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~.;/ l/ // <br />wRJ-25-66 ~ STATE~OF COLORADO <br />zo M-as DIVISION OF 66'ATER RESOURCES ~ ~~ ma`r` <br />C ~i~~~C Rn:~h ~. <br />Index No. II OFFICE OF THE STATE ENGINEER v` . <br />• sgistere ' i MAP AND STATEMENT FOR WATER WELL FILING , 9Rp~ pY3 % lg~s `' <br />PER3fIT NUMBER L•~~G, ~ ~~ <br />S~dTf fN,~~ <br />Know all men b these resents: hatth and r i ed <br />Y ! . <br />claimant(s)= whose address is ~ City~N ,~,° A • , <br />states: Claimant(s). is (are) the owner(s) of well No. ocated as shown on the.map below; the <br />total number of acres of land owned by him (them) to be irrigated from this well is ~ ih..iYh9 ~ wbrk <br />was commenced on this well by ctual construction ~ day of ~ ~- 19~y~ the <br />tested capacity of said well is ~~ (gpm) (cfs), for which claim is hereby ,ate de for <br />purposes; that the average. annual amount of water to be diverted is acre-ft. ; and that the <br />aforgmentioned,statements; ~t;e made and this map and statement a/re filed in compliance with the law: <br />State-oLColorado...._ :.. = _.. )-ss ~`~°~ ~"~'~ <br />County of rec exrwes ) Claimant(s) <br />Subscribed and sworn before me this` 23rd day of Map 19 ~ <br />.... <br />My Commissioti e5tpires ~so~tember 25. 1967. ;~.~3~~~.-~--.,~ <br />Notary Public <br />MAP <br />THE WELI. SHALL BE LOCATED WITH REFERENCE TO GOVERNMENT SURVEY CORNERS OR <br />MONUMENTS, OR SECTION LINES BY DISTANCE AND BEARING. <br />- -=' :~ T ~ --'Meet from _- (North or South) section line <br />- -- =.'~ - "-= - -feet from" = (East or West) section line <br />dF-WELL iS FOR-IftRIGA~iOIIi,~-THE AREA TO BE IRRIGATED MUST BE SHADED OR CROSS- <br />HATCHED.-----------: _.~ :. -- . <br />The square below. will be used to indicate the location of the well;and the irrigated land. <br /> <br /> <br />i 1 ..,:-i--., .; <br />i .-. ...1. '. j -~'= ~ <br />~-' <br />~ 1. <br />--- i 1 ~ <br />-'~i' - - 1 i <br />: <br />~' <br />- <br /> <br />~-...~.r- - <br />--T- <br />.~ <br />.. <br />r <br />-~ -- -- <br /> <br />~ I ~ " :l.~i ~~.: ~~ f :;T <br /> <br />--~--~--r-- --T--1---*-- <br />i 1 ~ ~ 1 i <br /> <br /> <br />~ I ~ ~ 1 i <br />- <br />~. 1 ~ ~- .. .1 -y . <br />.. <br />' <br />~ I ~ - ~ <br />~ ;~-11 <br />--1--1--1-- --~-~J--.L.. <br />r ~ 1 <br />~ I ~ i 1 ~ <br />- - + .. L - - a - - ~- - i - -~ ~ - - <br />-- <br />~ I i i ~ <br />~ <br />i I i ~ 1. ~ <br /> <br /> WELL LOCATI <br />N <br /> O <br />A _ ~ ~ <br />~ <br />d <br />~ <br /> iGl. <br />/ <br />YYt.O~ <br />( <br />P County <br /> <br />,V -!.... <br />/4 <br />~1/4 <br />1 <br />sea <br />~D <br />'J <br />x <br />! <br /> , <br />. <br />_/ <br />'' <br />'' <br />o- <br />, <br />3~ S <br />M <br />~P <br />~ <br /> . <br />T. <br />R. <br />. <br />, <br />_.. <br />.. . <br />-~ _. <br />Ground~Water Basin~uarsgd¢•~~ <br /> Water.IvIanagemenf ' ' ., <br />' '' <br /> - <br />District ~L+ ~y~„~.C~9_ <br /> <br /> Domestic wells ,m,~ay b~~e__lo~cz,t~~ d by the <br />1 mi. following <br />: <br />LOTBLOCK_ <br />'~L <br /> 0 <br />~ <br />\\~ <br />~ SUBDIVISIOA' <br />~«1~ c <br />jj//.. <br />. <br /> ~ <br />X91 <br />CEPTED FOR.FILING IN-THE.OFFICE OF THE STATE. ENGINEER OF -COLORADO ON THIS <br />DAY OF 19_. <br />State Engineer <br />