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Form No. <br />GWS-27 <br />5/2011 <br />COLORADO DIVISION OF WATER RESOURCES <br />DEPARTMENT OF NATURAL RESOURCES <br />1313 Sherman St., Room 821, Denver, Colorado 80203 <br />Phone: (303) 866 -3581 Fax: (303) 866- 3589 <br />For Office Use only <br />REVIEW INSTRUCTIONS PRIOR TO COMPLETING FORM <br />GRAVEL PIT WELL PERMIT APPLICATION <br />1. <br />TYPE OF PERMIT <br />X <br />X <br />NEW PIT(S) <br />PIT(S) EXIST, CONSTRUCTED AFTER DEC. 31, 1980 <br />2. <br />APPLICANT INFORMATION <br />NAME(S) Transit Mix of Pueblo <br />Mailing Address 444 E Costilla St. <br />City, St. Zip Colorado Srpings, CO 80903 <br />Phone ( 71 9 ) 475 -0700 <br />3 . <br />CONSULTANT /ATTORNEY /OPERATOR CONTACT (If different than #2) <br />PIT NAME Pueblo East P: <br />NAME(S) Bishop Brogden Associates, Inc. <br />Mailing Address 333 W. Hampden Ave., #1050 <br />DMG NO. M -1986 -015 <br />City, St. Zip Englewood, CO 801 10 <br />• <br />Phone ( 303 ) 806 -8952 <br />4. <br />GENERAL LOCATION OF PIT(S': COUNTY Pueblo <br />see Attachment <br />1/4 1/4, Sec. Twp. <br />— <br />._ <br />N. <br />S., Range _J E. ❑ W. P.M. <br />5. <br />Estimated maximum water surface to be exposed: 13.3 Acres. Number of Pits 3 . <br />6. <br />Estimated depth of pit(s) 37 Ft. Estimated depth to groundwater 1 Q Ft. <br />7. <br />Estimated date to expose groundwater February 1 , 201 2 ; to complete mining December 31 , 2015 <br />8. <br />ATTACHMENTS: (Check which have been attached.) <br />(a) <br />(b) C <br />(c) ❑ <br />(d) ❑ <br />(e) ❑ <br />Scaled map of pit area with range, township, & section clearly identified (REQUIRED). <br />Copy of the reclamation permit, if applicable. <br />Copy of pre 1/15/89 water conservancy dist. or water user assoc. augmentation agreement, if applicable. <br />Copy of proposed substitute water plan or augmentation plan application, if applicable. <br />Copy of court approved augmentation plan, if applicable. Case No. <br />(f) . ❑ Other <br />9. <br />Detailed description of any use, other than evaporation, and method of diversion, rate of diversion, and annual amou <br />diversion of any water withdrawn from the pond. <br />See Attachment 1 <br />10. <br />I (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 />„ Waul Bruss <br />Water Resource Engineer. <br />Signature <br />P4-".( 7 ..g <br />Date <br />t t'aal ( <br />Court Case No <br />Div. Co. _ WD Basin MD Use <br />