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GRAVEL PIT WELL PERMIT APPLICATION -INSTRUCTIONS This applications is for use in applying for a well permit for a gravel pit that exposes groundwater to evaporation as• required under the provision of 37-90-107(81 or 37-90-137171), C.R.S. If this is not such a gravel ph, use General Purpose Application Frorm GWS-45. A permit Is not required 'd the pit was constructed prior to December 31, 1980 and has not bean operated or reactivated after that date. ~~ A $60 non-refundable filing fee is required. One application is required for each DMG permit area. Cheeks should be payable to the COLORADO DIVISION OF WATER RESOURCES. A substitute supply plan or augmentation plan may be required for approval where groundwater was exposed after December 37, 1980. These plans are submitted separately and a filing fee of A7343.00 is it These plans may not be needed in areas where water is available and all other water rights are satisfied. Applications must be completed clearly, and leoibly in BLACK INK or typed. ALL ITEMS in the application must be completed. Incomplete applications may be retuned for more information. Do not change or alter the application in any way. Attach additional sheets ff more space is needed. ITEM 1 TYPE OF PERMIT -Check the appropriate box. ITEM 2 APPLICANT INFORMATION -This is the applieanYs name and the mailing address where all cortespondence will be sent. Include the phone number. ITEM 3 CONSULTANT/ATTORNEY/OPERATOR CONTACT - If there is someone different than the applicam to be contacted for additional Information, then complete this item. Indicate the name of the grevel pit and the assigned DMG number (include any prior DMG/MLRD perm.: numbers that may be assoicated with this pit. ITEM 4 LOCATION OF WELL -The general beacon of the well lpitl must be indicated and include a quarter/quarter, Section, Township, Range and Principal Meridian. An outline of the pit(s) on a USGS 7 1 /2 minute quadrangle map is desirable. ITEM 5 Indicate the maximum number of scree of groundwater to be exposed to the atmosphere and the total number of exeaved areas (pits) covered within the DMG permit. ITEM 8 Indicate the estimated proposed or actual depth of the pitls-, and estimated depth to groundwater. ITEM 7 Indicate the estimated dates of beginning to expose groundwater and completing the mining. ITEM 8 ATTACHMENTS -The list of attachments to this applleation provides information which is necessary m the evaluation. A scaled map of the pit area tied to a section comer is required. ITEM 9 USE -Complete this item 'rf water is to be used for any purpose other than evaporation, those uses must be detailed. The information required includes but is not limited to the volume of gravel mined, the method of diversion of water from the pit, the pumping rate in gallon per minute, the average annual amount of water diverted or used in acre-feet, and the Droposed use. ITEM 10 SIGNATURE - An ORIGINAL signature must be on each application. The individual signing the application must be the applicant, or an officer of the company identified es the applicant. Clearly print the name, end title, of the person signing the application and include the date. The applicant's authorized agent may sign the application, 'If a letter sinned by the aoolicant is submitted with the application authorizing them to as as agent for the purpose of obtaining a well permit. IF YOU HAVE ANY QUESTIONS regarding any item on the application form, please call the Division of Water Resources Ground Water Information Desk (303-886-35871, or the nearest Division of Water Resource Field Office located in Greeley 1970-352-87121. Pueblo (7 1 8-5 42-3 3 8 81, Alamosa (719-589-86831, Montrose (970-249-8822), Glenwood Springs 1970-945-58861, Steamboat Springs 1970-879-0272), or Durango 1970-247-78451. COLORADO DIVISION OF WATER RESOURCES, 7313 SHERMAN STREET, ROOM 821, DENVER, CO 80203 PHONE 303-9eB-3697 enformedeN. 303-ae&3681 (MdN. 9o3.e8&3447 Twee 8. Water fliahb Rewrde), 303-ae8-3689 (Fax)