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(5) THE LOCATION OF THE PROPOSED WELL and the area on <br />which the water will be used must be indicated on the diagram below. <br />Use the CENTER SECTION (1 section, (i40 acres) for the well location. <br />I <br />~~ 1MILE, 5280 FEET i <br />1 <br />1 - ~ T i I <br />~ I <br /> y- _ <br />I <br />NORTH <br />T <br /> <br />+ t <br /> <br />~ - -•- - <br />- -F - -~ <br /> <br />"~ l~ <br />I <br /> <br />I <br />T <br />- -)- - <br />I ~ ~ ~ <br />T ~ + T t t ~- <br />i ~ I <br />~ -~ --}- --f--~--+--+-+ -+ <br />The scale of the diagram is 2 inches = 1 mile <br />Each small square represents 40 acres. <br />WATER EQUIVALENTS TABLE IRoundetl Figuref) <br />An acre-foo[ covers 1 acre of land 1 foot tleep <br />1 cubic foot per second Icfsl ...449 gallons per minute Igpml <br />A family o} 5 will rlquir! apprpaimately 7 acr!-fOOt Of water per year. <br />t acre-foox ...43.560 cubic fee[ ...325.900 gallons. <br />1,000 gpm pumpetl continuously for one day produces 4 42 acre-feet. <br />(10) <br />Owner(s): <br />(6) THE WELL MUST BE LOCATED BELOW <br />by distances from section liners. <br />/. 7i50 (t, from So~T I, sec. line <br />(north or sou[n) <br />/ 0 SO ft. from ~i3 ~ sec. lir~ <br />least or west) <br />LOT /VA BLOCK ~~ FILING•_~ <br />SUBDIVISION /y/A <br />(7) TRACT ON WHICH WELL WILL BE <br />LOCATED Owner iJest(ern Q~~ <br />No. of acres .Will this be <br />the only well on this tfact? YI'1 ~~~~ <br />(8)PROPOSED CASING PROGRAM <br />Plain Casing <br />M <br />y in. from ~ ft. to ~O`I ft. <br />in. from ft. to ft. <br />Perforated rasing <br />y rr in. from ~~ 9 r ft. to ~/ 9' ft. <br />in. from ft. to `t. <br />(9) FOR REPLACEMENT WELLS 9ivedistance <br />and direction from old well and plans for plugging <br />it: <br />N/A <br />/i No. of acres: <br />;G. .st a rod...( rrA ~-s- <br />(11) DETAILED DESrCRIPTION of the use of ground water: Household use and domestic wells mtiit indicate type of disposal <br />system to be used. Ws)rr r p~~ Sim O~ ~Y .S~~r~e7 ~Wi// ~e <br />e ;oc/;ca/(J~ Celled <br />(12) OTHER WATER RIGHTS used on this land, including wells. Give Registration and Water Court Case Numbers. <br />Type or right Used for (purpose) Description of land on which used <br />~~~ . ' . <br />(13) ,14U ~j~ ¢~ EST OF HISSKNOWLEDGE,INFORMATION SET FORTH HEREON IS <br />S/GNATURE OF APPLICANT(S) <br />Use additional sheets of paper if more space is required <br />