PERMFILE105386

• Permit No: C1981013
• IBM Index Class Name: Permit File
• Doc Date: 12/11/2001
• Section_Exhibit Name: EXHIBIT 08 WATER WELL INFO
• Media Type: D
• Archive: No

WRJ•$-Rev. 76
Application must
be complete where
applicable. Type or
int in BLACK
NK. No overstrikes
or erasures unless
initialed.
COLORADO DIVISION OF WATER RESOURCES
816 Centennial Bldg., 1313 Sherman St., Denver, Colorado 80203
PERMIT APPLICATION FORM
( 1 A PERMIT TO USE GROUND WATER
1 1 A PERMIT TO CONSTRUCT A WELL
FOR: 1 ) A PERMIT TO INSTALL A PUMP
EcEivED ~_
APR 2 6 1982 (~~
,MfA7FA RESOURCES
~TA7E F11GIN.CP
00111
f y REPLACEMENT FOR NO.
(w OTHER YCaf~/tQf-ren /' .~~ irccl y..'i. ~//j35~
WATER COURT CASE NO.
(1) APPLICANT • mailing address
NAME ~+ ~ CK ~ r!'~tave 7
STREET C~yye.... Gen/`uP ~~• rP 7
CITY-~VeSIC!r1r Cn[n SllD91
/ Istanl (Zlf+)
TELEPHONE NO. ~ 6~ ~ ~ ~ ~
12) LOCATION OF PROPOSED WELL
County- ~4.5 ~/t r!/10 S
A1. E %. of the N. E, '/., Section / `/
Twp. ~ S , Rng. ~ ~, ~_P.M,
IN.S~ IE. WI
(3) WATER USE AND WELL DATA
•roposed maximum pumping rate Igpml ~o ~. P, m,
Average annual amount of ground water -f-
to be appropriated (acre-feed: ~ acre Fcn l
Number of acres to be irrigated: /I G n ~
ProDOSed total depth Ifeetl: ~C+ t7 /
Aquifer ground water is to be obtained from:
un know n
Owner's well designation
GROUND WATER TO BE USED FOR:
(x) HOUSEHOLD USE ONLY • no irrigation (01
1 1 DOMESTIC Itl ( 1 INDUSTRIAL (51
1 1 LIVESTOCK 121 ( I IRRIGATION 161
( 1 COMMERCIAL (41 ( 1 MUNICIPAL (8)
( I OTHER (91
DETAIL THE USE ON BACK IN 111)
FOR OFFICE USE O~NyyLY: DO NOT WRITE IN THIS COLUMN
ReceiptNo.~~~~`3 /
Basin Dist. ~~1 ~c `Oh
CONDITIONS OF APPROVAL
This well shall be used in such a way as to cause
no material injury to existing water 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. ~'
APPROVED FOR HOUSEHOLD USE ONLY, FOR ONE
Il) SINGLE FAMILY DWELLING AND NOT TO BE
USED FOR IRRIGATION. THE RETURN FLOW FROM
THE USE OF THIS WELL MUST BE RETURNED TO
THE SAME STREAM SYSTEM IN WFi1CH 7HE WELL`
1S LOCATED.
THE MUNICIPAL OR COUNTY GOPERN!lENT
SHALL BE CONSULTID WHEN LOCATING
THIS WELL. AND THEIR REGULATIONS
SHALL BE COMPLIED WITH„
APPROVED AS A REAPPLICATION
AND REINSTATEMENT Of WELL
PERMIT N0. ~ ~ 3 394
APPLICATION APPROVED
PERMIT NUMBER 1 13 3 4 4
(4) DRILLER ~nj ( DATE ISSUED M/~Y 5 ~9~~
Name ~ ~E 7( 1.) c c' 4 u EXPI R~1QN DATE
~reet n ~1 • I.J o Y a 4 S /v/, l~t,J
,
Gty ~c+KE r~; le Ca IO• (G3Z a TS ant (STAY ENGIAIE
15uu1 lzip) .~~
C/ I BY
Telephone No. nC n E Lic. No. a I
I.D. L- ---. ~ , ~ COUNTY