION ~ <br />NEW PIT(SI _ <br />PIT(SI EXIST, CONSTRUCTED AI7ER DEC. 31, 1980 <br />APPLICANT INFORMAT(Q~ <br />NAME(SI Western Mobile, Inc. a subsidiary of Lafarge <br />Melling Addroas 1400 peat 64th Awn,,. PO a~Y 2tsnol <br />City, St. Zip Denver. CO 80221 <br />Phone( 303 1657-4425 <br />CONSULTANT/ATTORNEY/OPERATOR CONTACT Iff different than ar21 <br />12:11; <br />u...dy <br />Page 3/3 <br />NAME(S) Anole~,te Grouu. Inc. PITI~AME Maan Lake <br />MaiRnp Addroas 1499 p. 120th Avenue. Suite 200 <br />Chy, St. Zip Denver. CO 80234-s^^.728 DMGINO. M-82-141 <br />Phdne( 303 - 452-6611 <br />4. SiENERAL LQCATION OF PITISI: COUNTY Adams County <br />1 /4 1 /4, Sac.~f r Tvp.~_ ^ N. ®S., RsnOe 67 ^ E. ®W. 6th P.M. <br />5. Estimated maximum water surface to be exposed: Acres. Num r of Pita e <br />8. Estimated depth of pit(s120-2 Ft. Estimated depth m Groundwater Pt. <br />7. Estimated date m expose proundwanr : m complsb ininp 2006 <br />B. ATTACHMENTS: (Check which have teen atachsd.) <br />Is) ®Scated map of pit area with mope, mwrtahip, & section clearry Irrde (REQUIRED(, <br />Ibl ^ Copy of the reclamation permit, if applicable. <br />ic) ^ Copy of pro 1 /15/89 water conservsncy diet. or water user assoc. sup entadon aaroemsnt, if applicable <br />(di ^ Copy of proposed substitute ureter plan or augmentation plan applicatlo , ff applicable. <br />(s) ^ Copy of court approved augmentadon plan, if applicable. Case No. <br />Ifl ^ Other <br />8. DmBSd description of any uw, other than evaporation, and method of diwroion, ra of diversion, and annual smoun <br />of diversion of arty water withdrawn from the pond. <br />0 I (we) have read the atatsmena made herein and know the conana theroof, and diet they srs true to my lour) <br />knowledge. (Pursuant m Section 24.4-104 11311a) C.R.S., the making of }alas eta msnta heroin constitutes vertu <br />in the second dsprw and is punishable as s class 1 misdemeanor.] <br />w.... <br />~• <br />'.~~, <br />For Orflca Un ody <br />