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<br />Application must <br />be complete where <br />applicable. Type or <br />print in BLACK <br />INK. No overstrikes <br />or erasures unless <br />initialed. <br />PERMIT APPLICATION FORM <br />24b5~ F <br />~•g~..1 <br />OCI Uy r~ <br />. tYIItER RESOURCES <br />QATE ENGINEEP <br />i9L0. <br />,. ~ <br />(X) A PERMt7 TO USE GROUND WATER <br />(X) A PERMIT TO CONSTRUCT A WELL <br />FOR: (X) A PERMIT TO INSTALL A PUMP <br />1 )REPLACEMENT FOR N0. <br />( )OTHER <br />1 <br />• mailing address <br />NaME Adolph Coors Company <br />STREET Land & Water Resources X309 <br />CITY Golden, Colorado 80401 <br />Isuul (z1u) <br />T_LEPHONENO. - 279-6565, Ext. 2844 <br />(21 LOCATION OF PROPOSED WELL <br />Gounty Weld <br />NE ~ of the St 'b, Section 25 <br />T:: p. 3 N. Rng. 64 W 6th P.M. <br />WATER USE AND WELL DATA <br />COLORADO DIVISION OF WATER ! <br />101 Columbine Bldg., 1845 Sberman St., Denre <br />Proposed maximum pumping rate (gpm) 60 gpm <br />Average annual amount of ground water <br />to be appropriated lacre-feet): - <br />'r;:mber of acres to be'irrigated: 5n aCra /~/aar <br />Proposed total depth (feet): 4DD <br />r;uifer ground water is to be obtained from: <br />Laramie Fox-Hills <br />G.iner's well designation <br />Keenesburg Al <br />GROUND WATER TO 8E USED FOR: <br />t 1 HOUSEHOLD USE ONLY <br />i X) DOMESTIC (t) <br />~ Xi LIVESTOCK (2! <br />~ XI COMMERCIAL (41 <br />1 OTHER (91 <br />no irrigation (O) <br />(XIINDUSTRIAL(51 <br />(X 1 IRRlGAT10N (61 <br />( 1 MUNICIPAL (81 <br />~4) DRILLER <br />;.ame To be determined <br />~:reet <br />City <br />15brel Iz.nl <br />FOR OFFICE USE ONLY: DO NOT WRITE IN THIS COLUMN <br />Receipt No. 107009A / <br />Basin Dist. <br />CONDITIONS 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 seeking relief in a civil court action. <br />1. GROUND WATER PRODUCTIONS SHALL BE LIMITID.TO <br />THE LARANITE-FQX HILLS AQUIFER WHICH IS EQUIVA- <br />LENT TO A DEPTH FROM 340 FEET TO 400 FEET ON THE <br />LOG ~' WELL LOCATID IN THE SWu OF NE4, SECTION 36i <br />TOWNSHIP 3 N, RANGE 64W, PLAIN (NON-PERFORATID) <br />CASING MUST BE INSTALLED AND PROPERLY SEALID TO <br />PREVENT THE APPROPRIATION OF GROUND WATER FROM <br />OTHF,R ZONES, _ <br />2. THE AVERAGE ANNUAL APPROPRIATION FROM THIS <br />i~LL TOGETHER WITH WELL #,2H631-F SHALL NCIT ~ <br />•~CCEID 167 ACRE-FEET. <br />3. A TOTALIZING FLOW METER MUST BE INSTALLID <br />ON THE WELL DISCHARGE WHEN THE WELL IS PUT TO <br />EENEFICLAL USE. DIVERSION RECORDS 1<R]ST BE SUB- <br />A;ITTID TO THE DIVISION OF WATER RESOURCES UPON <br />REQUEST. <br />4. THE ENTIRE LENGTH OF THE HOLE SHALL BE GEO- <br />PHYSICALLY LOGGID PRIOR TO INSTALLING CASING. <br />COPIES OF THE LOGS MUST BE SUBMITTID TO THE <br />DIVISION OF WATER RESOURCES. <br />5• THE WELL MUST BE EQUIPPID (PREFERABLY WITH A <br />3/i+" ID TUBE FROM TOP OF WELL TO TOP OF PL'N1P) SO <br />THAT THE WATER'LEVEL IN THE WELL CAN BE MEASURID <br />AND MONITORID.TT~k,~j,'r,~ <br />P~~~TC~~II~b7pk8~~DEXTENDED 1 YEAR TO FEB. Zls <br />^1982. ~Crn f.b•%7. J I <br />PERMIT NUMBER ~'Z~~~O-/ <br />DATE ISSUED FEB 2 1980 <br />E%PIRATIONDpATE FFB 2]-~?9f.?1 <br />\\ A ~ f <br />BY <br />