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WRJ-5-G7 <br />• <br />STATE OF COLORADO DIVIS N OF WATER RESOURCES <br />APPLICATION FOR: <br />PRINT OR TYPE <br />/YAW <br />~ A PERMIT TO USE GROUND WATER <br />A PERMIT TO CONSTRUCT A WELL <br />G7 REPLACEMENT FOR N0. <br />(Reason) <br />Q OTHER <br />APPLICANT C~ /, S7`D R z. <br />Street Address .f3o xrl7 <br />City b State c.Srn ~°o.Ln,P/Ia ~/d9/ <br />Use of ground water Domestic <br />Owner of land on which well <br />is located 0. T. Storz <br />Number of acres <br />to be irrigated None <br />legal description of <br />irrigated land <br />Other water rights on <br />this land <br />Owner of irrigated <br />land <br />Aquifer(s) ground water is to be obtained <br />from Unltnown <br />ESTIMATED WELL DATA <br />ESt. quantity of ground water to be claimed: <br />Es[. Max. Yield 10 GPM or ~~ <br />Est. average annual amount [o be <br />used in acre-feet <br />Storage capacity AF <br />Sfo ~~ <br />- ~ ~ P~~f~~~~~~~ <br />0 CT 3 01969 , , <br />6R01lNB~ OR11D0 ~: <br />LOCATION OF WELL <br />gTtTF ENGINEER <br />COUNTY ,[..45 A./iw~t its <br />/f/ ~j/ ~, S,t ~, sec. ,2 / <br />T. "~3 S .R. G S yL, ~P.M. <br />Street or <br />Lot b Block <br />City or <br />Subdivision <br />Ground Water Basin Unknown <br />Water Management <br />District Unknown <br />LOCATE WELL ON THE BALK OF THIS SHEET <br />Driller M. Snyder No. 47 <br />Driller's P. U, isoz 53 <br />Address Yrinidad, (:olorado 81082 <br />~~ <br />~/' S of Applicant <br />CONDITIONS OF APPROVAL <br />Anticipated start of drilling Nnv_ R 19Syq <br />I , <br />Hole Diameter: i <br />8 in, from tQp- f[. to 2n ft. <br />~in. from~ft. to_125 ft. <br />Casing: <br />Plain 7 in, from to7Lft. to 20 ft. <br />in, from ft. to ft. <br />Perf. in. from ft. to ft. <br />in. from ft. to ft. <br />PUMP DATA; Outlet <br />Type Submersible HP~ Size 1 inch <br />FOR STATE ENGINEER OR COMMISSION USE <br />APPLICATION APPROVED: <br />VALID FOR ONE (1) YEAR AFTER DATE ISSUED <br />UNLESS EXTENDED FOR GOOD CAUSE SHOWN TO <br />THE ISSUING AGENCY <br />PERMIT No. 3 3 6 8 6 CONDITIONAL // <br />DATE ISSUED OCT 3 01969 <br />STATE ENGIN ER or !•CHAIRMAN GROUND <br />WATER COMMISSION <br />APPLICATION MUST BE COMPLETED SATISFACTORILY BEFORE ACCEPTANCE <br />