2013-07-19_PERMIT FILE - C2010089A

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COLORADO DIVISION OF WATER RESOURCES Office Use Only Form GWS -45 (04/2012) DEPARTMENT OF NATURAL RESOURCES 1313 SHERMAN ST, RM 821, DENVER, CO 80203 Main 303 866 -3581 Fax: 303 866 -2223 dwr ertnrtsol)fine state co us GENERAL PURPOSE Water Well Permit Application Review Instructions on reverse side prior to completing form. The form must be computer generated, typed or In black or blue Ink. 6. Use Of Well check a licable boxes - - -- --- - -- - ... - - - - -- - - -- Name -- Name of applicant Attach a detailed description of uses applied for. Western - Fuels- Colorado, LLC ® Industrial ® Dewatering System Mailing address ❑ Municipal ❑ Geothermal (production or reinjection) P.O. Box 33424 CIb State - i Zip code ❑ irrigation ® Other (describe): Dust suppression Denver 1 CO 80233 ❑Commercial 7, Well Data (proposed) Telephone #(area code - &numoer) E- mad lent ire filing required) _____ - -'- - (303) 255-5800 _ Maxrmum pumping rate Aiinual amount tob`e withdrawn t (In combination w/ gpm 800 !See Attachment B acre -feet 2-1 Total depth Aquifer 2. Type Of Application check applicable boxes YP pp ( pp ) ® Construct new well ❑ Use existing well ❑ Replace existing well ❑ Change or increase use i 65 ❑ Change source (aquifer) ❑ Reapplication (expired permit) feet ;Bedrock/Coal 8, Land On Which Ground Water Will Be Used ❑ COGCC Well ❑ Other: Legal Description of Land (may be provided as an attachment) 3. Refer To (if applicable) Wellpetnatd - - -_ - — - watercourtcasa# - ^ - - -- West 1/2 of Section 25, Township 47 North, Range 16 West N/A N/A Designated Basin Determination if - I Woo name or #--'' of the N.M. P.M. j DW12 -2 4. Location Of Proposed Well County (If used for crop irrigation, attach a scaled map that shows irrigated area.) Montrose SW 1/4 of the SW 1/4 A. Acres -- - B. Owner _ -_.-- _ - Sedion Township Nor § Range [ or W Princpal Mardian —I 320 ' See Attachment A Ix 1 ► , 25 47 ! 16 N.M. -- — - -- — - -- - - - -)- - -- C. List any other wells or water rights used on this land Distance of well from section lines (section lines aretypically notproperty lines) Others wells and water rights operated under Case Nos. 738 Fl from N IX S 792 Ft frorr❑E EW 10CW208 and 09CW171 and related SWSPs . 9• Proposed Well Driller License # o tional : For replacement welts only- distance arid drechon from old well to new weli - - 10. Sign or Entered Name Of Applicant(s) Or Authorized Agent feet direction Well location address (Include City, State, Zip) ❑ Check if well address Is same as In Item -1 ` The making of false statements herein constitutes perjury in the second degree, which is punishable as a class 1 misdemeanor pursuant to C.R.S. 24 -4 -104 (13)(a). I have read the statements herein, know the contents thereof rid state that they are true to my knowledge. Optional GPS well location information in UTM format You must check GPS unit for Sign or i er ( of p s) sut mithng application Datee(( required settings as follows - _ - � - - -- - -_ /mm/dd/yyyy) / J Formal must be UTM i ( Zone 12 orlj I Zone 13 i Easting - If signing print name and title Units must be Meters /'1- , • _ J %t Y /��G 1L',?I- �,h,C,� , Wf Datum must be NAD83 ` Northing Office Use Only Unit must be set to true north Was GPS unit checked for above'? ❑ YES i Remember to sat Datum to NAD83 _- - - ___ - -_-- - -, - USGS map name DWR map no. Surface elev - 5. Parcel On Which Well Will Be Located (PLEASE ATTACH A CURRENT DEED FOR THE S_ UBJECT PARCEL) Receipt area only A. Legal Description (may be provided as an attachment) West 1/2 of Section 25, Township 47 North, i Range 16 West of the N.M. P.M. I i B. # of saes In parcel j C. Owner - -'- - I AOUAMAP 32.0 j See Attachment A WE - -- - -- D. Will thus be the orgy well on this parcel? © YES Mx NO (d no list other wells) wR Others wells operated under Case Nos, 10CW208 and CWCB 09CW171 and related SWSPs. TOPO E. Stale Parcel ID# (optional) MYLAR S85 DIV WD BA MD