Laserfiche WebLink
FORM NO. STATE OF COLORADO For Office Use only <br /> GWS10 OFFICE OF THE STATE ENGINEER <br /> 6100 823 Centennial Bldg., 1313 Sherman St., Denver, Colorado 80203 <br /> (303) 866-3581 Fax (303) 866-3589 <br /> -r?t1/F f1 <br /> STATEMENT OF BENEFICIAL USE <br /> Insert the Well Permit Number 057389-F APR 0 7 2003 <br /> Name address and phone number of the well owner: <br /> <br /> NAME(S) Ronald E and Marie E. Tipping STA <br />boLow <br /> Mailing Address P O Box 1849 --- <br /> City, St. Zip Grand Junction CO 81502 o v S/14 a <br /> Phone 97( 0 ) 243-4604 <br /> WELL LOCATION: County Mesa <br /> Owner's Well Designation: 23 Road Pit Second Enlargement <br /> N/A <br /> (Address) (City) (State) (Zip) <br /> E 112 of the SE 1/4, Sec. 6 Twp. 1 ? N. or m S., Range 1 ? E. or 0 W. Ut_ P.M. <br /> Distance from Section Lines 1.320 Ft. from ? N. or 0 S. Line, 200 Ft. from m E. or ? W. Line. <br /> Subdivision Name Orchard Grove Subdivision Lot All or portions of Lots 3 4 5. 6.9. 10, and 22 <br /> The well is being used for the following purpose(s): See Exhibit A <br /> <br /> Water from the well was first used beneficially under this permit number, for the above described purposes on or about <br /> December 29, 2002 <br /> (Do not report a date which is before the issued date of this permit) <br /> <br /> The pumping rate claimed is 1.204 gallons per minute. (Maximum) <br /> The average annual amount of water diverted is 344.08 acre feet. (See Exhibit A) <br /> The land area irrigated (watered) by water from this well is: N/A ? Acres or ? Square Feet, described as: _ <br /> (Number) <br /> N/A <br /> or as Subdivision Lot(s) Block Filing/Unit <br /> Well constructed by: Lessee Grand Junction Concrete Pipe Co. (Gravel Pit) License No: <br /> Pump installed by: Lessee Grand Junction Concrete Pipe Co. License No: <br /> Meter Mfg. by N/A Serial No: Date Installed: <br /> I (we) claim and say that I (we) are the owner (s) of the well described above, know the contents of the statements made <br /> herein and state that the are true tom our knowledge. <br /> Please print the Signer's Name & Title Signature(s) of the owner. Date <br /> Ronald E. Tipping and Marie E. Tipping <br /> Owners <br /> April 2003 <br /> <br /> For Office Use Only <br /> State Engineer By Date