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<br />Perron V. berl
<br />C ass ertnn
<br />Sechan/ ibrt
<br />Class ❑Revrswn - - - - - - - - - - - - - - - -- - - - -
<br />Type /Seq
<br />_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
<br />Class O Report ❑ Hytlro OGeneral
<br />Doc Type
<br />DApplwahon (Coal only) O Bond Ei Enforcement ❑Inspection
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<br />F 1,001(A00 ill11,1�,11d F 1�1`LitrYtL,�Al111C15
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<br />PL 1 �LS'1 (f) t WILL DR 1 LU k ,( )I" � � ' ATTI)ANO (�)
<br />Well Permit Arpiieatior for c non- oxempt well
<br />Wu ore surry for thu dtlay and incunvoniuou u, but your application fur a well permit
<br />being returned for the rtcson(t) indicated below. Thu additional data, which ws are
<br />questing It required by sletute end pill aid us in evaluating your application. Prompt
<br />mr- iletion or correction of ILL itent checked in RED and tho ir.rnedlato return of the
<br />•plicatlon to Chit arfica w1w expedite Its procetsiog. Additiunel dglay in the hand -
<br />ng of your oppllCetIon can be avuidee by CORACCTLY co:rpleting the APELICATION JN FULL
<br />,d supplying any additional Information which iL requested.
<br />itotutct �equlres a S
<br />Fee' 'for,
<br />tfllt tYpa s((`,appl "1¢tt(on.� Please returnytl►o
<br />appl{Callor, with requirpd`Ir`"`
<br />W'111V It the Court docreu nu111ber?l tr r °,eCI "( �i , 1, � •" ,, `
<br />The 'r TAL FE will be $
<br />. ','You have alrtladq paid,$ � of this.
<br />P1✓ese out and compap eLothe enclosed form. (a) Supplonantal n ornution drool ( )
<br />(b)11Anu ndront of Existing records O (c) Affid avit of ownership O (d) Blank
<br />.glpl icatlon ( )
<br />Inbtructiuns are enclosed, *Theta forms Mutt ba notariled.
<br />Thu well lua.dtion Mitt be dutignatod by the county and the I/h of IA. Section,
<br />Tuavnthir, R.nlge, and Principal herldlan. (I tom 2)
<br />D{ttenees frlmn section Iinus rrjtt be tApwm. (Itunl 6). this wall oust pe at 1uu4t
<br />i 690 Not fro/ on axtitjn4 I' " -weer t lr; p- oacelnV__fEiiai the tali' zone.
<br />i 1„e i!t► of I/I seetlon (Item 2) does not egree with dittancet from section linot.(1lem,.
<br />Dittences eiven piece well In the of the ,
<br />'It-4•v Ind%cctu the pr «•+osed skpapnv -t pump n�j� g arc (Item jI
<br />The acre -feet indicated appears exeettive for this ate, 111em 3),
<br />Pluase indicate average onnubl appropriation in acre -feet. (Iten 3), (1 acre foot .r
<br />325,900 tiallons). We estln:ate that 100 heed of cr.ttle use 1,3 acre feet a your.
<br />How many aeros of land will Chit well irrioatu7 ,(Itcmt 3, S, and 10)
<br />Please indicate the prup3sed total dupth (Item 3).
<br />I Pluase Indicate the aquifer the ground walur will be Obtaitlud fru-
<br />supury 1, i
<br />this well must bu cmistr�eled only by or under isiun of o licensed well drlTlur7; I
<br />I If this it not the only vall on this tract (Item 7), pluasu explain in Item 12 and
<br />Indicate the permit nur,bar(s).
<br />Thu proposed casing progiram rust be completed (IL4xr. E3)
<br />Thu uxi9tInit well rout to plugged and ubandonud accord Inq to ruler. and regulaLiun,.
<br />This condition it requlrsd for repldcamanl wullb, (Item 9). i
<br />A rupiaeurlent wall rust r:aintain thu Sans pumping rate (gpn:) a•% thu sxasL{ng wull. (ILL11
<br />Pluase describe the acre2ge irrigated under LOCAL DESCRIPTION in Ite1n 10. This shuuld
<br />.1211 uu with
<br />auabu ihdic.ltu the spuCirlc uC0 intended for till tratur, u. flood, pivot
<br />lug-, etc. (Item li). g• llulnl 5pri1,1.•
<br />Piearoa indic.,tu thu athur Water rights on this land, and Iht.ludu thu regisu`atlon nuudlvi
<br />Of any uIller wul leg.
<br />Pleatu india.dtu the IeraLleft of the propubcd wall and the irrlgatud ua,wuju (Itum:
<br />'ihlt thould agree with I:Cna9 3 and 10.
<br />PIe.1300 Cullgrlete ILO.-o(j)
<br />51"iture go" appllcont H required un applications (IL in rod.
<br />Contact c licensed well Jrillur for assistancu, if nee*,
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