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Form No. OFFICE OF THE STATE ENGINEER <br />GWS -25 COLORADO DIVISION OF WATER RESOURCES <br />818 Centennial Bldg., 1313 Sherman St., Denver, Colorado 80203 <br />(303) 866 -3581 <br />APPLICANT <br />COLORADO BOARD OF LAND COMMISSIONERS <br />PO BOX 1094 <br />CRAIG, CO 81626- <br />(970) 824 -2850 <br />PERMIT TO CONSTRUCT A WELL <br />ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT <br />CONDITIONS OF APPROVAL <br />1 ) This well shall be used in such a way as to cause no material injury to existing water rights. The issuance of this permit <br />does not ensure that no injury will occur to another vested water right or preclude another owner of a vested water right from <br />seeking relief in a civil court action. <br />2 ) The construction of this well shall be in compliance with the Water Well Construction Rules 2 CCR 402 -2, unless approval <br />of a variance has been granted by the State Board of Examiners of Water Well Construction and Pump Installation <br />Contractors in accordance with Rule 18. <br />3) Approved pursuant to CRS 37 -90- 137(2) for the construction of a well to divert ground water tributary to Grassy Creek, a <br />tributary of the Yampa River, at a point where unappropriated water is available for withdrawal. <br />4) The pumping rate of this well shall not exceed 10 GPM. <br />5) The average annual amount of ground water to be withdrawn shall not exceed 10 acre -feet. <br />6) The use of ground water from this well is limited to industrial. <br />7) The approval of this permit does not grant a water right. This well is subject to administration by the Division Engineer in <br />accordance with applicable decrees, statutes, rules, and regulations. <br />8 ) The owner shall mark the well in a conspicuous place with well permit number(s), name of the aquifer, and court case <br />number(s) as appropriate. The owner shall take necessary means and precautions to preserve these markings. <br />9 ) A totalizing flow meter must be installed on this well and maintained in good working order. Permanent records of all <br />diversions must be maintained by the well owner (recorded at least annually) and submitted to the Division Engineer upon <br />request. <br />10) This well shall be constructed not more than 200 feet from the location specified on this permit and at least 600 feet from <br />any existing well, completed in the same aquifer, that is not owned by the applicant. <br />NOTE: This well may be subject to administration in the water rights priority system in the future. It is recommended that a <br />water court decree be obtained to affirm the priority of the <br />7s9 37,0 <br />APPROVED <br />JSG <br />Receipt No. 0048913 <br />State Enginearl <br />LIC <br />WELL PERMIT NUMBER 69012 -F <br />DIV. 6 WD 57 DES. BASIN MD <br />APPROVED WELL LOCATION <br />ROUTT COUNTY <br />NE 1/4 NE 1/4 Section 3 <br />Township 5 N Range 87 W Sixth P.M. <br />DISTANCES FROM SECTION LINES <br />538 Ft. from North Section Line <br />464 Ft. from East Section Line <br />UTM COORDINATES (Meters,Zone:13,NAD83) <br />Easting: Northing: <br />By <br />DATE ISSUED 02 -23 -2010 EXPIRATION DATE 02 -23 -2011 <br />