Laserfiche WebLink
- j,,. <br /> Form STATE OF COLORADO or Office Use Only <br /> No. OFFICE OF THE STATE ENGINEER <br /> GWS-10 818 Centennial Bldg., 1313 Sherman St., Denver, CO 80203 <br /> 6/00 (303) 866-3581 Fax (303) 866-3589 <br /> STATEMENT OF BENEFICIAL USE <br /> Insert the Well Permit Number 051128-P <br /> Name. address and phone of the well owner: <br /> Loveland Ready-Mix Concrete, Inc. <br /> NAME(S) <br /> <br /> Mailing Address 1811 West 12th Street <br /> City, SL Zip Loveland, CO 8053 i <br /> <br /> Phone ( 970 ) 667-2680 <br />WELL LOCATION: County Larimer Owner's Well Designation Larimer Pit <br />644 N. County Road 19E Loveland CO 80537 <br />(AOaress) <br />lC:y) (Slate) (Lp) <br />~ j <br />Allf/e of the ~~/4, Sec. 15 Twp. 5 LI <br />N <br />. <br />or C S., Range 69 ~ E. or ~ W., 6th P.M. <br />~ <br />' <br />j <br />NA Ft <br />NA Ft <br />Di <br />n <br />f <br />m S <br />ti <br />n Li <br />m ^ E <br />t <br />F <br />J N <br />F <br />r ^ W <br />Li <br />^ S <br />. or <br />s <br />a <br />ce <br />ro <br />ec <br />o <br />nes <br />. <br />rom <br />. <br />ro <br />. o <br />ne. <br />., <br />. <br />Subdivision Name Lot ,Block , Filino/Unit <br />Theweilisbeingusedforthefollowingpurpose(s): Temporary Subsitute Supply Plan, Larimer Pit, <br />DMG ;;74-069 Sections 15, 16, 17, Water Division I, District 4 <br /> <br />Water from dre well was first used beneficially under ;his permit number, for the adove described purposes on Dec . 11 , 1998 <br />(Do not report a date of use before the issued date of this permit) <br />The pumping rate c:aimed is NA gallons per minute. (Frcm the Pump Installation and Test Repor,.) <br />The average annual amount of water diverted is 45.36 acre feet. <br />The land imgated (watered) by water from this well is NA ^ Acres ^ Square feet, described as: <br />Numcer <br />or as *IA Subdivrsion Lot(s) NA Block NA Filing/Unit NA <br />Well consCVC.ed Cy: NA License No. ' <br />Pump instilled by : ~`~ License No. <br />Meter Mfg. 9y : ~ NA Sedal No. NA Date Installed NA <br />I (we} claim and say that I (we) are the owner(s) of the well aeschbed aeove, know the contents of the statements made herein, and state <br />that they are true to my tout) knowledge. ~~ <br />Ple <br />se print the Signer's Name <br />~TiUe <br />a <br />B Signatupe' of ow l Date <br />~ <br />- <br />/ <br />~ <br />c <br />~oG'v~ <br />C, Es <br />cwt/ l'NiyeifcyL L 3-10-03 <br />/~ <br />~~ ~ <br />'~ , <br /> <br />For Office Use Only <br />Stare cngmeer 9y Dare <br />