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WATER WELL WRHIN 600 FEET <br />WELL OWNER CONSENT FORM <br />To Whom if may Concern <br />1, Reuben Wagner ,being the owner of the <br />well{s) referenced herein, do hereby give Consent for CAMAS Colorado, inc. to <br />Construct a well (gravel mine) within 600 feet of my well I am the owner of fhe follovying <br />well{s) which may lie within 800 feet of the Brighton Mine <br />Well Permit Number 64670 <br />Lotxted in the _s1~l~t16t (Qtr/QV} <br />Section 14 <br />Township 1 S {S/N) <br />Range s7w {W/E) of the 6" P M <br />COUnty Adams , Colorad0 <br />Coordinates 2300N feet (SM) <br /> 2320W feet (EtIN) <br />From the Nw '/~ comer of the said Section ~g_ <br />Well Permit Number <br />Logted in the / {Qtr/Qtr) <br />Seaton <br />Township (SM) <br />Range (W/E7 of the B" P M <br />Courtly ,Colorado <br />Coordinates feet (SM) <br /> teat (ElW) <br />From the S/. comer of the said Section <br />Welt Permit Nuttwer <br />Located n the t (QtrlOffj <br />Section <br />Township (S/N) <br />Range (WtE7 of the 8'^ P M <br />C~+nb , Coto-ado <br />Coordinatas feet (SJN) <br /> feet (~M <br />From the Y comer of the card Section <br />Signed <br />Pnnted Name <br />Date <br />Address <br />Wdr WcA l:onaetd Form <br />bubefilrata Supply Plan, and <br />OMO Eahrhd O - Water InMrmttgn <br />