PERMFILE62861

• Permit No: C1981012
• IBM Index Class Name: Permit File
• Doc Date: 7/28/1986
• Section_Exhibit Name: EXHIBIT 11 WATER WELL INFO PART 2
• Media Type: D
• Archive: No

APR . 7 1970
~R~-zsµs STATE OF COLORADO `!~ r-
Indes..No. zO qk DIVISION OF WATE RESOURCES i~~ ~,
IDwD CI/•r,(/v OFFICE OF THE ST TE ENGINEER r ~
"QN 7 1970
u.~ tp WAi
aeq~srereE MAP AND STATEMENT F'~ORgWATE~R /WELL FILING ,0~~ sky'j
. PERMIT NUMBER L/ ~ OJo ~iTE iYn;iue.~
STATE OF COLORADO )
SS
COUNTY OF
Know all men by these presents: Thot the undersigned _
WELL LOCATION
A (~
-nom County
~% of ~Y, sec. ~ L_
T. ~ 3,~S F2. ~ ~~ , ~ P.M.
INDICATE WELL LOCATION ON DIAGRAM
Claimant(s) is (are) the owner(s) of the well described hereon;
the~~t~~ota~~l""number of acres of land to be irrigated from this well
is,m~;~work was commenced on this well by actu/alQcon-
struction~~_day of ~ r ,191]_7;
the yield to be used from said well isy~_(gpm), for
which claim is hereby made for purposes;
•at thq~average dnnual ~amaunt of water to be diverted is
/~~~ ~~i .acre-feet; and that the aforementioned
statements ore made and this map and statement are fled in
compliance_with the low.
X ~ `% ~ _ /r~ra
Claimant(s) ~~
Subscribed before me on this ~ day of
'~-~-=J-r- ~ ,' 193:.
My commiss~ expires ~ ~- ~y~ /9 7 2-
~~1 ,~
Notar Public
NORTH
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WELL SHALL BE LOCATED WITH REFERENCE
TO GOVERNMENT SURVEY CORNERS OR MON-
UMENTS, OR SECTION LINES 8Y DISTANCE
AND BEARING.
ft. from section line.
(North or South)
ft. from section line.
(East or West)
Ground Water Basin
Water Management
District err
~Y. ~ ~ ~ WELL DATA Q Domestic wells may be located by the Following:
Date Completed ~/ ~ ~ LOT ,BLOCK
Static Water Level ~ ~ SUBDIVISION
Total Depth ~~ ~-~: FILING a
ACCEPTED FOR FILING IN THE OFFICE OF THE STATE ENGINEER OF COLORADO O1J THIS
• ~ DAY OF 19 _.
State Engineer
FORM TO BE MADE OUT IN QUADRUPLICATE: WHITE FORM MUST BE AN ORIGINAL COPY ON BOTH SIDES AND SIGNED.
WHITE copy~8 GREEN copy must be filed with the State Engineer within 30 days after well is completed. PINK copy
r. .~_ n...___ o vci i nur _ .. .~ I_-.4. fl.:ll~.
I--
claimant(s), whose address is/ ~ _ ,
City~~~tiL s, 0 ,states: