PERMFILE100451

• Permit No: M1982131
• IBM Index Class Name: Permit File
• Doc Date: 7/27/1982
• Doc Name: MEMO BUCKLEN EQUIPMENT CO APPLICATION FOR MINING RECLAMATION PN 81-131
• From: DWR
• To: MLR
• Media Type: D
• Archive: No

Wk J~S~Hc.. /G COLO~O DIVISION OF WATER RESOUR~
818 Centennial Bldg., 1313 Sherman St., Denver, Colorado 80203
PERMIT APPLICATION FORM_
ADPlication must
be complete where ( 1 A PERMIT TO USE GROUND WATER
applicable. Type or (X) A PERMIT TO CONSTRUCT A WELL
print in CK FOR: 1 1 A PERMIT TO INSTALL A PUMP
INS No ovorstrikes
ur erasures unless ( 1 REPLACEMENT FOR NO.
initialed. IXIOTHER (,ravel {~ rn inn
WATER COURT CASE NO.
APPLICANT -mailing address
NAME ~ Any GraYCl Company
STREET Basic Riverside Drive
CITY Rivrrhntton fnlnrado
Isut.l Iziol
TELEPHONE NO.
12-
County weld County
NE I4 of the SE '/., Section 36
Twp. ~2_ ,f].., Rng. _¢~
IN,$1 IE, WI
13) WATER USE AND WELL DATA
Proposed maximum pumpirq role IgPml ,.._ N/A _
Averayo annual amount of ground water
to be appropriated lacre•feetl: 14 AF Cva~
Number of acres to be irrigated: N/A
Proposed total depth ffeetl: 20 feet
Aquifer ground water is to be o0tained from:
Alluvial
Owner's well designation Bass Pit
GROUND WATER TO BE USED FOR:
1 HOUSEHOLD USE ONLY
1 1 DOMESTIC 111
1 1 LIVESTOCK 121
f 1 COMMERCIAL 141
no irrigation 101
1 INDUSTRIAL 151
1 IRRIGATION 161
( 1 MUNICIPAL (81
IX 1 OTHER (91 IVildlife
DETAIL THE USE ON BACK IN (11)
141 RI N/A
Name
$tnet
City
I nt.l
Telephone No. h Lic, No. _
I r
FOR OFFICE USE ONLY: DO NOT WRITE IN THIS COLUMN
Receipt No.
Basin

Dist.
CONDITIONS OF APPROVAL
This well shall be used in such a way as to cause
no material injury to existing wate- rights. The
issuance of the permit does not assure the applicant
that no injury will occur to another vested water
right or preclude another owner of a vested water
right from seeking relief in a civil court action.
APPLICATION APPROVED
PERMIT NUMBER
DATE ISSUED
EXPIRATION DATE
(STATE ENGINEER)
BY
I,O. COVNTY rl' i
'~~~'