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r <br />Form No. <br />GWS-25 <br />APPLICANT <br />1099 <br />WELLPEfiMfTNUMBER ~,[,~{ ~~~i <br />DN. 1 CNTY. 7 WD 5 DES. BASIN MD <br />.et aIOCr[ FiNna~ Subdiv. <br />PROVED WELL LOCATION <br />OFFICE OF THE STATE ENGINEER <br />COLORADO DMSION OF WATER RESOURCES <br />ere c.~w alOp., rats sMmrn st, am«, CoronAe ao2m <br />post ses~aser <br />CHARLES R HALL <br />5467 HYGIENE RD 620 <br />LONGMONT CO 80501• <br />(303)823.8596 <br />BOULDER COUNTY _ _ _ <br />SE 1/4 SE 1/4 Section 28 <br />Twp 3 N RANGE 70 W 6th P.M. <br />pISTANCE3 FROM SECTION ONES <br />190 FG tram South Section Line <br />460 FG from East Section tJne <br />PERMIT TO USE AN E7QSTWG WELL <br />ISSUANCE OF THIS PERMR DOES NOT CONFER A WATER RIGHT <br />CONDITIONS OF APPROVAL <br />1) This well shall he used h such a way as ro cause rw material irt(ury to existing water rights. The Issuance of the <br />permk does rrot assure the appfkartt that ra injrsy wW ot:cur to another vested water rigfrc or preclude aratlter <br />owner of a vested water rlgM troirl aaekklg relief in a civU cant action. <br />2) The cortstroctlon of this we9 sha8 be In compliance with the Water Wep Construction Rules 2 CCR 402-$ uNess <br />approval of a variance has been greMad by the State Board of Examiners of Water Well Constnucton and Pump <br />kutallatkxt Corwatxors (n accordance wkh Rule 18. <br />3) Approved pursuam ro CRS 37-92.602(3) (c) for the relocation of an existing well, pem~t 24324. The oki we11 must <br />be pklgged and sealed according 1o the Water WeA Construction Rules within Winery (90) days of completion of <br />the new wall. The erx~OSed Web Abandorrrlertt Report form must be and submitted >o alfinn Ulaz the <br />ald web was properly pktgged and sealed. <br />4) The use of ground water from tttis web is irrlked to ordi<lary ltouaeftoW purposes 6tside one (1) singie family <br />dwe8ing, the watering of domestic animals, and the irti9atbn of not more than one acre of hone gardens and <br />lawns. <br />5) The maximum pumping rate shall not exrreed 15 GPM. <br />6) This well shall be axtstruaed. not more than 200 feet from the kxretlon specified on this permk. <br />7) Approved for the installatlon of a pump kl, and the use of, an existing well, coratructed on December 29, 1998, <br />to a depth of 880 feet, urxter monkogng hole notice MHS5268, acknowledged Decemtx3r 9, 1998r-, .7a/:~/y y <br /> <br />~ ~~ <br />APPROVED ~ L1 •~ <br />~_...._..' r~ • ~~ <br />JSG <br />Receipt No. 0441625 ~~ DATE ISSUED M~ 0 2 1999 ExPIRATION DATE ~°"~ ' 2 u;Cl <br />