PERMFILE114359

• Permit No: M1999117
• IBM Index Class Name: Permit File
• Section_Exhibit Name: EXHIBIT A LEGAL DESCRIPTION
• Media Type: D
• Archive: No

WRJ 5 72
Application must
be complete where
pplicable. Type or
rint in BLACK
INK- No overstrikes
or erasures unless
initialed.
COLOf~O DIVISION OF WATER RESOURC~
101 Colum Bldg., 1845 Sherman St., Denver, Colorado 3
PERMIT APPLICATION FORM
FO
i
RECEIV '.-~-
APR I 3 ~~
WATER gESOUReE
SIAT~~rydH[T~ S
~, R
1 (OTHER
(1) APPLICANT - ma
FOR OFFICE USE ONLY: DO NOT WRITE IN THIS COLUMN
( 1 A PERMIT TO USE GROUND WATER
I X) A PERMIT TO CONSTRUCT A WELL
R: ()() A PERMIT TO INSTALL A PUMP
( f REPLACEMENT FOR NO.
NAME Joseph R. & Leona Bernard
STREET
Rt. I Box 128
CITY Center, Colo. 81125
(Slate) (tip)
TELEPHONE N0.- _75h-3369
(2) LOCATION OF PROPOSED WELL
County SafR13Ch2
'/. of the ~:~7 '/., Section ~5
TwIT.T.~I.l_ ~,Rng.~_ ~, N.T9. P.M.
(3) WATER USE AND WELL DATA
~oposed maximum pumping rate Igpm) 15
I '
Average annual amount of ground water #is~~itYti3.T4 1
to be appropriated (acre-feet):
Number o4 acres to be irrigated:
less than 1
Proposed total depth (feetl: 1-UU -
Aquifer ground water is to be obtained from:
Unconfined
# 1 Lotaestic
Owner's well designation
GROUND WATER TO BE USED FOR:
( IIiOUSEHOLD USE ONLY
( X) DOMESTIC (t)
1 1 LIVESTOCK 12)
( )COMMERCIAL 141
)OTHER
no irrigation 101
( (INDUSTRIAL (51
I IRRIGATION (61
( )MUNICIPAL (81
(4) DRILLER
ame
reet
Licensed to be selected
City
(State) (Zlp)
Telephone No. Lic. No.
Receipt No. i><~~~ k Si
Basin Dist.
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.

APPLICATION APPROVED
PERMIT NUMBER 68"8
DATE ISSUED MAY s 1973
EXPIRATION DATE MAY 8 1975
•.~
•r
INEER)
BY
2- 7. ,-s . , ~.~-