PERMFILE49711

• Permit No: M2005066
• IBM Index Class Name: Permit File
• Doc Date: 4/6/2006
• Doc Name: Adequacy Response
• From: Banks and Gesso LLC
• To: DMG
• Media Type: D
• Archive: No

r ~ STATE OF COI.ORApO
'~ lairrllat a DIVISION OF WATER RESOURCES Zyd
I!lllb_ '_ OFFICE OF TfiE STATE ENGINEER tt -'
7 ~ ~'n
Y,ald __ MAP AND STATEMENT FOR WATER WELL fIIING FE8 1917 ..y
Chedod ey r~ ,
` PERMIT u ER - ~ W~ECElVFO ~•
WE~~ • S~ JFrr n,~ y ,~i. •6
STATE OF COLORADO 1 55 rq s `~
~` 6Z
CLAIMANT Isl~da ..nn •`S= 7~>':~~
e7,55_QC• Z11C. County
be mg tlu!y sworn upon oetn deposes and says tna; he Itheyl is l ore) -~-!{ °} ~ ", sec. ?S
the ownar (e1 0l the ww!I describes nerem, [he total number o1 pores
T. 1N R, (,T.r Arh P. M.
of land ungstod from this well is
work was com•rancrxl on this well by actual consvuction on the INDICATE WELL LOCA'ION ON DIAGRAM
-OS~day of ~nA 19.x; :he sustained
yield From ea~d well is~.Q-~gbm, For wh ch claim is hereby matle
ror-- riun. c-. na r palt)06@ (6):
the averatte annual amount tc bo dlvertod ra n b+ ~0
acrd taeC this crap ald stetemont ie f~lad in compliance wqh taw;
ho f;hov! has ihevCl road the ateloments natlr. ngrCpn: know9 the
COIHOIR IhCrC01: and :hat the Banc drn tr~C o1 h~5 fthCi'; Own
know'.eogo. ~`~ ~ /
X Signat JfC i s! _[=."~As~-+G! s~
1 Je-
.Address: 1
~~~~~ ''f!,,
°u5sc•i c dnd sworn to befo•e me-Ion/ tnis_!.{.~day
o! ___l~_~ _. . ' 91~i~
My Coamissiai expJ.k• : ' +:
ISeal!
._ ~, -
• '. ~ arv ub'IC
_ ~ ,_
WEL: DATA " ~ -
Dave Conpleted_.TA_n=_ 1_r1C~71
Static Water Lovel~>~~'
WELL SHAII BE LOCATED Wllrl RFFE~ENCE TO
GOVERVM7YT SURVEY CORNERS UR MENJUMENTS,
OR SECTION LINES Rr D'~STANC[ AND BEARrNG.
i
-__3QD_h. Iron. trA er sectan hne.
(Nartn or Soutn
4R3 ft. fmm alnn«h aect~un liry
iEas; or Wesv
Grountl We:e~ Basin _
Weler Manegemont
Dlevict
Domnsnr. wells may bO locetcd by the following;
LOT ,BLOCK
ACCO' cC t;~'1r ~ '^t~ v. i! CFnC: OF THE STATE P.I~G!N~EI OF COLORADO ON TH!5 DAY
:i. __ _ -- - ~- - --
?.tTE FNIi~?'LLR
.~ ~~ ~ ~~N
~..
FORK TO ~~ .1.jT Tk Ol1AURl11'l ICATE~ WHITE. FORSt n>tist ba nn Original arov on both aides and nignad.
wHITF 4lm• ,~!~.cyr,.va m.r~t 4< litoa w.th Ihw Srala Lngl nvm w~Jiin 3U Joys altar Nv wa,l r, cunr:!nlrJ w wrthn, 7 rlnvM
alto ucjrrcMgn alwtn nr 1M 1*nr•r~ll, w'nc \wvvr ,b atwror, nl'vN ~OnY rt. Iro thv Owna ar..l YEL_Ow CVVY .a lur Ihi. pni'~~r.