REV02769

• Permit No: C1981010
• IBM Index Class Name: Revision
• Doc Name: PERMIT APPLICAITON FORM
• Type & Sequence: MR115
• Media Type: D
• Archive: No

~
wee-s-Re.. 7a LORADO DIVISION OF WATER RESOURCES II I IIIIIIII IIIII II I
818 Centennial Bldg., 1313 Sherman St., Denver, Colorado 80203 ggg
PERMIT APPLICATION FORM_
Application must
be complete where I X) A PERMIT TO USE GROUND WATER
applicable. Type or (X) A PERMIT TO CONSTRUCT A WELL
print in BLACK FOR: (X) A PERMIT TO INSTALL A PUMP .
INK. No overstrikes
or erasures unless (X) REPLACEMENT FOR NO. 019872-F
initialed. ( )OTHER
WATER COURT CASE N0.
APPLICANT - madinq.address
NAME Trapoer Mining Inc.
STREET P.O. Box 187
CITY Craig CO 81625
(Stale) (ZiDI
TELEPHONE NO. [phone]
(2) LOCATION OF PROPOSED WELL
County Moffat
NE '/. of the NlJ '/., Section 27
Twp. 6 N , Rng. 91 W 6th p.M.
IN,SI IE. WI ,
13) WATER USE AND WELL DATA
Proposed maximum pumping rate (gpml SO Rpm
Average annual amount of ground water
to be appropriated (acre-feet): 80 acre-feet
Number of acres to be irrigated: None
Proposed total depth (teed: 1 , 200
Aquifer ground water is to be obtained from:
Twentv mile sandstone
Owner's well designation
S~ROUND WATER TO BE USED FOR:
I )HOUSEHOLD USE ONLY - no irrigation {0)
( X) DOMESTIC It) IX) INDUSTRIAL 151
~~~ ( I LIVESTOCK 12) ( )IRRIGATION 161
( I COMMERCIAL {41 { )MUNICIPAL (BI
( )OTHER (91
DETAIL THE USE ON BACK IN 111)
(4) DRILLER
FOR OFFICE USE ONLY: DO NOT WRITE IN THIS COLUMN
Receipt No. !
Basin Dist.
CONDITIONS OF APPROVAL
This well shall be used in such a way as to cause
no material injury to existing water rights. The
issuance of the permit does not assure the applicant
that no injury will occur to another vested water
right or preclude another owner of a vested water
right from seeking relief in a civil court action.
APPLICATION APPROVED
PERMIT NUMBER
DATE ISSUED _
Name Licensed Driller EXPIRATION DATE
Street
Gty
( t,rq I IDI
Telephone No. Lie. No.
(STATE ENGINEER(
BY _ _ -
I.D.
COUNTY