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WATER WFJ.L WITHIN 600 FEET <br />WELL OWNER CONSENT FORM <br />To Whom fi may concern <br />the owner of the <br />wail(s) referenced herein, do hereby glue consent for CAMAS Colorado, Inc. to <br />Constnux a well (gravel mine) wdhln 600 feet of my well I am the owner of the follovnn~ <br />well(s) which maybe Mnthin 800 feet of the Brighton Mine <br />Weil Permit Number 215794 <br />Located in the NE / NE (QV/QV) <br />Season 22 <br />Township 1s (S/N) <br />Range 67W (W/E) of the 8" P M <br />County Adams ,Colorado <br />Coorclinatas 750N feet (S/N) <br /> 200E feet (F_NV) <br />From the NE '/. comer of the said Section 2z <br />Well Permit Number <br />Located In the / (Qtr/Qtr) <br />Section <br />Township (S/M <br />Range (W/E) of the 6'" P M <br />Courrty .Colorado <br />Coordinates feet (SM) <br /> teat (E/V1~ <br />From the %a comer of the said SecUOn <br />Weli Pennlt Number <br />Located mthe / (QV/lam <br />Section <br />Township (SM) <br />Range (W/E) of the 6'" P M <br />County ,Colorado <br />Coorcflnates feet (SIN) , <br /> feet (fJ1A~ <br />From the '/a comer of the said SecUOn <br />Signed Date <br />Pnnted Name <br />Address <br />wae• wea cenae,d Form <br />Sutrbade Supply Plan, and <br />bM6 Ed~~bd O -Water Infomutgn <br />