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' 9Et:F.iVF'= <br />- RECEIVED ~ <br /> RECEIVEpiiAY 0 31999 <br />coioRAU~onn-rs~oxoFwAT$RRiasouRCi~s <br /> DE?'ARTMENT pF NATURAL R&40URCffi JUN 111999 <br /> ~ <br />;:.~`°' <br />><313 sAN_sr., a~t._a>!a, DENV~t c_o_s_o~ao JUN 0 ~ ~`~~.. - <br /> , <br />, <br />ir phone • htM:130316883587 tttaht: (303! 88&3581 ~au <br />l <br /> n <br />., .,... w~rf <br />NEW HOUSEHOLD USE ONLY G~ •- Water innit A plication <br />- ~ « <br /> <br />- 1. APPLICANT-81EORMATION - -8•-USE OF-WELL- - - <br />- <br />- <br /> ~~~~ <br />- ORDINARY HOUSEHOLD PURPOSES IN810E ONE <br /> ~'~1ew SINt;LE FAMILY DWELLNO <br />- <br />- <br />- - - --- - -- - - -- (~Ol%1~IOEl/Sbl <br /> oin wr. ~ eaM <br /> 7. WELL OATA <br /> T"'M'°"'N""r"p'd"""°°aa _ RAAXYYIUM.PRODUCTIOH.RAT1E-OF-THE-WELL-- -- <br /> <br /> Wp.L NOT EXCEED 18 QPM <br /> Z TYPE OF APPLICATION <br /> - • - - - - - " - _ -- - - '8:"TYPE"OF'RESIDENTiAL SEWAQE' SYSTEM' <br /> CONSTRUCT A NEW HOUSEHOLD U8E ONLY Septic tank / etisorption leach field _ <br /> WEfl ON LESS THAN HfT ACRES O Central system <br />~wiw: <br /> 3. ~ TO Ot ): f7 Vauft <br /> <br />-- <br />~~~ _ <br />Ia0a11011pNpamMhrMm: . AarA.iS~v~eP~M['f-' <br /> MH- ~ Othw I.e..~ wsr d watYMMb aryn) <br /> <br /> 4. tACAT10N OF WELL 8. PROPOSED WELL DRILLER - -- - <br /> owwq mwnrfaAw w.d. <br />S W to us Wawa tla.nn n.ubw <br />~ <br /> a.aYn *~ N . a n.ne. saw htadva wn8.~ 10. SItiNATURE of ieeltt s or authorhed a ant <br />-- _ _ _ _ -. .The nMl3np.ot toles ataoematta herein wgfEyOes.psjiay <br /> ora.ae. m w.e « raw to the abcerd detlee, which ie puYdueb as a eieas t mis- <br /> demeanor puseantto c.a.s. 244-tOri731W. I have read <br />t ! D the sbtemenb heroin, know the ecn0lyda theraot end eLte <br /> ww uesoon.arwa.. a eer.a aea.rorsaa.+enw a+we+rl <br /> <br /> <br /> 6 ON BE LOCATED <br /> n. ya was dwak.e. a w.+as.wMS • w rwacean. ow. <br />-- -- <br />-SubtGVision: ti.n.Great Di ~:~!-... - <br />_ ~~~ _ <br />- - -- - - - - - - -- - -`r'_27 <br />oMa u« a+r own we sa. - <br /> ,~ <br />lot f ~`i !z WooR f~RrepNnica <br /> 0 Coumy ExMnpdOnrrrwawnrw..+a..wr•.wr.e.+ro <br /> - - - <br /> t a.e.ra nnt! <br /> ~ Mininp tdaim «.+~...........~ <br /> Claenrwnelt+ <br />__ ,~ : .r7 - -DIV--~ <br />- 7RFF 4v~tQ87. s/.3/94 66 ck: <br />- <br /> o otlnr ~ m <br /> R STATE-A1e.8 COQ~s <br /> ID/ <br />- --- C.-Id.aa~w to tees -- -- - -- - <br />- - - _ - - <br />-- - <br />-- - - --- -~ ~ <br />- ~ - <br /> - <br />- <br />~ - - <br />- - - <br />-- <br />- <br /> a 6A <br />T TNI8 WILL BE 7HE ONLY WELL ON THIS TRACT <br /> USE MD - - <br />.~ Fetm GWSd911~195) <br />