1981-11-13_PERMIT FILE - C1981013 ‎(21)‎

• Permit No: C1981013
• IBM Index Class Name: PERMIT FILE
• Doc Date: 11/13/1981
• Doc Name: Water Well Information
• Section_Exhibit Name: Volume 2 Exhibit 8
• Media Type: D
• Archive: No

i
wa1 1% 70! STATE OF COLM.A"01
tndree Nn = IJ 4 4_ DIVISION OF WATER RF:'f;trtGFS w, 1
IDWD _ OFFICE OF Ttfv STATE ENGINEER
reeld_._ _ MAP AND S1ATEMkr4T FOR WA"ER WELL FILING N ��vt
Checked By
— - _- --- PtRMiT NUMBER
STATE OF COLORADO I SS WG i L L(WATIO�yl35
CLAIMANTIsI /♦ ��_l2-!_h �,�' '!rf1P �.G —tit —_ ------- -
1s1 _ . ice-'
being duly sworn won oath dopo.r5 and says that h, ;they) i•, (ar( I -
r
the owner (s) of the well described hereon, the total euril)vr of acre,
J J � y * l
of land irrigated from this well is_L_L=�
work was commenced on this well by actual c(nstructiun on thta INDICATE WELL LOCATIOrJ ON t, ,.aRA,,i
—day of •Lr i. —19-V. the SLI't,WINl NORTH -- --
((J/ —j—
'�� I� I I
yield from said well is�_gpm, for which claim Is hereby made
i I
for purpose (s); ---�— — I --- ;
I t
the average annual amount to be diverted is to __ I D T ;
- - r ---
acre-feet; this map and statement is filed in compliance with law;
he(they) has (haves read the statements made hereon; knows the l ( 1
content thereof; and that the same are true of his (their) own
knowledge. I I
Signature (s)
G'
SOUTH y
Address: _�h
r r•�t_t.� �t e,_�� j^� f D,,C, WELL SHALL BE L0,CATED WITH REFERENCE TO `
GOVERNMENT SURD,EY CORNERS OR MONUf'•ENTS,
Subscribed and sworn to before me on this— day OR SECTION LINES BY Di"ANCE AND
�L l
of ��. _i Gs *}c << 19 ft. from _s ction line. I
(North or SoLth)
My Commission expires: l
yft. from section line.
L/OF +-,% �.. .s�cc if/ (East or West)
Notary Public
Ground Water Basin,_"t_-4'-V t- t r-,& If< '
WELL DATA Water Management
District
Date Completed �tF� Z Domestic wells may he located by the following: s
Static Water Level_C� LOT , E1.00K f
Total Depth of Well SUBDIVISION
FILING a h1c
r
ACCEPTED FOR FILING IN THE OFFICE OF THE STATE ENGINEER OF COLORADO ON THIS ____DAY
i
OF 19 STATE FNGI"JEER
FORM TO BE k.ADE OUT IN OUADRUPLICATE: WHITE FORM must be an original copy on boat aides and:signed. �
WHITE AND GRftH tepees mmil be filed with t!*.a Snits Engineer within 30 sears after tt=s well is ca r-Ir"d ar with;n 7 days
after expiration date of the pw-mit,whichever is sooner,PINK COPY is for the OWTW 7--d YELLOW Cv^Y Is Pw the 0-.111eK.
at .v,r.di�i.'.udaa�,.YfJrowYy."�ui..e..-•w..�.ait.+, :`tea.....u..1w:.. ..,,_an..,. .u. ...-,...�nd4..r.,u,k...ava.w,".a.wJs'�lfa...n.a.r..h.x..v- --.+uc_., j
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