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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 />303 886 3581 <br />APPLICANT <br />LR <br />WELL PERMIT NUMBER 295950 _ <br />DIV. 2 WD 15 DES. BASIN MD <br />Lot: 29 &30 Block: Filing- Subdw: STATE ADDITION TO RYE <br />APPROVED WELL LOCATION <br />PUEBLO COUNTY <br />SW 1/4 NE 114 Section 36 <br />ERNESTINA E COKER Township 24 S Range 68 W Sixth P.M. <br />2615 ROXANNE CT DISTANCES FROM SECTION LINES <br />COLORADO SPRINGS, CO 80922- 2081 Ft. from North Section Line <br />2107 Ft. from East Section Line <br />(719) 214 -4694 <br />UTM COORDINATES (Meters.Zone:13.NAD83) <br />KLU151KATION OF EXISTING WELL vv�vvv 11"111111:1• T' °VV'° <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) Construction details for this existing well have not been provided to this office; therefore, it is not known if the construction <br />of this well is in compliance with the Water Well Construction Rules, 2 CCR 402 -2. The issuance of this permit does not <br />relieve the well owner of responsibility or liability in the event contamination of the groundwater source results from the <br />construction or use of this well, nor does the State Engineer assume any responsibility or liability should contamination <br />occur. <br />3) This well is recorded and permit approved in accordance with CRS 37 -92- 602(5) for historical use as indicated herein <br />and described in CRS 37- 92- 602(1)(b), being a well producing 15 GPM and used for ordinary household purposes inside 1 <br />single family dwelling. <br />4) The date of first beneficial use, as claimed by the applicant, is January 1, 1963. <br />NOTICE: This permit has been approved for a change to the well location. The distances from section lines have been <br />adjusted to place the well on the applicant's parcel. You are hereby notified that you have the right to appeal the issuance of <br />this permft, by filing a written request with this office within sixty (60) days of the date of issuance, pursuant to the State <br />Administrative Procedures Act. (See Section 24 -4-104 through 106, C.R.S.) <br />NOTE: The uses identified in condition #3 above are based on the Applicant's written claim regarding the historical use of <br />this well prior to May 8, 1972. These uses have not been verified or confirmed by field inspection from DWR staff. Any <br />expanded use of this well occurring on or after May 8, 1972, or any use that had been abandoned by 10 or more <br />consecutive years of non -use, shall not be covered by this permit. <br />VAX! "0' <br />APPROVED <br />SMJ <br />State Engineer By <br />DATE ISSUED 10 -10 -2014 EXPIRATI <br />