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Form No. COLORADO DMSION OF WATER RESOURCES For Office Use only <br /> GMIS-27 DEPARTMENT OF NATURAL RESOURCE <br /> 612006 1313 Shmnan St, Rm 818, Deriver, Colmado 80203 <br /> Phone: (303) 86'f-Ml <br /> ,. REVIEW INSTRUCTIONS PRIOR TO COMPLETING FORM <br /> 'RAVEL PIT WELL PERMIT APPLICATION <br /> RECEIVED <br /> Z. D UP OF PERMIT <br /> NEW PIT(S) MAR 2 3 2011 <br /> <br /> <br />? <br />PIT(S) EXIST <br />El <br />CONSTRUCTED AFTER DEC <br />31 <br />1 <br />0 <br />URCES <br /> , <br />. <br />, <br />98 WATER RESO <br />ONEER <br />^TATEO <br /> <br />2- <br />APPLICANT INFORMATION L <br />C <br /> NAME(S) Duckels Construction, dba Yampa Aggregates <br /> Mailing Address 3500 Duckels Ct. <br /> City, St zip Steamboat Springs, CO 80487 <br /> Phone ( 970 ) 879-6072 <br /> 3. CONSULTANT/ATTORNEY/OPERATOR CONTACT (if different than #2) <br /> NAME(S) H-Bruce Humphries, Regulatory Permits Management, Inc. PIT NAME Hogue River Pit <br /> Mailing Address 7425 winter Berry r,n_ <br /> <br /> <br />2p Castle Rock, CO 80108 <br />City, <br />St I <br /> <br />DMf3 NO. M1992-066 <br /> Phone 303 854-7499 <br /> 4. GENERAL LOCATION OF Plt(S)• COUNTY Routt <br /> NW 114 Ns 1/4, Sec., 9 Twlp. 6 Li N <br />6th P <br />Range 85 ? E <br />? S <br />MW <br /> . <br />., <br />- <br />- <br />-M. <br /> 5_ Estimated maximum water surface to be MpDSed- 43.5 Acres. Number of Pits one <br /> Estimated depth of pit(s) 47 Ft Estimated depth to groundwater 3 Ft <br /> Estimated date to expOSe g=ridwater Rxisting Mi .,i ng operat . 10 complete mining 2020 <br />8. AJT?7TACIH TS-- (Clerk which have been attached.) <br /> (a) $ Scaled map of pit area with range <br />township <br />& section dearl <br />identifi <br />d <br />REQUIR <br /> , <br />, <br />y <br />e <br />( <br />ED)- <br />(b) Q Copy of the reclamation permit, if applicable. <br /> (c) Copy of pre 1/15/89 water conservancy disc or water user assoc <br />augmentation a <br />reement <br />if <br />li <br />bl <br /> g <br />. <br />, <br />app <br />ca <br />e. <br />d <br /> ( <br />) Copy of proposed subsblute water plan or augmentation plan application, if applicable. <br />F] C <br /> (e) <br />OPY of court approved augmentation plan, if applicable. Case No <br /> . <br /> (f) Other supportive material Note: No significant change to the approved DRMS reclamation pl <br />9- Detailed description of any use, other than evaporation, and method of diversion, rate of diversion <br />and annual amount of <br /> , <br />diversion of any water withdrawn from the pond. <br /> Please see attached material <br /> <br /> <br />Trans Number: 31349561 <br /> <br />11 <br />10. 1(we) have read the statements made herein and lam the contents thereof, and <br />y ( ) <br />WAV <br />)our <br />tu <br />knowledge (Pursuant to Section 24-4-104 (13)(a) C.R-S., the maldng of false sfal <br />be <br />l <br />s perjury <br />in the second degree and is punishable as a class 1 misdemeanor.] CHECK <br />Namell'itle (Please type or prime Signature <br />---F. <br /> <br />ec Arna( <br />.GO <br />Fred Duckels, President <br />c. L ?- - <br />Court Case No. Div. Co. WD Basin MD Use