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(5) THE LOCATION OF THE PROPOSED WELL and the area on <br />which the water will be used must be indicated on the diagram below. <br />Use the CENTER SECTION (1 section, 640 acres) for the well location. <br />• I ~ t- 1 MILE, 5280 FEET .1 <br />+ -}- -~ -•- + 1- ~ T <br />i I I I <br />i NORTH SECTION LINE <br /> <br />I <br />NORTH 1 <br />T T <br /> 2 <br /> J <br /> 2 <br /> O <br />-(- -{- u <br /> <br /> u, <br /> <br />I H <br /> <br />I <br /> <br /> <br /> <br />+ <br /> <br /> <br /> <br />~- - I i <br />I j <br />~ ~ <br />I I <br /> • <br /> <br /> I <br />4 <br /> ~ <br />> I <br />N <br />y I <br />rn <br />m <br />n <br /> <br />-/ 1 <br />0 <br />Z I <br />m <br />Z + I <br />i <br />-~-- -+ <br /> <br />I <br />~ SOUTH SECTION LINE <br />~ <br /> ~ <br />I <br />t <br />- --~ <br />- +- II <br />- T - 't - --~ - -(- <br />- + <br />• The scale of the diagram is 2 inches = 7 mile <br />Each small square represents 40 acres. <br />(6) THE WELL MUST BE LOCATED BELOW <br />by distances from section lines. <br />L/ d O ft. from S6 V sec. line <br />~~~-` Inar[h rspulh) <br />_ IISo ft. from _ W e S~ sec. line I'. .~ <br />(east or west) <br />LOT N/~ BLOCK FILING • <br />SUBDIVISION <br />(7) TRACT ON WHICH WELL WILL BE <br />LOCATED Owner: ~fH~e <o ~ o~Lp <br />No. of acres ~~`'f'U .Will this be <br />the only well on this tract? 1KQ C _ <br />(8) PROPOSED CASING PROGRAM <br />Plain Casing <br />in. from ft. to ft. <br />in. from ft. to ft. <br />Perforated casing <br />_ in. from ft. to ft. <br />in. from ft. to ft. <br />(9) FOR REPLACEMEPJT WELLSgivedistance <br />and direction from old well and plans for plugging <br />it: <br />N ~ ~,.. <br />WATER EQUIVALENTS TABLE (Rounded Figures) <br />An ecro-foot w~ers 1 acre of land 1 foot deep <br />1 cubic }pot per secontl Icfsl ...449 gallons per minute (gpm) <br />A family of 5 will require approaimately 1 acre foot of water per year. <br />1 acro-foot ... d7,660 cubic (eet ...725,900 gallons. <br />t,000 gpm pumped continuously Ipr one tlay produces 4.42 acre-fee[. <br />(10) LAND ,O/N WHICH C <br />Ownerlsl: /r a MD~1r <br />No..of acres: <br />Lega4 description: <br />(11) DETAILED DESCRIPTION of the use of ground water: Household use and domestic wells must indicate type of disposal <br />rystem to be used. f ' <br />No ~r~oc~nolWr,4C~VCQ. TL.Q. wGl~!_r fnr' Aon,~nr-+'t5- <br />only - - ~ -J. <br />(12) OTHER WATER RIGHTS used on this land, including wells, Give Registration and Water Court Case Numhers. <br />Type or right Used for (purpose) Description of land on which used <br />N /~ <br />(13) THE APPLICANT(S) STATE(S) THAT THE INFORMATION SET FORTH HEREON IS <br />TRUE TO THE BEST OF HIS KNOWLEDGE. <br />• <br />SIGNATURE OF APPL ICANTISI <br />