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' WRJ•S-Rev. 76 <br />tcation must <br />omplele where <br />,slicable. Type or <br />print In BLACK <br />IN K. No overstrikes <br />or erasures unless <br />initialed. <br />COLORADO DIVISION OF WATER RESOURCES <br />Bl8 Centennial Bldg., 1313 Sherman St., Denver, Colorado 80203 <br />PERMIT APPLICATION FORM <br />~ X79 A PERMIT TO USE GROUND WATER <br />OS]d A PERMIT TO CONSTRUCT A WELL <br />FOR: C~-73 A PERMIT TO INSTALL A PUMP ' <br />( 1 REPLACEMENT FOR NO. <br />( (OTHER <br />WATER COURT CASE N0. <br /> a <br /> ( <br />RECEIVED <br /> <br />JUN 0 1 1981 <br />fYArut arsaurtcU 1 <br />~AlC E)s»1f fR ~ <br />f1alO. <br /> <br />(11 APPLICAN 1 • mailing address <br />NAME Pueblo Cosl <br />STREET (320 Hamilton Bldg. <br />CITY ;~litchita Falls, TX •/6301 <br />tsul.l 1zio1 <br />TF. L E PHON F. NO. l O C al 21 F j -9 f fig <br />(2) LOCATION OF PROPOSED WELL <br />County La Plata <br />Sl'f % of the r'i~ y., Section <br />Twp. 341 ~t , Rng. 9 LJ rn,f P.M. <br />_ ~N,SI IE. WI <br />WATER USE AND WELL DATA <br />Proposed maximum pumping rate (gpm) 9U g}lm <br />Average annual amount of ground water lOC <br />to be appropriated (acre-leer): <br />Number of acres to be irrigated: 22 <br />Proposed total depth Ileetl: ~ OV ft <br />Aquifer ground water is to 6e obtained Irom; <br />Pictured Cliff Sandstone` ` <br />Owner's well designation C3P(1011 Cflri'f On ./1. . <br />GROUND WATER TO BE USED FOR: <br />( (HOUSEHOLD USE ONLY - no irrigation 101 <br />kX) DOMESTIC 111 Rt-79 INDUSTRIAL (51 <br />( 1 LIVESTOCK f21 OW IRRIGATION (61 <br />~I COMMERCIAL 141 ( 1 MUNICIPAL 181 <br />1 1 OTHER (91 <br />DETAIL THE USE ON BACK IN (111 , <br />DRILLER <br />.dame Puoillo Coal ~'p <br />Street (J~0 linmilton Bld ~,• <br />City :litcllit~ i'nll:,, T:C 76301 <br />Isln•1 1 col <br />FOR OFF{CE USE ONLY: DO NOT WRITE IN THIS COLUMN <br />Receipt No. /~u ~ / <br />Basin <br />Dist. <br />CONDITIONS OF APPROVAL <br />This •.ye!! shsll 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 tfte 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 />i <br />APPLICATION APPROVED <br />~ PERb11T NUMBER <br />DATE ISSUED <br />EXPIRATION DATE <br />(STATE ENGINEER) <br />nv <br />DEC S g 1992 <br />