Laserfiche WebLink
Form No. COLORADO DIVISION OF WATER RESOURCES For Office Use only <br /> GWS-27 DEPARTMENT OF NATURAL RESOURCES <br /> 6/2006 1313 Sherman St., Rm 818, Denver, Colorado 80203 <br /> Phone: (303) 866-3581 <br /> REVIEW INSTRUCTIONS PRIOR TO COMPLETING FORM <br /> GRAVEL PIT WELL PERMIT APPLICATION <br /> 1. TYPE OF PERMIT <br /> LYJ NEW PIT(S) <br /> TER DEC <br />31 <br />1980 <br />? <br />UCTED A <br /> F <br />. <br />, <br />PIT(S) EXIST, CONSTR <br /> 2. APPLICANT INFORMATION <br /> NAME(S) A. A. CoNe-mer-e GoN STRVGTto N toe. <br /> Mailing Address 237-3 F=1JER, RoAD <br /> City, St. Zip GaAuD J vNcTio1J . Go 61 SOS <br /> Phone ( 970 ) ,2yt3 - 33Z 1 <br /> 3. CONSULTANT/ATTORNEY/OPERATOR CONTACT (If different than #2) <br /> NAME(S) SAME PIT NAME <br /> Mailing Address 145, <br /> City, St. Zip ??OVE DMG NO. <br /> Phone ( ) <br /> 4. GENERAL LOCATION OF PIT(S): COUNTY ME $ A <br /> SE 1/4 V E 1/4, Sec. 23 Twp. ? N. © S., Range__L_ E. ? W. G117E. P.M. <br /> 5. Estimated maximum water surface to be exposed: Acres. Number of Pits <br /> Estimated depth of pit(s) 10 Ft. Estimated depth to groundwater 6 Ft. <br /> Estimated date to expose groundwater . vtje 2001 ; to complete mining 3yNE 1, 2014 <br /> 8. ATTACHMENTS: (Check which have been attached.) <br /> (a) ? Scaled map of pit area with range, township, & section clearly identified (REQUIRED). <br /> (b) ? Copy of the reclamation permit, if applicable. <br /> (c) ? Copy of pre 1/15/89 water conservancy dist. or water user assoc. augmentation agreement, if applicable. <br /> (d) ? Copy of proposed substitute water plan or augmentation plan application, if applicable. <br /> (e) ? Copy of court approved augmentation plan, if applicable. Case No. <br /> ? <br /> (f) <br />Other <br /> <br /> 9. Detailed description of any use, other than evaporation, and method of diversion, rate of diversion, and annual amount of <br /> diversion of any water withdrawn from the pond. <br /> <br /> <br /> <br /> 10. 1 (we) have read the statements made herein and know the contents thereof, and that they are true to my (our) <br /> knowledge. [Pursuant to Section 24-4-104 (13)(a) C.R.S., the making of false statements herein constitutes perjury <br /> in the second degree and is punishable as a class 1 misdemeanor.] <br /> Name/Title (Please type or print) <br />MpirriN Aze_A izm 441 Signature Date <br /> owP2P__ t t , - 2 O <br />or Office Use only .r/ <br />Court Case No. Div. Co. WD Basin MD Use