2011-09-08_REVISION - M1984040 (4)

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ell Permit Number 73613 FF Owner's Designation CHART L cated in the 1/4, of the S /4, Section 14, Townshi HARTIER LARRY L 305 MCR 28.5 B USH CO 80723- 0 RE: DEPARTMENT OF NATURAL RESOURCES DIVISION OF WATER R ursday, June 0 TICE PIT , Range 56 W, S P.M. 3645688 73613 F Div. 1 ick Wolfe, P.E. Director /State Engineer I rector This permit to construct a II -was issued on 7/27/2010. The expiration date of the permit is 7/27/2011. In order for the permit to remain valid, certain actions must be taken by the well owner. As of this date, the Well Construction and Test Report has not been received. The Pump Installation and Test Report has not been received. Furthermore, a request for extension of the expiration date have not been received by the Division of Water Resources. This permit was approved under Section 37 -90- 137(2), Colorado Revised Statutes. The well must be constructed and the pump installed, prior to the expiration date of the permit. These reports are the responsibility of the licensed water well contractors, or the well owner if the work was performed by the owner. The Well Construction and Test Report (GWS -31) and the Pump Installation and Test Report (GWS -32) must be received by the Division of Water Resources prior to the expiration date of the permit. If pumping equipment has not been installed in the well, the well owner may request a one -time in writing by letter or on form GWS -64, General Request from Extension of Well Permit Expiration Date, a one year extension of the expiration date. The request must be received with a $60.00 (sixty dollar) filing fee prior to the expiration date and must provide a reason or reasons for not constructing the well, installing pumping equipment and why the expiration date should be extended for an additional year. The extension request and other forms are available on our website at http: // water. state.co.us /DWRDocs /Forms /Pages /FormsHome.aspx. If -the well has been constructed, - pumping equipment will not be installed by the expiration date and an - - extension of the expiration date has not been approved, the permit will expire and be of no force or effect. It will be necessary for you to obtain a new well permit by submitting a completed application for an existing well along with a $100.00 (one hundred dollar) filing fee. If the well will not be constructed, and you do not wish to pursue construction of a well, please advise us in writing in order that we may formally expire the permit without requiring additional notification from you. If the expiration date has already been extended for one year, the statute does not allow more than one extension of time. If the well construction and the pump installation reports are not received by the expiration date, the permit expires and is of no force or effect. If you have any questions, please contact any of the Division Field Office in your area, or the Ground Water Information Desk in Denver at (303) 866 -3587 between the hours of 9:00 a.m. and 4:00 p.m., Monday through Friday. Thank -you for your immediate attention. Orrice of the ate Engineer 1313 Sherman Street, Suite 818 • Denver, CO 80203 • Phone: 303 - 866 -3581 • Fax: 303 - 866 - 3589 http://water.state.co.us