Laserfiche WebLink
v.•RJ. y.Rc.. IG •~LORADO Dlt!{SION OF WATCR R JRCES <br />818 Centennial Bldg., .313 Sherman St., Denver, Colorado 80203 <br /> PERMIT APPLICATION FORM <br /> <br />Application must _ <br />be complete where ( I A PERMIT TO USE GRUUfJD WA~I ER <br />applicable. Type or (X l A PERMIT TO CONSTRUCT A WELL <br />pool in BLACK FOR: ( I A PERMIT TO INSTALL A PUMP <br />INK Nu ovurslrikes <br />ur erasures unless ( )REPLACEMENT FOR NO. <br />initialed. (XI OTHER Gravel Operation <br /> WATER COURT CASE N0. <br />11) <br />manlny auaress <br />NAME Any Gravel Company <br />sTREET_Basic Riyerside_Drive_ _ -._ _- <br />clrv Riverbottom, Colorado <br />ISlale) (Lp) <br />TE LEPh10NE N0. <br />12) LOCATION OF PROPOSED WELL <br />Cotmty Weld Countv <br />NE '/, of the SE %, Section 36 <br />Twp. 12 .N , Rng. 67 __ W P,M. <br />~rt.S~ ~r..wi <br />(3) WATER USE AND WELL DATA <br />Proposed maximum pumping rate 19pm1 N/A <br />Averaye annual amount of ground water <br />to be appropriated lane-feet): 14 AF Evap, <br />Number Of acres to 4c irrigated: <br />Proposed total depth Ucet1: 20 <br />Aquifer ground water is to be obtained from: <br />Alluvial <br />Owner's well desiynalion $aSS Plt <br />GROUND WATER TO BE USED FOR: <br />1 1 NOl1SEl-10LD USE ONLY ~ na ung:nian 1(11 <br />I II10MEtiIlC 11) ( IINUIJSIIiIAI-(bl <br />( 1 LIVESTOCK (21 ( 1 IR111GATION (6! <br />I I COMMERCIAL (hl ( 1 MUNICIPAL lRl <br />IX 1 O'rHER 491 Wildlife <br />DETAIL THE USE ON BACK IN (11) <br />(4) DRILLER N/A <br />Name <br />Suect <br />(,lfy <br />Telcl+hnnc No _ «__~_. __ Lrr Nu -__ -. -. .. <br />FUR UPFICE USE ONLY. UU NOI Wlillf_ IN 1f11S COLUh4r! <br />Receipt No. <br /> <br />COND{TIONS OF APPROVAL <br />This well shall be used in ,such a way as to cause. <br />no material injury to existing water rights. The <br />issuance of the permit does not assure the applicant <br />that no injury will occur to another vested water <br />right or preclude another owner of a vested water <br />right from seekiny relief In a civil court action. <br />APPLICATION APPROVED <br />PERMIT NUMBER <br />DATE ISSUED <br />EXPIRATION DATE <br />(STATEENGINEERI <br />RY ______ _-.- ._ __. <br />r ~~ <br />... n.+ . <br />