PERMFILE134885

• Permit No: M2001023
• IBM Index Class Name: Permit File
• Doc Date: 1/4/2001
• Doc Name: PERMIT TO EXPOSE WATER IN A PIT
• Media Type: D
• Archive: No

1 TA5 1313 Shertnen St., Rm ~ Darner, Colorado 80203
Phora: [phone]
REVIEW INSTRUCTIONS PRIOR TO COMPLETING FORM
GRAVEL PIT WELL PERMIT APPLICATION
TYPE OF PERMIT t(;dVLU
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ONSTRUCTED AFTER DEG. 31, 1980
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2. APPLICANT INFORMATION '
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NAMEIS- Camilletti and Sons, Inc. ~,m;~~ ~
Mailing Address P.O. Box 69 '9m~p
City, St. Zip Milner, 40 80487
Phone 1 970 ) 879-0838 ~
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3. CONSULTANT/ATTORNEY/OPERATOR CONTACT Ilf different tfian A'2)
NAMEIS) ^avid S. Zehner Precision Excavating Inc. PIT NAME l(i.FFF~ I~zF(,' M. Iltw P~~ktya

Mailino Address P.O. Box 790
City, St. Zip Hayden, CO 81639 DMG NO.
Phone 1970 ) 276-3359
4. GENERAL LOCATION OF PITISI: COUNTY
((~-~ In~
SE 1 /4 SE 1 /4, Sec. 15 Twp.~_ Ly,J N. ^ S., Ranga~(j_ ^ E. 44-~ W. 6 tIP.M.
5. Estimated maximum water surface to be exposed: 31 .3 Acres. Number of Pits 2
8. Estimated depth of pills? 36 Ft. Estimated depth to groundwater 5.5 Ft.
7. Estimated date to expose groundwater January 2001 ; to complete mining September 2017
8. ATTACHMENTS: (Check which have been attached.?
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Scaled map of pit area with range, township, & section clearly indentifed (REQUIRED).
Ibl ^ Copy of the reclamation permit, 'rf applicable.
(cl ^ Copy of pre 1!15/89 water conservancy dist. or water user assoc. augmentation agreement, if applicable
Id1 ^ Copy of proposed substitute water plan or augmentation plan application, 'rf applicable.
le) ^ Copy of court approved augmentation plan, if applicable. Case No.

Ifl ® Other ltoutt County Special Use ]?ermit Application.
9. Detailed description of any use, other than evaporation, and method of diversion, rate of diversion, and annual amoun
of diversion of any water withdrawn from the pond.
The waters fran this gravel pit will be generated by dewatering activities. It is
sad that these waters will ei
ece>.ving wa ercourse, some w>. us in a 1 a lication manner to irri ate ad'ance
0 ! Iwe) have read the statements ma a herein an ow a contents r~eofyan~tli'a ey a e flue lour)
knowledge. [Pursuant to Section 24-4-104 1131Ia1 C.R.S., the making of false statements herein constitutes perju
in the second degree and is punishable as a lass 1 misdemeanor.]
Neme/Trde (Fleece type or prinU ignature ate
Frank H. Camilletti n„/ ~~~~L'~(/"
-/ Y L 10 OCT 00
For ofGa Uea ady
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Court Case No. D
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