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nsu-zs-TS ~ BY THE OFFICE 01`~ <br />THE STATE ENGINEER <br />COLORADO DIVISION OF WATER RESOURCES ACCORDING TO THE <br />~~PE OR 300 Columbine Bldg., 1445 Shermon St. DECREE GRANTED UNDER <br />PRINT IN BLACK INK <br />CJPr OF aCCEPTED Den.er, Colorodo 80203 CASE. N0. W-722 <br />5 SMENT MAILED WATER DIVISION ~~" <br />c.ouesT STATE OF COLORADO I AFD(p(/~yrj~jiT TO SECTION <br />COUNTY OF 1 SS -92-304 (8),.CRS <br />1973. <br />DATE J <br />STATEMENT OF BENEFICIAL USE OF GROUND WATER = <br />AMENDMENT OF EXISTING RECORD <br />LATE REGISTRATION nnrr~~ ~+^ ?y=°°w-PF--~=S 1 O; - <br />PERMIT NUMBER UC+10U9 F LOCATION OF WELL / <br />SHE AFFIANT(S) John M. Mecom C,,,,,,y Le.s Animas <br />wfiose mailing <br />address Is 2960 IBZy Iaae NW ~ ol,h. NE r, s.<r.o~ ~~ <br />City Houston, Texas 77001 T_,. 33 S a~, 68 W 6th P M <br />being duly sworn upon oath, deposes and Boys that he (they) is (are) the owner(s) of the well described hereon, the well is <br />located as described above, at distances of feet from the section line and feet from the <br />.,,... p. ,pp,.i <br />section line; water from this we)I wos first applied to a beneficial use for the purpose(s) described herein on the '31 <br />~r.n o...r•-i <br />day of December 1956 ,the moximum sustained pumping rate of the well is _~gallons per minute, the pumping <br />claimed. hereby is _ 36 gallons per minute; the total depth of the well is ~O feet; the averoge onnual amount <br />ter to be diverted is 25 acre-feet; for which claim is hereby made For 1TL'1g'8t10n, dome StlC, St'.OCiS, fish <br />and W]-7~17fe purpose(s); the legal description of the land on which the water from this well is used is <br />of which <br />acres are irrigated and which is illustrated on the map on the reverse side of this form; that this well was completed in <br />compliance with the permit approved therefor; this statement of beneficial use of ground water is filed in compliance with law; he <br />(they) has (have) read the statements mode hereon; knows the content thereof; and that the same are true of his (their) knowledge. <br />(COMPLETE REVERSE SIDE OF THIS FORM) <br />Signature(s) <br />Subscribed and sworn <br />to before me on this day of 19 <br />My Commission expires: <br />gar .. <br />+a •....~. uc <br />aCCEPTED FOR FILING BY THE STATE ENGINEER OF COLORADO <br />PURSUANT TO THE FOLLOWING CONDITIONS: <br />• <br />FOR OFFICE USE ONLY <br />Court Case No. W-7ZZ <br />Prior Mo. _ Dey __ r. <br />D,.. 2 _,y. 36 <br />Se<. 'r. 'r.. '.. <br />y,,,, u„ 6 1 2 4 <br />Derr. 1) _ B.e~~ Mun D•+ <br />arE 'STATE ENGINEER Pr <br />