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<br /> <br />'~' <br />CULURADO tJATER Lr1~J5 <br />Tne pennittee is encouraged to contact the State Engineer, 'with reyard to the <br />administration of water riyhts, and the ~oloradu Uepartment of Health, with reyard to <br />the discharge of pollutants into the waters of the State. Violation of Colorado water <br />laws could result in enforcement actions taken by the State Engineer acrd/or the Colorado <br />Department of Health. <br />ADDITIUiJAL INFURt~WTIUN <br />This space can oe referenced for further infonnation of any of the items on this form. <br />•.~e.e,. ~~rs e~ c~er~a! ~i-o.n. .S'~~ f P ~4 /~f PPrf an ~ c e <br />To the nest of my knowledge, all the information presented in this application is true <br />and correct. <br />Data: /~ - Z5 ' ~~ <br /> <br />~~,~./ w <br />Title <br />(Rev. 'U/33) <br />uoc. iJU. »a~ <br />