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wa.;.;S-I,5 <br />7rPE OR <br />P 'T IN BLACK INN. <br />OF ACCEPTED <br />5 ENE NT WAILED <br />~OUEST. <br />~/} 'RECEIVED ~ <br />ED <br />COLORADO DIVISION OF WATER RESOU~~E~ {g77 REC~~~ <br />300 Columbine Bldg., 1d3S 5{i'errriari'St. ' - .-~Cj <br />Denser, Colorado 80203 ~L1o <br />STATE OF COLORADO <br />COUNTY OF Las Animas ` SS <br />WSTaTECBlO~.AA,tFIDAVIT ~OP~E~xENN`~"' <br />~' <br />X AMENDMENT OF EX STING RECORpF GROUND WATER R~OE~~EO <br />LATE REGISTRATION e' 1j}t~~ <br />PERMIT NUMBER 83620 LOCATfON OF WELL F~ Up;,ES <br />WASE~ ~OINF.FR <br />*HE AFFIANT(S) Robert E. and Elaine R Hall ce~~ry Las Animas s<p c~+A <br />,hose mailing c o Rev. Joseph Saint ~ Stonewall Gap L <br />address i5 NE `/. of r6e I~Y~I 2, Srclla. _30__ <br />C,ty Westcm fnlnrarfn Rlagl r..P. 33 _~ Rey 68 ~ 6th P N <br />la~.al Ipl.l w o. 5~ ~E <br />being duly sworn upon ooth, deposes and says that he (they} is (are} the owner(s) of the well described hereon, the well is <br />located as described abose, at distances of 200 feet from the nOit}1 section line and 3392 feet from the <br />aa••. o• ,o ~~,.i <br />?Li i'- <br />- SP2 T section 4ine; water from this well was first applied to o beneficial use for the purpose(s) described herein on the l8th <br />,r.,. e. a,,~,.~ ~-:}~ a urt ~~ <br />day of~~LObeT 19 r~ the maximum sustained pumping rate of the well is ~ lb gallons per minute, the pumping <br />rclaimed hereby i ~~~~j~pllons per minute; the total depth of the well is 7_~feet; the average annual amours: <br />t ZZ-- ®s'~ <br />of water to be diverted is ~~_ acre-feet; For which claim is hereby made for HOtisehOld dv£~ Js/~~ <br /> purpose(s); the legal description of the land on which the water from this well Is used .s <br />Lot 10 Stonewall Plaza of which <br />none acres are irrigated and which is illustrated on the map on the reverse side of this form; that this well was completed in <br />compliance with the permit approved therefor; this statement of beneficial use of ground water is filed in compliance with law; he <br />(they) has (have) read the statements made hereon; knows the content thereof; and that the same are tnre of his (their) knowledge. <br />•/ ~~ OMPLETE REVERS~EI SIDE OF THIS FORM) <br />Signaturo( ~~ - L ^ V /Ya 0~/ ~/l_ 'y !/ ~ n// <br />Subscribed and sworn ~~ <br />'o before me on this 23 dos of November 19 Sb <br />My Commission expires: MaI'C}1 31'd~a.978 <br />,e. ,. ~. <br />ACCEPTED FOR FILING BY HE STATE ENGINEER OF COLORADO <br />'URSUANT TO THE FOLLOWING CONDITIONS: <br />"HE PUMPING RATE CLAIMED SHALL NOT EXCEED FIFTEEN (15) <br />GaTLONS PER MINUTE. <br />• <br />".AY 13 1977 !~~-e-6~. ~~`7~ir.H <br />+'E <br />rATE E~3INEER <br />FOR OFFICE USE ONLY <br />Cewr Ceu Ne <br />P,~o~ No. __ Day _- Y. <br />D... ~- .,.. 3 ~ <br />Sec '/.. '/. .. <br />well Use aO <br />D n,. ~ I _ Basin Non D~, <br />B, ~ <br />