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<br /> <br />F O R M COLORADO DIVI OF WATER RESOURCES office use only <br />No. <br />G'/VS-27 DEPARTMENT OF NATURAL RESOURCES <br />12/95 1313 Sherman St., Rm 818, Denver, Colorado 80203 <br /> Phone: (303)866-3581 <br />REVIEW INSTRUCTIONS PRIOR TO COMPLETING FORM <br />GRAVEL PIT WELL PERMIT APPLICATION <br /> TYPE OF PERMIT <br /> NEW PIT(S) <br /> ^ PIT(SI EXIST, CONSTRUCTED AFTER DEC. 31, 1980 <br />2. APPLICANT INFORMATION <br /> NAMEISI All RIte Paving & Redi-Mix, Inc. <br /> Mailing Address P • 0 • Box 1 1 28 <br /> City, St. Zip La Junta, CO 81050 <br /> Phone 1 719 I 383-2600 <br /> <br />3. CONSULTANT/ATTORNEY/OPERATOR CONTACT (lf different than #21 <br /> NAME(S) Banks & Gesso, LLC. PIT NAME North River Pit <br /> Mailing Address 720 Kipling St. , Suite 117 <br /> City, St. Zip Lakewood, CO 8021 5 DMG N0. <br /> Phone ( 3031 274-4277 <br />4. GENERAL LOCATION OF PITISI: COUNTY <br /> 1 /4 S E 1 /4, Sec. 3 6 Twp. 2 3 ^ N. 0 S., Range 5 5 ^ E. 0 W. 6 P.M. <br />5. Estimated maximum water surface to be exposed: 2 .0 Acres. Number of Pits 1 <br />6. Estimated depth of pitlsl 36 Ft. Estimated depth to groundwater 2 Ft. <br />7. Estimated date to expose groundwater ; to complete mining <br />8. ATTACHMENTS: (Check which have been attached.) <br /> ~ <br /> lal <br />Scaled map of pit area with range, township, & section clearly indentifed (REQUIRED). <br /> (bl ^ Copy of the reclamation permit, if applicable. <br /> f <br />1 <br />8 <br />^ C <br /> pre <br />opy o <br />/15/ <br />Icl <br />9 water conservancy dist. or water user assoc. augmentation agreement, if applicable <br /> 0 <br /> Id) <br />Copy of proposed substitute water plan or augmentation plan application, if applicable. <br /> ^ <br /> Ie) <br />Copy of court approved augmentation plan, if applicable. Case No. <br /> ^ <br /> Other <br />Ifl <br />9. Detailed description of any use, other than evaporation, and method of diversion, rate of diversion, and annual amoun <br /> of diversion of any water withdrawn from the pond. <br /> <br /> <br />0 1 Iwe) have read the statements made herein and know the contents thereof, and that they are true to my (our) <br /> knowledge. [Pursuant to Section 24-4-104 11311a) C.R.S., the making of false statements herein constitutes perjur <br /> in the second degree and is punishable as a class 1 misdemeanor.] <br />Name/Title (Please type or print) ignature Date <br />For Office Use only <br />Court Case No. Div. Co. WD Basin MD Use <br />