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Form No. OFFICE OF THE STATE ENGINEER <br />GWS-25 COLORADO DIVISION OF WATER RESOURCES <br />818 Centennial Bldg., 1313 Sherman St., Denver, Colorado 80203 <br />(303 866-3581 <br />• <br /> <br />APPLICANT <br />NORTHFIELD PARTNERS LLC <br />PO BOX 630678 <br />LITTELTON, CO 80163-0678 <br />(303) 267-0668 <br />APPROVED WELL LOCATION <br />FREMONT COUNTY <br />SE 1/4 NE 1/4 Section 14 <br />Township 19 S Range 70 W Sixth P.M. <br />DISTANCES FROM SECTION LINfS <br />2500 Ft. from North Section Line <br />500 Ft. from East Section Line <br />UTM COORDINATES 1Meters,Zone:13.NAD83) <br />C..~K.-~. AL..aL.:..~. <br />'ERMIT TU U5E AIV EJCIS f IIVti VYtLL `-""""y' "'"'"""~' <br />ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT <br />CONDITIONS OF APPROVAL <br />1) This weH shall be used in such a way as to cause no material injury to existing water rights. The issuance of this permit <br />does not ensure that no injury will occur to another vested water right or preclude another owner of a vested water right from <br />seeking relief in a civil court action. <br />2) The construction of this well shall be in compliance with the Water Well Construction Rules 2 CCR 402-2, unless approval <br />of a variance has been granted by the State Board of Examiners of Water Well Construction and Pump Installation <br />Contractors in accordance with Rule 18. <br />~) Approved pursuant to CRS 37-92-602(3)(b)(I) for uses as described in CRS 37-92-602(1)(f). Use of this well is limited to <br />monitoring water levels and/or water quality sampling. <br />4) Approved for the use of an existing well known as NF-03A. <br />5) This well must be equipped with a locking cap or seal to prevent well contamination or possible hazards as an open well. <br />The well must be kept capped and locked at all times except during sampling or measuring. <br />6) Records of water level measurements and water quality analyses shall be maintained by the well owner and submitted to <br />the Division of Water Resources upon request. <br />7) Upon conclusion of the monitoring program the well owner shall plug this well in accordance with Rule 16 of the Water <br />Well Construction Rules. A Well Abandonment Report must be completed and submitted to the Division of Water <br />Resources within 60 days of plugging. <br />8j The owner shall mark the well in a conspicuous place with the well permit number and name of aquifer as appropriate, <br />and shall take necessary means and precautions to preserve these markings. <br />9) This well must have been constructed by or under the supervision of a licensed well driller or other authorized individual <br />according to the Water Well Construction Rules. <br />10) This well must be located not more than 200 feet from the location specified on this permit. ~ y/~~i/off <br />APPROVED <br />CDK <br />3613627A <br />State Engineer <br />'~~~IVED~ <br />`: ~:E'_ a 3 ~ao~ <br />EXST <br />WELL PERMIT NUMBER 273356 <br />DIV. 2 WD 12 DES. BASIN MD <br />~~ e <br />DATE ISSUED 04-19-2007 <br />A <br />