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o R M COLORADO DIVISION WATER RESOURCES For Use only <br /> 0. DEPARTMENT OF NA AL RESOURCES <br /> OWS-27 <br /> 12/96 1313 Sherman St., Rm 818,Denver, Coforedo 80203 <br /> Phone:(303)866.3681 <br /> REVIEW INSTRUCTIONS PRIOR TO COMPLETING FORM <br /> GRAVEL PIT WELL PERMIT APPLICATION <br /> TYPE OF P RMIT <br /> x NEW PIT(S) <br /> ❑PIT(S) EXIST, CONSTRUCTED AFTER DEC, 31, 1980 <br /> 2. APPLICANT INFORMATION' <br /> NAME(S) All RIte Paving & Redi—Mix , Inc . <br /> ' Mailing Address P.O . Box 1128 <br /> City, St. Zip La Junta , CO 81050 <br /> Phone ( 779 ) 383-2600. <br /> ' 3. CONSULTANT/ATTORNEY/OPERATOR CONTACT (If different than #2) <br /> NAME(SI Banks & Gesso, LLC , PITNAME North River Pit <br /> ' Mailing Address 720 Kipling St . , Suite 117 <br /> City, St. Zip Lakewood , CO 80215 DMG NO. <br /> Phone ( 303) 274-4277 <br /> 4. GENERAL LOCATION OF PIT(S): COUNTY <br /> ' 1/4 SE 114, Sec. 36 Twp. 23 ON. EDS., Range 55 ❑ E. OW. 6 P.M. <br /> 5. Estimated maximum water surface to be exposed: 2 •0 Acres. Number of Pits 1 <br /> 6. Estimated depth of pit(s) 36 Ft. Estimated depth to groundwater 2 Ft. <br /> 7. Estimated date to expose groundwater ;to complete mining <br /> 8. ATTACHMENTS: (Check which have been attached.) <br /> ' (a) Scaled map of pit area with range, township, & section clearly indentifed (REQUIRED). <br /> (b) ❑ Copy of the reclamation permit, if applicable. <br /> (c) ❑ Copy of pre 1/15/89 water conservancy dist. or water user assoc. augmentation agreement, if applicable <br /> (d) 0 Copy of proposed Substitute water plan or augmentation plan application, if applicable. <br /> ' (a) ❑ Copy of court approved augmentation plan, if applicable. Case No. <br /> (f) ❑Other <br /> ' 9. Detailed description of any use, other than evaporation, and method of diversion, rate of diversion, and annual amoun <br /> of diversion of any water withdrawn from the pond. <br /> 0 1 (we) have read the statements made herein and know the contents thereof, and that they are true to my (our) <br /> ' knowledge. [Pursuant to Section 24.4.104 (131(a) C.R.S., the making of false statements herein constitutes perju <br /> in the second degree and is punishable as a class 1 misdemeanor,) <br /> Name/Title (Please type or print) ignature Date <br /> ' For Office Use only <br /> fnurt Case No. Div. — Co. WD Basin MD Use_ <br />