Laserfiche WebLink
WRJ-S-Rev. 76 COLORADO DIVISION OF WATER RESOURCES <br /> 818 Centennial Bldg., 1313 Sherman It., Denver, Colorado 80203 <br /> TI <br /> PERMIT APPLICATION FORM <br /> Application must kJ 3_( 7 <br /> be complete where (>X) A PERMIT TO USE GROUND WATER <br /> applicable. Type or ( ) A PERPAI T TO CONSTRUCT A WELL 4 <br /> print in BLACK FOR: ( ) A PERMIT TO INSTALL A PUMP <br /> INK.Nooverstnkes WATER RM1JRCE3 <br /> or erasures unless ( ) REPLACEMENT FOR NO. STATE VIC-NUR <br /> initialed. ( ) OTHER CM-0. <br /> WATER COURT CASE NO. <br /> (1) APPLICANT - mailing address I FOR OFFICE USE ONLY: DO NOT WRITE IN THIS COLUMN <br /> NAME MID-CONTIN IT COAL, AND COIF CO?V1PANY Receipt No. / <br /> STREET P. 0. BOX 158 Basin Dist. <br /> CITY CARBONDALE, COLORADO 81623 <br /> (state) (ZIP) CONDITIONS OF APPROVAL <br /> TELEPHONE NO. (303) 963-2581 This well shall be used in such a way as to cause <br /> no material injury to existing water rights. The <br /> (2) LOCATION OF PROPOSED WELL issuance of the permit does not assure the applicant <br /> that no injury will occur to another vested water <br /> right or preclude another owner of a vested water <br /> County G.ARFTELD right from seeking relief in a civil court action. <br /> S11 Y. of the SE Section 35 <br /> Twp. 7 S. Rng. 88 W. 6th P.M. <br /> !N.S) iE,w) I <br /> (3) WATER USE AND ;^JELL DATA <br /> Proposed maximum pumping rate (gpm) 15 <br /> Average annual amount of ground water <br /> to be appropriated (acre-feet): 1.5 <br /> Number of acres to be irrigated: <br /> Proposed total depth (feet): 85 <br /> Aquifer ground water is to be obtained from: <br /> River gravels <br /> Owner's well designation No• I <br /> GROUND WATER TO BE USED FOR: <br /> ( ) HOUSEHOLD USE ONLY - no irrigate (0) <br /> ( ) DOMESTIC (1) (1) INDUSTRIAL (5) <br /> ( ) LIVESTOCK (2) ( ) IRRIGATION (6) <br /> ( ) COMMERCIAL (4) ( ) MUNICIPAL (8) <br /> ( ? OTHER (9) APPLICATION APPROVED <br /> DETAIL THE USE ON BACK IN (11) <br /> PERMIT NUMBER <br /> (4) DRILLER <br /> DATE ISSUED <br /> Name SHE LTO`T EXPIRATION DATE <br /> Street' <br /> City CARBONDALE, COLORADO 8i623 (STATE ENGINEER) <br /> (State) (Zio) <br /> 2 BY <br /> Telephone No. _ L ic_ Nn _.— _ <br />