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Ls~L <br />wR~~-Rem.'-'6 O COLORADO DIVISION OF WATER RESOURCES <br />' ``'~. 818 Centennial Bldg., 1313 Sherman St., Denver, Colorado 8020a11AY -8 1986 <br />Rv~` V r~(~ PERMIT APPLICATION FORM ~~~ ~~ <br />Application u ~, L~'~ ,+ '~ SUUE'~t1E~li <br />\0~ <br />be ::omelet r_ GeC ( ) A PERMIT TO USE GROUND WATER ~~ <br />applicable. ~pe or 8\SS~~ (XI A PERMIT TO CONSTRUCT A WELL <br />print in BLA \t`et FOR: ( 1 A PERMIT TO INSTALL A PUMP <br />INK. No~~g es ~2_~F~_S Ca St '(3d ~-~ Chu.-w~ <br />or erasu s unless ( )REPLACEMENT FOR NO. _ <br />initialed. 1XI OTHER C;racal nr Gratin - ~(--a~Q9 lvo~o -~/t~ ~pc <br />WATER COURT CASE N0. U S R b ~ q : S tt.' 3,5- 'u..'~t ~ <br />~o <br />(1) <br />NAME ~L <br />manmg address <br />STREET 1805 Kipling Street <br />cITY_ t.,akewood, Co 80215 <br />tsta,et cno) <br />TELEPHONE NO. - 233-1 223 <br />(2) LOCATION OF PROPOSED WELL <br />County yJPld <br />N 1/2 x of the SR Y., Section 36 <br />Twp. 3 N . Rng. 68 _ ['~1 ~ 6th P.M <br />~N.S~ ~E.W~ <br />13) WATER USE AND WELL DATA <br />Proposed maximum pumping rate (gem) N/A <br />Average annual amount of ground water ~21~ AF <br />to be appropriated (acre-feed: _______ <br />Number of acres to be irrigated: <br />Proposed total depth Ifeet): 20 - 30 feet <br />Aquifer ground water is to be obtained from: <br />Owner's well designation Bailey Plt <br />GROUND WATER TO BE USED FOR: <br />( )HOUSEHOLD USE ONLY <br />1 1 DOMESTIC 111 <br />( I LIVESTOCK (21 <br />I 1 COMMERCIAL l41 <br />no irrigation 101 <br />( 1 INDUSTRIAL (51 <br />1 1 IRRIGATION 161 <br />1 1 MUNICIPAL l81 <br />(XI O~iHER (gl blildlife <br />DETAIL THE USE ON BACK IN It i1 <br />(4) DRILLER N/A <br />Name <br />Permit <br />From: ~~ <br />Doc. Name: <br />Doc. Date i no <br />Confidental?: ___ <br />FOR OFFICE// USE ONLY: DO NOT WRITE IN THIS COLUMN <br />Receipt No. k1~s <br />Basin _ - Dis[ <br />CONDITIONS OF APPROVAL <br />This well shall be used in such a way as to cause <br />no material injury to existing water rights. The <br />issuance of the permit does not assure the applicant <br />that no injury will occur to another vested water <br />right or preclude another owner of a vested water <br />right from seeking relief in a civil court action. <br />1) APPROVED PURSUANT TO C.R.S. 37-90-137(2) ON <br />THE CONDITION THAT THE WELL (GRAVEL PIT LAKE) <br />IS OPERATED IN ACCORDANCE WITH THE AUGMENTATION <br />AGREEMENT BETWEEN THE APPLICANT'AND THE CENTRAL <br />COLORADO WATER CONSERVANCY DISTRICT DATED <br />MARCH 18, 1986. THE WELL SHALL NOT BE OPERATED <br />UNLESS IN ACCORDANCE WITH THE AGREEMENT OR IT <br />IS INCLUDED IN A PLAN FOR AUGMENTATION APPROVED <br />BY THE WATER COURT. IF THE AGREEMENT IS CAN- <br />CELLED OR IF A COURT DECREE IS NOT ENTERED FOR <br />A PLAN FOR AUGMENTATION, THE USE OF THIS WELL <br />(GRAVEL PIT LAKE) SHALL CEASE AND THE LAKE <br />SHALL BE BACKFILLED. <br />2) THE OPERATION OF THIS WELL (GRAVEL PIT LAKE) <br />IS SUBJECT TO THE TERMS STATED LN PARAGRAPHS <br />1, 3, 4, 5, 6, 7, 11, 12 AND 16 OF THE CENTRAL <br />AGREEMENT. <br />3) THE ONLY CONSUMPTIVE USE FROM THZS WELL <br />(GRAVEL PIT LAKE) SHALL BE EVAPORATION. GROUND <br />WATER SHALL NOT BE USED FOR OTHER PURPOSES <br />SUCH AS GRAVEL TdASHING OR DUST SUPPRESSION. <br />4) THE OWNER SHALL MARK THIS WELL IN A CONSPICU- <br />OUS PLACE WITH APPROPRIATE WELL PERMIT NUMBER. <br />HE pSHAgLL TAKE NECESSARY MEANS AND PRECAUTIONS <br />APPLICATION APPROVEDINGS. ' j{~rrm -r)3i~g7, <br />PERMIT NUMBER 30329Q~Q-~ <br />DATE ISSUED ~AUG O ~ 1986 _ <br />EXPIRATION DATE _ AUG 0~-- <br />~.~ <br />STATE ENG VEER) <br />r' <br />BY / - 0 S f'~ ~ -- <br />