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Form No, OFFICE OF THE STATE ENGINEER <br />Gws-zs COLORADO DIVISION OF WATER RESOURCES <br />818 Centennial Bldg., 1313 Sherman St., Denver, Colorado 80203 <br />(303)866-3581 <br />~`"i <br />' . <br />WELL PERMIT NUMBER G~4P~o -~'~~`~~~'.~~, f <br />APPLICANT DIV. 6 WD 44 DES. BASIN MD ~. { °- <br />j: _ ~ <br />APPROVED WELL LOCATION ~~ra.~ } <br />MOFFAT COUNTY <br />PAUL & ROSEMARY HERTZOG NE 1/4 NW 1/4 Section 12 <br />P O BOX 24 Township 6 N Range 95 W Sixth P.M. <br />MAYBELL, CO 81640- <br />DISTANCES FROM SECTION LINES <br />0 Ft. from Section Line <br />(970) 272-3289 ~ Ft frnm Cartinn I inP <br />ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT <br />CONDITIONS OF' APPROVAL <br />1) This well shall be used in such a way as to cause no material injury to existing water rights. The issuance of this permit <br />does not assure the applicant that no injury will occur to another vested water right or preclude another owner of a vested <br />water right from seeking relief in a civil court action. <br />2) The construction of this well shall be in compliance with the Water Well Construction Rules 2 CCR 402-2, unless approval <br />of a variance has been granted by the State Board of Examiners of Water Well Construction and Pump Installation <br />Contractors in accordance with Rule 18. <br />3) Approved pursuant to CRS 37-90-137 (2) and (11) for tfle construction and operation of a well (gravel pit} exposing and <br />diverting ground water tributary to the Yampa River at a point where water is available for appropriation. <br />4) The approval of this permit does not grant a water right. This well (gravel pit) is subject to administration by the Division <br />Engineer in accordance with applicable decrees, statutes, rules and regulations. <br />5) The average annual amount of ground water to be appropriated shall not exceed 30 acre-feet with the total surface area of <br />the proposed ground water pond limited to 10.3 acres. <br />6) The use of ground water, in addition to evaporation {27.1 acre-feet), is limited to gravel washing {2 acre-feet), and livestock <br />and wildlife watering (0.9 acre-feet). No other use of water is allowed unless a permit therefor is approved. <br />7) The owner shall mark the well (pond) in a conspicuous place with well permit number(s) and court case number(s) as <br />appropriate. The owner shall take necessary means and precautions to preserve these markings. <br />8) Pursuant to Rule 10.1.6 of the Water Well Construction Rules, gravel pit wells are exempt from the minimum well <br />construction standards except for contamination considerations as stated in the Rule. The owner of the gravel pit shall <br />take necessary means and precautions to prevent contaminants from entering the gravel pit well. <br />9) Pursuant to Rule 17.1.4 of the Water Well Construction Rules, the owner shall submit, after initiation of construction, site <br />plan and cross section drawings on 8-1/2" x 11" paper showing the extent of intended excavation, the maximum depth of <br />the pit, and the initial static water level. <br />10) The boundaries of the gravel pit pond shall be more than 600 feet from any existing well. <br />NOTE: This well may be subject to administration in the water rights priority system in the future. It is recommended that a <br />water court decree be obtainetl to affirm the priority of the well. r,~,, ~f_~ _~ <br />APPROVED <br />JD2 <br />State <br />ov o2 <br />M <br />~~ ~ <br />- ..~6 <br />