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Form No. OFFICE OF THE STATE ENGINEER <br />GWS-25 COLORADO DIVISION OF WATER RESOURCES <br />818 Centennial Bltlg., 1313 Sherman St, Denver, Calorntlo 80203 <br />(303) fi6fi-3581 <br />APPLICANT <br />WELL PERMR NUMBER 250144 _ <br />DIV.1 WD2 DES. BASIN MD <br />LAFARGE WEST INC <br />%T AXLEY rLilWATER & WASTE ENG <br />621 17TH ST STE 1020 <br />DENVER, CO 80293- <br />(303)292-3503 <br />APPROVED WELL LOCATION <br />WELD COUNTY <br />NW 1/4 NE 114 Section 24 <br />Township 1 N Range 67 W Sixth P.M. <br />DISTANCES FROM SECTION LINES <br />1300 Ft. from North Section Line <br />1675 Ft. from East Section Line <br />UTM COORDINATES <br />,..,.,.. ,.y. ~..., ..y. <br />ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT <br />CONDITIONS OF APPROVAL <br />1) This wall shall bo 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 ConstruGion 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 37-92-602(3)(6)(1) for uses as described in CRS 37.92-602(1)(f). Use Oi this well is limited to <br />monitoring water levels and/or water quality sampling. <br />4) Approved for the use of an existing well acknowledged for construction under monitoring hole notice MH-47775, antl <br />known as N003 MW02. <br />5) This well must bo equipped with a locking cap or seal to prevent well wntamina8on or possible hazards as an open well. <br />The well must be kept capped and locked at all 8mes except during 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 Division o(Water Resources upon request. <br />7) Upon conclusion of Ne monitoring program the well owner shall plug this well in accordance with Rule 16 of the Water <br />Well Construction Rules. A Well Abandonment Report must be completed and submiaed to the Division of Water <br />Resources withlri 60 days of plugging. <br />8) The owner shall mark the well in a conspicuous place with well permit number(s) and name of aquifer 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 authorized individual <br />according to the Water Well Construction Rules. _ ~~^~ <br />10) This well must be located rrot more than 200 feet from the location specified on this permit. S/72~03 ^'~ <br />RAB <br />Q: <br />stare <br />