PERMFILE111899

• Permit No: M2004047
• IBM Index Class Name: Permit File
• Doc Date: 2/11/2005
• Doc Name: Response to Adequacy Review Comments
• From: WSI Weiland Inc.
• To: DMG
• Media Type: D
• Archive: No

PRRTY of FIVE, LLP 303-404-0778
=eb 11 OS 09:20a
Form
No. GWS-2 NON-EXEMPT
6!2004 STATE OF COLORADO
DIVISION OF WATER RESOURCES
OFFICE OF THE STATE ENGINEER
821 Centennial Bldg., 1313 Sherman St„ Denver, Colorado 80203
[phone] Fax [phone]
WELL PERMIT INFORMATION, PERMITS APPROVED PURSUANT TO CRS 37-90-737(2)
Carefully read the conditions of approval on your wel! permit .The conditions and the Information on
this information sheet must be conrpliedwittritrorderfortlre permt'Cto-rernain valid.
THE ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT
The well permit number Is located In the upper right comer of the_pefRtlt, and theesplratlondate !s -
tocated ih tfre lawe~ rightcoiner.
THE. WELL PERMIT EXPIRATION DATE IS ONE YEAR FROM TtiE GATE ISSUED. Evidence of wel?
construction and pump installation must be r®celved on appropriate forms PRIOR TO THE EXPIRATION ,
DATE OF THE PERMR. The required forms are the Well Construction and Test Report (Form No. GWS-31),
and.the Pump installation and Test Report (Fonm;No. GWS-32). There are,penaities if evidence of well
construction and pump installation is nat reaeiveti prior to the expiration date:" TtTe licensed contractor w wail
owner (under the private driller oc pump installer statutes and hales) performing the work is responsible for
rx~mpieting the appropriate form(s) and submitting it to the Division of Water Resources.
Tfie expiration date of the permit rfaay bt;.extended one tittte,only for` a pertod'nat to exceed one yearforv .
good cause shown, at the distxetion of the Stale Erigirteer. Ilan eztehsion of time Is necessary tti construct the .
Ellin fees .The request and fee must be received by the State. Engineer Drioi to the expiration date. The request
must state._why the well .has not been constructed. andlor pumping equipment installed; and must Include an
estimate of time required to construct the well.andior insta(1 pumping equipment: ~ _
Water ~weil rAnstruction and pump fnstaliation eontractora are tlcensed In Colorado to peefornt these
specialized tasks. It Is illegal for individuals who. do not:hold these licenses to construct. wells and
install pumping equipment In or on wells. The. well must be constructed grid pumping equipment
Installed by contractors wfth current license(s) issued by the State df Colorado unless exempted as
described on the reverse side. Additional information. regarding well cgnstrudion, pump tilstallatiati; required
testing and well plugging anal seating regltiationsare found on the reverse side of this shoat _ _
You have beerc provld~d with of leas one copy of the well permit Keep a copy for your recorcis. At least
one copy has been sent. to the well driller •rf you ind)(xted.a tlriiler license number on the application. 'You may
make additional copies for the weft driller if you select one different from the one indicated in your application.
The original permit is on file in our Denver office Records Section. Copies tray be ohtained for a fee of 56 cents
per page. Statutes require that any change of mailing address or ownership be reported to the State Engineer.
Use Forth No. GWS-11. There is.no filing fee.
If you have questions,.contadtha Denver Office, or the Division Office in the area where your well is located.
Division 1 pMsWn 2 Oivisi9n 3 ~ Division 4
810 9°1 St, Ste. 200 310 E. Abrierido Ave Ste B
- 30t Murphy Odva 1871 East Main St
Greeley, CD 80631 Pueblo, CO 81004 Aiamosa, t:0 81101 Montrose, CO 81402
[phone] [phone] [phone] [phone] -
Fax [phone] Fax 19 544A800 Fait 19 589-6fi85 Fex 970 249-6728
Division 5 ~ ~Divisian 6 Division 7 ~ Denver Office
Dlca~t mail to Box 396 Dlrod matt to box 773x50 701 Camino Del Rio 1313 Sherman St Rm.~816
Glenwood Spgs CD 87602 505 Mglels Or. Suite 1C1 Ste. 205 Denver, CO B02D3
50633 U.S. Hwy 6 & 24 Steamboat SP9s, CD eDS77 Durango, CO 813D1 [phone]
Clenwood SP9s., CO 8760T ~ [phone]
(97 02 247-1 8
45
_.. , . -
F..ax (303) t;66-3589 ~~- ~ -
[phone]
~ .Fax(970),879-t D7D .,
- - ~ ~ ~ ~ _
_ _
FaX{97D) 259A944
Fax 97D 945.8741 Calt Fr3c