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iC~'~'~ ' <br />Rev. STATE OF COLORADO <br />9-62/lOM A PERMIT TO USE GROUND WATER ~~~G(~,,.,',, - <br />- APPLICATION FOR: ~ A PERMIT TO CONSTRUCT A WELL u-~ APR $ g :304 <br />• <br />Applicant <br />i i ,..cc r~ ~..cc._-.--~ <br />P. O. Address ~ { T~.~- <br />Quantity applied for ~ gpm or <br />AF Storage <br />~~ ~~ <br />Used for <br />~-c Purposes <br />~O7iu <br />c <br />( w <br />. <br />, <br />. <br />~ <br />on/at;,~„1 ~ 7 d7Lv 1 <br />:1'wY ly~ ° c, <br />. <br />(legal descriptio of land site) ~ <br />"3 <br /> aw.. <br />c. o <br />Total acreage irrigated and other rts. ° ~ <br />ESTIMATED DATA OF WELL °p~ <br />Hole size: (•, in, to~~ft. ~ d <br />in, to ft. <br /> <br />Casing Plain 6 in. from o to 47~ft. 0 <br />60O <br />'~ <br />~' <br />in. from to ft. a <br />, <br />Open or Perf_~in. from~to~ft. m <br />in. from to ft. c m <br />_ <br />PUMP Outlet <br />DATA: Type <br />HP~Size w.~ <br />_ <br />. <br />.$ o <br /> <br />Use initiation date !r 19~ n <br />~~ <br />(Use Supplemental pages. or additional data) ,;;rte <br /> A3 <br />PERMIT NO. '1 9533 <br />ISSUED: <br />DATE APR 29 1964 is <br />LOCATIQN OF WEL~~'~p w'4,t" S~ <br />County -~Li~ L~i)-s ;~, ,. +COLORADv <br />`" ' tfffitGfMEfF: <br />h~ ~ of ~'~ ll;','-, of Sect. ~ D , Twp. ~ ~ , <br />Rge.~~ ~ P. M. OR <br />Stre t Address or.L!~~ Block No. <br />Town or Subdivi <br />N <br />i <br />~ <br />~ 1/` <br />~ <br /> <br />- - i - <br />i i <br />- i <br />~ <br />~ <br />i <br />- r - - ~ <br />i <br />- - " - <br /> <br />W <br />Locate <br />well in <br />E 40 acre <br />(small) <br />square <br />as near <br />as possible. <br />Large square <br />is one section. <br />$25.00 fee required for uses other <br />than Domestic or Livestock. <br />Applicant ~ .(/, ~ ~~,p~,(,~ , <br />Agent or 'Z~ <br />Driller "~~.C/-Q,Npo.~( <br />Address~:~ .~. ~~~ wr"~-C4 ~ t~7 , <br />NOTE -SATISFACTORY COMPLETION REQUIRED FOR APPROVAL OF APPLICATION <br /> <br />