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Form No. OFFICE OF THE STATE ENGINEER <br />Gws-zs COLORADO DIVISION OF WATER RESOURCES <br />818 Centennial 61tlg., 1373 Sherman 5[., Derwer, Colorado 80203 <br />.. (303)8663581 <br /> WELL PERMIT NUMBER 250147 <br />APPLICANT I l DIV. 1 WD2 DES. BASIN MD <br /> <br /> APPROVED WELL LOCATION <br /> WELD COUNTY <br /> NW 1/4 NW 1/4 Section t8 <br />LAFARGE W EST INC Township 1 N Range 66 W Sixth P.M. <br />%T AXLEY @WATER & WASTE ENG DISTANCES FROM SECTION LINES <br />621 17TH ST STE 1020 1000 Ft. from North Section Line <br />OENVER, CO 80293- 1150 Ft. from West Section Line <br />(303)292-3503 <br />UTM COORDINATES <br />ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT <br />CONDRIONS OF APPROVAL <br />1) This well shall be used in such a way as to cause no matedal injury to existing water fights. 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 hom seeking relief in a civil court agbn. <br />2) The censtrucdon of this well shall be in compliance w8h the Water Well Construction Rules 2 CCR 402.2, unless approval <br />of a valance has been granted by the Stale Boats of E7raminers of Water Well ConsWClion and Pump Installalbn <br />Conhaclors in accordance with Rule 18. <br />3) Approved pursuant to CRS 37-92.602(3)(b)(I) for uses as descdbed in CRS 37-92-602(1)(f). Use of this well is limited to <br />monitodng water levels and/or water qua0ty sampling. <br />4) Approved for the use of an exisOng well acknowledged for construction under monkodng hole notice MH-01773, and <br />known as CH03 MW03. <br />5) This well must be equipped with a ticking cap or seal to prevent well contamination or possible hazards as an open well. <br />The well must be kept capped and ticked at all Umes except dudng sampling or measuring. <br />6) Records of water level measurements and water quality analyses shall be maintained by the well owner and submitted to <br />the DNision of Water Resources upon request. <br />7) Upon conclusion of the monitoring program the well owner shall plug This well In accordance with Rule 16 of the Water <br />Well Construc8on Rules. A Well Abandonment Report must be completed and submitted to the Division of Water <br />Resources within 60 days of plugging. <br />8) The owner shall mark the well in a conspicuous place with well permit number(s) and name of aqu'rfer as appropriate, <br />and shall take necessary means and precautions to preserve these markings. <br />9) This well must have been constructed by or under the supervision of a licensed well driller or other authored IndNidual <br />according to the Water Well C.OnslNCtlOn Rules. <br />70) This well must be located not more than 200 feet from the location specfied on this permit. >/i 203 <br />APPROVED /,~ y~ ~ ~ r ~\\~,vla_~"'~y~ <br />RAB ~/ e5J 7 <br />State Engineer <br />