HomeMy WebLinkAbout20122332.tiff 'Project No. 564-51. 1
' January 3, 1966
ACTIVE TAPS
1
73N27267
TAP FEE AGREEMENT
THIS AGREEMENT, made and entered into this /3>,/ day of-W9../ ,196-e
by and between the CENTRAL WELD COUNTY WATER DISTRICT, hereinafter called
the first party, and7F.4.,✓..,i.,iK-r CCas2wc. and ,hereinafter
called second parties, WITNESSETH:
WHEREAS, first party has beenorganized as a legal body and is known as the
Central Weld County Water District, and
WHEREAS, second parties are taxpaying electors within said District, or
desiring to join said District, and
WHEREAS, second parties are desirous of purchasing / _water taps
of / inches in diameter from the said District,
NOW, THEREFORE, in consideration of the premises and the terms of this
agreement, it is mutually agreed as follows:
Sa°'`L
1. Second parties agree to pay the sum of $ arc,'-`t' as follows: $/s2i °
upon execution of this agreement and the balance of $ — '/0°°f
TN6 TiC ecw.v o✓ /5 ,r4JOG
2. In the event second parties desire to sell the water tap or taps purchased
from the District, they hereby agree to give the District first option to repurchase
said taps, at the tap price paid to the District when said taps were originally purchased
from the District.
3. In the event it is not economically feasible to extend the water to the pro-
perty line of second parties, which matter is in the entire discretion of first party,
then all sums paid hereunder shall be returned to second parties and the agreement
shall be null and void.
4. The description of the premises for which these taps are being purchased
is as follows: G
,'sr Src x r,z r 7
5. This agreement, when approved by the Board of Directors, shall become
a legal and binding contract upon all parties hereto.
6. Second parties further agree to execute any and all easements needed by
first party at no expense to first party, across second parties' property for the pur-
pose of installing any pipelines constructed by first party.
7. It is further mutually agreed that this agreement shall extend to and be
binding upon the heirs, executors, administrators and assigns of the parties hereto.
IN WITNESS WHEREOF, the parties hereto have hereunto and hereunder
set their signatures the day and year first hereinabove written.
CENTRAL WELD COUNTY WATER DIST.
BY „Is
ATTEST ,/_ el/7
(Second Parties)
a'
(13
st
WJR.26-77 ,
1 COLORADO DIVISION OF WATER RESOURCES ' RECEIVED
THIS FORM MCAT BE SUBMITTED 1313 Sherman Street • Room 818 - , w
WITHIN 60 DAYSp F COMPLETION Denver, Colorado 80203
OF THE WORK,DISCRI BED HERE- .JUL 17198}` •
ON.TYPE 9WCPRINT IN BLACK WELL COMPLETION AND PUMP INSTALLATION REPORT INK• PERMIT NUMBER 23191-F Warne
_ • grin maw
COW WELL OWNER Street Turkey Farms (Premium) SW b of the NE x of Sec._ 22 g
1O848 Weld County Road #19 �
ADDRESS t. Lupton, Colorado 80621 T. 2 14 R. 67 W 6th P.M.
DATE COMPLETED March 30 . 19°S HOLE DIAMETER
WELL LOG ...10_•_in.from 0 to 516 ft_
• Water
From To Type and Color of Material Loc. — in.from to ft.
in.from . to ft
0 4 overburden DRILLING METHOD Rotary
4 8 decomposed gravel CASING RECORD: Plain Casing
8 15 sandy clay
15 20 gravel, large rock Sizeb 31.8"& kind steel from Q to 150 ft.
20 50 brown clay • ,
50 120 gray shale Size & kind _from_ _. ._to ft.
120 262 brown, gray, landing of coal
262 265 hardpan Size . _.. & kind_.__._.:..—from _ to ft.
265 ' 317 dawson
317 320 hardpan, dawson •
Perforated Casing
320 405 dawson
405 512 fox hill Size 6 5 8& kind steel from 330 to 516 ft.
512 516 gray shale
Size & kind _from to ft.
Size & kind • • • from to ' ft.
GROUTING RECORD
. Material
•
Intervals_T., -
Placement Method .
GRAVEL PACK: Size 3/8" pea gravel
Interval 350'-516'
TEST DATA
Date Tested March 30 19 81
•
Static Water Level Prior to Test 100 ft.
Type of Test Pump - ball
Length of Test 4hrs
Sustained Yield (Metered) 17g
TOTAL DEPTH 516' tsm
Use additional pages necessary to complete log. Final Pumping Water Level 200'
1 A
PUMP INSTALLATION REPORT ^a^•'.
Vtt .-,A
.a
Pump Make Jacuzzi j1. ty'.,
t
;:;,e : i� 1�
Type Submersible ?1`
• • `\
.e+- e— -` `
Powered by Electric HP 5
A
Pump Serial No. _
to •WATER
•Motor Serial No. �> TABLE
ti:; W Fw
Date Installeo _ May 6, 1981 w.,
cc an
Pump Intake Depth _490' r ' _
e
Remarks
• .� a z
f. .. x
. - �. -a _ _ r.' _ .._
• a
W `• ' : :S
• Z t • ' •
i-
WELL TEST DATA WITH PERMANENT PUMP a • 4
O (,
Date Tested May 6, 1981 _i z •s, ,' , _co, of
s w a .'E . DEPRESSION
Static Water Level Prior to Test _ .10r g w
.
Length of Test 10 Hours
Sustained yield (Metered) 20 GPM
Pumping Water Level 440' t.
''
Remarks
r t
ara
it
CONTRACTORS STATEMENT • . i
The undersigned,bei • duly sw n up th, deposes and says that he is the contractor of the well or
pump installation . •ri d h on; at e has read the statement made hereon; knows the content
thereof,and that e e is u of I is n kno dge.
Signature ._... . ._,. License No. #267
State of Colorado, Count of Adams SS
Subscribed and sworn to betore me this..iS day of lot,/ , is Eli.
My Commission ii•esi' , 19 a5.
Notary Public
FORM TO BE MADE OUT IN QUADRUPLICATE: WHITE FORM must be an original copy on both sides and signed.
WHITE AND GREEN copies must be filed with the State Engineer.PINK COPY is for the Owner and YELLOW COPY is for the Driller.
d
A
er 1
-
WRJ-5-Rev. 76 COLORADO DIVISION OF WATER RESOURCES
818 Centennial Bldg., 1313 Sherman St., Denver, Colorado 80203 pp
PERMIT APPLICATION FORM nECEwED 23N
Application must JAN 2 71981
be complete where I X) A PERMIT TO USE GROUND WATER
applicable. Type or ( X) A PERMIT TO CONSTRUCT A WELL i glva RE3tRC4S
• print in BLACK FOR: (X) A PERMIT TO INSTALL A PUMP SitC ENGINES'
0(1?
'
INK.No overstrikes
or erasures unless ( X) REPLACEMENT FOR NO.
initialed. ( ) OTHER
WATER COURT CASE NO. s02p
(1) APPLICANT• mailing address FOR OFFICE USE ONLY: DO NOT WRITE IN THIS COLUMN
// 7// / -Q/c: 14 TV y ,
" ,c
NAME Strear Parma Receipt No. / 2. -6. (,e.:. j;i?,ze vY3 a
STREET 6825 East Tennessee Room 235 Basin Disc.
CITY Denver Colorado 80224
(State) (zip) CONDITIONS OF APPROVAL
•
TELEPHONE NO. 1-7E5-2488 This well shall be used in such a way as to cause
no material injury to existing water rights. The
(2) LOCATION OF PROPOSED WELL issuance of the permit does not assure the applicant
that no injury will occur to another vested water
right or preclude another owner of a vested water
county Weld right from seeking relief in a civil court action.
S17 'hofthe NE Section 22 1 ) PRODUCTION FROM THIS WELL SHALL BE RESTRICTED
TO THE INTERVAL BETWEEN 320 FEET AND 490 FEET
Twp 2 N Rng 67 W 6th P.M. BELOW GROUND SURFACE WHICH CORRESPONDS TO THE
mi.si :E.vo FOX HILLS AQUIFER. PLAIN CASING SHALL BE PROPERLY
(3) WATER USE AND WELL DATA SEALED TO PREVENT PRODUCTION FROM OTHER ZONES.
2) AVERAGE ANNUAL APPROPRIATION FROM THIS WELL
20 SHALL NOT EXCEED 18.0 ACRE-FEET FOR LIVESTOCK AND I
Proposed maximum pumping rate Igpm) COMMERCIAL PURPOSES.
Average annual amount of ground water 3) TOTALIZING FLOW METER MUST BE INSTALLED ON THE
to be appropriated (acre-feet): 18 DISCHARGE OF THIS WELL WHEN THE WATER IS PUT TO
USE. DIVERSION RECORDS SHALL BE SUBMITTED UPON
Number of acres to be irrigated: 0 REQUEST AND AS REQUIRED TO THE DIVISION OF WATER
Proposed total depth (fee 480 RESOURCES.
t): •n) PURSUANT TO 1973 C.R.S. , 37-90-137(13) , THE
Aquifer ground water is to be obtained from: - - EXISTING WELL MUST BE ABANDONED WITH THE
Arapahoe ICOMPLETION OF THE NEW WELL, AND PLUGGED ACCORD- '
IMG TO RULES AND REGULATIONS FOR WATER WELL AND
Owner's well designation !PUMP. :INSTALLATION CONTRACTORS. THE ENCLOSED
GROUND WATER TO BE USED FOR: AFFIDAVIT IIUSTBEBE SUBMITTED WITHIN 60 DAYS OF
;COMPLETION OF .THE NEW WELL, TO AFFIRM PLUGGING
( ) HOUSEHOLD USE ONLY - no irrigation (0) OF THE OLD WELL.. ? 21'z/et
( I DOMESTIC (11 ( ) INDUSTRIAL (5) •
(X) LIVESTOCK (2) ( ) IRRIGATION (6) •
( X) COMMERCIAL (41 I ) MUNICIPAL lel
•
( ) OTHER (9) APPLICATION APPROVED
DETAIL THE USE ON BACK IN (1 1) aliati
PERMIT NUMBER(4) DRILLER DATE ISSUED I-Lr rU�" 13 1901- "‘
•
Name Boma reto Pump 6, Equipment Company EXPIRATION ATE FEB 13 1982
Street 5511 North Washington Street j /J (Q „
City Denver Colorado 80216 (STATE GINEER)
(state) (7,01 " jw''�"�/`/ ,Q 'E
Telephone No. 534-1351 267 gV �'`
Lic. No. / 1-
I.D. / -' 0 .2. COUNTY 6 2•
_. .
- . s. .
.
(5) THE LOCATION OF THE PROPOSED WELL and the area on (6)THE WELL MUST BE LOCATED BELOW
which the water will be used must be Indicated on the diagram below. by distances from section lines. •
Use'the'CENTER SECTION (1 section. 640 acres)for the well location.
+ — + — --- — ± — —I-— _i_ _ -i- — —E _ + 1890 _ft.from (nwttnn or scum) _sec.line
1-4-,----I MILE,6280 FEET--tl I 1950 ft.from eat
sec.line
least or west)
+ + -v -F -I- -1- + -P
LOT BLOCK FILING x
I I i I
+ — 4 - i NORTH SECTION LINE — — SUBDIVISION
1.
I (7) TRACT ON WHICH WELL WILL BE
LOCATED Owner.Struar Pares
NORTH
'�' + Is
— + — x +___ m + + No.of acres 105 . Will this be
I I •
• F I m .the only well on this tract? Yee
+ w 1 0 4. - + (8),PROPOSED CASING PROGRAM
I a I r I Plain Casing . . ..
+ 3 - -.1-. _ + _ Z + f 6 5/8" in.from . " -0'7- ft.to 250 ft.
I I 1 in.from ft.to ft.
— 'i- SOUTH SE ON LINE
I I — + — 4 Perforated casing
I 8..
I 6 in.Nom 250 ft.to 480 ft
•
+ + 1 t •-I- -I- 4 . -I- + . in.from ft.to h.
I I I I I . (9) FOR REPLACEMENT WELLS givedistance
and direction from old well and plans for plugging
-I- — -I- - F" — -I- + — — 4- — -I- — -- it:
The scale of the diagram is 2 inches= 1 mile 40• northwest
Each small square represents 40 acres.
WATER EQUIVALENTS TABLE (Rounded Figures)
An acre-toot covers 1 acre of land 1 foot deep •
. 1 cubic toot per second ids)...449 gallons per minute[gam) •
A family of 5 will require approximately 1 acre•foot of water par year.
1 acre-foot...43.550 cubic feet...325,900 gallons.
1.000 apm pumped continuously for one day produces 4.42 acre-feet.
(10) LAND ON WHICH GROUND WATER WILL BE USED: • . -
•
Owndris): Strear Parma No.of acres: 105
Legal description: SW3 of the I a no 22, fwp 2N, rng 67W, 6th PM Weld county
(11) QETAILED DESCRIPTION of the use of ground water: Household use and domestic wells must indicate type of disposal -
system to be used. 3,-.))ovo . .
Turkey Para water for animals and necessary for sanitary use
•
(12) OTHER WATER RlfHtS used on this land, including wells. Give Registration and Water Court Case Numbers.
Type or right Used for(purpose) Description of land on which used
none
(13)THE APPLICANT(S) STATE(S) THAT THE INFORMATION SET FORTH HEREON IS
TRUE TO THE B T OF HIS KNOWLEDGE.
.
SIGNATURE OF PPLICANTfSJ
Use additional sheets of paper if more space is required.
r ,
WRJ•25uj5
• RECEIVED
COLORADO DIVISION OF WATER RESOURCES
TMPE OR . 818 Centennial Bldg., 1313 Sherman St. JAN 2 71981
PRINT IN BLACK IRK
COPY OF ACCEPTED Denver, Colorado 80203 BM RESOURCES
STATEMENT MAILED net :;:
ON REQUEST. STATE OF COLORADO rr AFFIDAVIx"
} SS.
COUNTY OF 111
STATEMENT OF BENEFICIAL USE OF GROUND WATER
AMENDMENT OF EXISTING RECORD
X _ LATE REGISTRATION
PERMIT NUMBER LOCATION OF WELL
THE AFFIANT(S) Street Farms county Weld
whose moiling
address is 6825 Last Tennessee Room 235 SW Y.of the NE Y, Section 22
City Denver _, ....Colorado 80224 T.p. 2 N Rng ,.67 W 6 P „
tsysnl MP,
being Ir oe Wl'
being duly sworn upon oath, deposes and says that he (they) is (ore) the owner(s) of the well described hereon; the well is
located as described above, at distances of 1650 feet from the north section line and 1850 feet from the
Wo.tn u, iOu,,.i
east section line; water from this wc(I was first applied to a beneficial use for the purpose(s) described herein on the —
tr •a. en•i
•
day of Septeetber , 19. 64 ; the maximum sustained pumping rote of the well is• 20 gallons per minute, the pumping
rate claimed hereby is , 20 gallons per minute; the total depth of the well is 360 feet; the average annual amount
of water to be diverted is 18 acre-feet; for which claim is hereby made for livestock
purpose(s); the legal description of the land on which.the water from this well is used is
. of the NEt, sec 22, twp 2N, rng 67W, 6th W Weld county .. _of which
105 acres are irrigated and which is illustrated on the map on the reverse side of this form; that this well waseompleted in
compliance with the permit approved therefor; this statement of beneficial use of ground water is filed in compliance with law; he
(they) has (have) read the statements made hereon; knows the content thereof; and that the same are true of his (their) knowledge.
c A2„OMPLETE REVERSE SIDE OF THIS FORM)
• Signature�fs "'l�`--m�-"-r—�.-e � �C cltn ' 1 l l/I •
Subscribed.and sworn. Yfs FOR OFFICE USE ONLY
to before me anTihii 77 ay of SAfJUAer , 19,1
-^^r Court Case No. ,
My Commission=ex
Marti •�/��a•�r(\{/{�). - Prier.
• • .Otat cue Llr Div. i! Cty.
ACCEPTED FOR FILING BY THE STATE ENGINEER OF COLORADO
PURSUANT TO THE FOLLOWING CONDITIONS:
•
Well Use
Ont ii ti._ Bas,n Man. D.s. ,
•
•
DATE MATE ENGINEER —. --- . BY �� --
- • .-
I
Well drilled by Lic. No.
Permanent
Pump installed by Lic. No.
Meter Serial No. ❑ Flow Meter Date Installed
Owner of land on which
water is being used
THE LOCATION OF THE WELL MUST BE SHOWN AND FOR LARGE CAPACITY IRRIGATION WELLS THE
AREA ON WHICH THE WATER IS USED MUST BE SHADED OR CROSS-HATCHED ON THE DIAGRAM BELOW.
This diagram represents nine (9) sections. Use the CENTER SQUARE
(one section) to indicate the location of the well, if possible.
I I I 1 1 • I
. — +. — + - + — . .,.. + . ' +
•
I I 1 4 I I
— + — + — -I- - + -- + - + _ . .
I I NORTH SECTION LIME I I
NORTH
as
-- + . . . + It __.._ — �. + _
m
I
I o r u 1 I law tie
vi 0
SOUTH, SECT IOM l 11 E I I .
— + — + — + — + — + :.{
t
THE SCALE OF THE DIAGRAM IS TWO INCHES E 7UALS ONE,-M!l E ,;.+ " ;=�I .l •
.
— + •— + — —}- — -r a}=. . . .. +. - isee.:
•
i L �1II' I�'I I i
i(
WATER EQUIVALENTS TABLE (Rounded Figures)
An ocre-foot covers 1 acre of land 1 foot deep.
1 cubic foot per second (cfs) . . . 449 gallons per minute(gpm).
1 acre-foot . . . 43,560 cubic feet . . . 325,900 gallons.
1,000 gpm pumped continuously for one day produces 4,42 acre-feet.
100 gpm pumped continuously for one year produces 160 acre-feet.
(WHITE AND PINK COPY TO BE FILED WITH THE STATE ENGINEER
• PINK COPY WILL BE RETURNED TO OWNER)
WRJ.75-Z5.C1 RECEIVED
COLORADO DIVISION OF WATER RESOURCES �l��vf:.IVED
YPE OR 818 Centennial Bldg., 1313 Sherman St.
PRINT IN 1st ACK ref-.
COPY OF ACCEPTED Denver, Colorado 80203 APR 20 12
STATEMENT MAILED
ON REQUEST. STATE OF COLORADO / AFFIDA
I' SS. Mt MOD
COUNTY OF —..,._ 1
t STATEMENT OF BENEFICIAL USE OF GROUND WATER
- AMENDMENT OF EXISTING RECORD
- LATE REGISTRATION
PERMIT NUMBER 25191-P LOCATION OF WELL
!HE AFFIANT(S) _.Stria rot County lets
whose mailing
address is 10548 We14 County Road 419 _.- -_ SW y.of the ... . ., , ,,an 22
- City Pt. lmploe, . Colorado 80691 _.. flop 2 N . Rag. 67 _ .. • 6th phi
rp..rr) .N on sr IF as ;4
being duly sworn upon oath, deposes and says that 'he (they) is (are) the owner(s) of the well described hereon, the well is
located os described above, at distances of 1690 feet from the north section line and _„ 9150 _ feet from the
woe,.as wvr•,
nest section line; water fron, this well was first applied to a beneficial use for the purpose(s) described herein on the 6_
. .s•Ce nil',
day of !fay , 19.81.; the maximum sustained pumping rate of the well is 17 gallons per minute, the pumping
rate claimed hereby is - 17 gallons per minute; the total depth of the well is 516 feet; the overage annual amount
of water to be diverted is 18 acre-feet; for which claim is hereby made for livestock atmdagreial
purpose(s); the legal description of the land on which the water from this well is used is
SYk or the fit. section 22. tom 20. rug 67W. 6th ---------__-- of which
0 acres are irrigated and which is illustrated on the map on the reverse side of this form; that this well was completed in
compliance with the permit approved therefor; this statement of beneficial use of ground water is filed in compliance with law; he
(they) has (have) read the statements made hereon; knows the content thereof; and that the some are true of his (their) knowledge.
(COMPLETE REVERSE SIDE OF THIS FORM)
Signoturefs)..=_ - - r - -•
Sub scribed.oed:fworri I n FOR OFFICE USE ONLY
to before me-on Thi .�-`✓s.' day of ��r' , 19 7.7,
1 . . Court Case No.
• S- /98.51
My Cemmrstmon expires:- _
':- r ; Prior. Mo __ Y Dv Yr.
y� C'o�a> J ... .
•ae.,c Div. C,Y.
ACCER,ItEiXOR'FertGBY THE STATE ENGINEER OF COLORADO
PURSUAWT:10.THE FOLLOWING CONDITIONS: Sec - •
Disc _ Basin Basin Moo D.s
•
C -
DAIE STATE ENSiNEER BY
. : I
b—
•
E. ..
Well drilled by Lic. No.
Permanent
Pump installed by Lic. No.
Meter Serial No. .— O Flow Meter Dote Installed
Owner of land on which
water is being used •
THE LOCATION OF THE WELL MUST BE SHOWN AND FOR LARGE CAPACITY IRRIGATION WELLS THE
AREA ON WHICH THE WATER IS USED MUST BE SHADED OR CROSS-HATCHED ON THE DIAGRAM BELOW.
This diagram represents nine (9) sections. Use the CENTER SQUARE
(one section) to indicate the location of the well, if possible.
I I 1 I 1 I
— +. — } — — — -I-
I I I I I i--
F + —
NORTH SECTION LIME I
NORTH
-- -z + — -F -
rn J
m a
1I n o I r
z
- + -- I m, -a + -- -I- -
W
SOU* 5EC1ION LII4E I I
- -F - +- . - + ..- + +
. THE SCALE OF THE DIAGRAM IS TWO INCHES E]UALS ONE-MILE • - -
- _
: :-
WATER EQUIVALENTS TABLE (Rounded Figures)
An acre-foot covers 1 acre of land 1 foot deep.
1 cubic foot per second (cfs) . . . 449 gallons per minute(gpm).
1 acre-foot . . . 43,560 cubic feet . . 325,900 gallons.
1,000 gpm pumped continuously for one day produces 4.42 acre-feet.
100 gpm pumped continuously for one year produces 160 acre-feet.
(WHITE AND PINK COPY TO BE FILED WITH THE STATE ENGINEER
PINK COPY WILL BE RETURNED TO OWNER)
WRJ•25.7a`
•• •• �° COLORADO DIVISION OF WATER RESOURCES
TYPE OR V 818 Centennial Bldg., 1313 Sherman St.
PRINT IN atAtcor C'.
COPY OF ACCEPTED Denver, Colorado 80203
STATEMENT MAILED
ON REQUEST. STATE OF COLORADO —� AFFI Ding 0182
SS.
COUNTY OF __ .._ • WNfiit n l=
•
j_ STATEMENT OF BENEFICIAL USE OF GROUND WATER
AMENDMENT OF EXISTING RECORD
LATE REGISTRATION
PERMIT NUMBER 25191_,F LOCATION OF WELL •
THE AFFIANT(S) ,Strfilsri _,_,___-__. County_, .Weld
whose mailing — — —
address is 10848 Well Cattail—taut s#19 .__ SW ,. PI the NE Y. swim.
City Rte Lupton, Qnlersrin ROSl1 T.PP. ...2 .. N--1 1, Rng. - 6Z-- TSi At h- P M ,
Is'url lilsl IN aN 9 <P M1
being duly sworn upon oath, deposes and says that he (they) is (are) the owner(s) of the well described hereon; the well is
located as described above, at distances of ..i5fl._,__ feet from the _myth_section line and 1050 feet from the
I.,OP!.OP •Ov.1
_east_section line; water from this well was first applied to o beneficial use for the purpose(s) described herein on the _6_
day of MaY , 19 81. ; the maximum sustained pumping rate of the well is _17—gallons per minute, the pumping
rate claimed hereby is 17 gallons per minute; the total depth of the well is ,.-_515 feet; the overage annual amount
of water to be diverted,is• 1R acre-feet; 'for which claim is hereby made for 11Y-stack Fuldatrc1a1
purpose(s); the legal description of the land on which the water from this well is used is
g a ttt. w4, eeetion 2t. tip 2W1 mg 67W. 6th 114 of which
O acres ore irrigated and which is illustrated on the map on the reverse side of this form; that this well was completed in
compliance with the permit approved therefor; this statement of beneficial use of ground water is filed in compliance with low; he
(they) has (have) read the statements made hereon; knows the content thereof; and that the some ore true of his (their) knowledge.
(' ' (COMPLETE REVERSE SIDE OF THIS FORM)
$ignatur •
E, �-
Subscribed and MOM n FOR OFFICE USE ONLY
to.beTdre1'me own this _ day of fer , 19 .
• �, _ Cov.l Cot. No.
..-- �.(.�_ � 5" /9rs
My,CAmm1'suaei-eX@ires
��1er.•1 ,• / Prior. Me._Day—Yr.
e ^ Y
NOTARY I.u.41u Div. Cly,
ACCEPTED FOR FILING BY THE STATE ENGINEER OF COLORADO
PURSUANT TO THE FOLLOWING CONDITIONS: saa. !•. ._.. .. n. R.
w.N
Diet. __ Bann M.,,. Dn
4e
DATE • 51ATF ENGINEER ' BY
1
.1 PP
a.
. Well drilled by Lic. No.
y
Permanent
Pump installed by — Lic. No.
Meter Serial No. __ O Flew Meter Data Installed
Owner of land on which
water is being used
THE LOCATION OF THE WELL MUST BE SHOWN AND FOR LARGE CAPACITY IRRIGATION WELLS THE
AREA ON WHICH THE WATER IS USED MUST BE SHADED OR CROSS-HATCHED ON THE DIAGRAM BELOW.
This diagiom represents 'tale(9) sections. Use the CENTER SQUARE
(one section) to indicate the location of the well, if possible.
I I I —� I I .
— + — + — 1- — + — + — + —
_ .. '. . .. . ... _ _ .. l .. _._ ..u-
I I -- 1I I I I
•
— + — + + —_
NORTH SECTION LINE I
•
NORTH
m
I I n o r
I ii-
-
' 2•
r a .
- + — + m -- --- + _ T —
SOUTH SECS ION LWEE I 1
+ — • + — . + — + — - + — •+; — -
v
1 I i - 1 : ' -_' -
THE SCALE OF THE DIAGRAM IS TWO INCHES E2UALS ONE-MILE .~ — - #:c
— T 1 — + — - — + + — -(`_ J`---•_ - + , -�
I I '11 M i l e�-
WATER EQUIVALENTS TABLE (Rounded Figures)
An oere•foot covers 1 acre of land 1 foot deep.
1 cubic foot per second (cfs) . . . 449 gallons per minute (gpm).
1 acre-foot . . . 43,560 cubic feet . . . 325,900 gallons.
1,000 gpm pumped continuously for one day produces 4.42 acre-feet.
100 gpm pumped continuously for one year produces 160 °ere-feet.
(WHITE AND PINK COPY TO BE FILED WITH THE STATE ENGINEER✓• .
PINK COPY WILL BE RETURNED TO OWNER)
STATE OF COLORADO RECEIVED
' DIVISION OF WATER RESOURCES FEB 0 6 1981
ma Moue=
STATE OF COLORADO ) EWE eneeEP
cots
SS AFFIDAVIT
COUNTY OF )
The affiant(s) Strear Farms Co., Ina. (Premium Turkey Perm) whose
mailing address is 682) E. Tennessee Rm. 235 , Denver
(itreet) (city)
Colorado , 80224 , being duly sworn upon oath
(state) (zip code)
'deposes and says that he is the owner of the following described property
situate in the County of Weld , State of
Colorado: (insert legal description or attach hereto]
•
SW% of the NE}, section 22, tvp. 2N, rng 67W, 6th PM u'
NE%, sec 22, top. 2N, reg. 67W, except E $601 _04 5 1210' except 006.1E
SE%, sec 22., top. 2N, rng. 67W 32':
Further, the affiant(s) deposes and says that he has read the statements
made herein; knows the contents hereof; and that the same are true of his
own knowledge.
. Subscribed and sworn to before me this . 4014% day of imi _.=L9Qi�.
My Commission expires: i /t�1 /e3 r,; '=_ ,
Notary�ubl1 c
g
Accepted this day of , 19
• State Engineer
GW-10-75
OF CO6
�ti • y
RICHARD D.LA,A1 t :.�" J. A. DANIELSON
GovernOr "' v` Slate Engineer
A
*1276
DAYMMMON OF WATER RESOURCES
Department of Natural ReSOWLee
1313 Sherman Street-Room 81 e
Denver,Colored*e0203
Administration(303)anS-3581
Ground Water(303)e3S-3587
February 10, 1981
Mr. Sidney Strear
Strear Farms
6825 East Tennessee, Room 235
Denver, CO 80224
Dear Mr. Strear:
Enclosed please find a permit to construct a well . The Late Registration
which was submitted could not be accepted, since its use is in excess of
acceptable uses under Colorado Statutes. Please note that the conditions
of approval of the new well require the old well plugged and abandoned
according to rules and regulations. The enclosed abandonment affidavit
is to be submitted once the new well is constructed and put to beneficial
use.
If you have any questions concerning this matter, please contact this
office.
Very truly yours,
Richard A. Bell
Water Resource Geologist
Ground Water Section
RAB/ew
Enclosure
... _ .. •
•
•
Applicant: Date Sub.:
See:. _ 'lip: itrlg: FM:
•
•
•
loy i
2 'i moo 55 22. 2 3
zg . z7 -
•
Aarnerts• _ nL by! 0 Date! fY /ii Aflutter! k
12ev. of
top 49-709../..---
no .. SO 20 Site Elev.
Parr. of 33.41
Prop, Plain
thickness /SO 2soexneeta /4O Prot:.
Perf
•
pc. Yield . a/s LOS Acreara
Wee for 1og 213 Aeneas"2Averac.,
snao..rsm°T. INFORMATION
Initial Permit No. Date verbal approval given:
. Pinal Permit No. REQUFST PCR VERBAL APPROVAL
Owner Driller Location
County:
'Address: Lic. No. Phone
See. flip. na.
New Q Rep].. MINI
Pandit No.
phorie Alt. Pt. DivTJ T.H. Distances i'remiSec. Lines
Approved Yes QNo Prrrwnaa D h: Casino:
•
to ar ConstructionPertpima;
IZ1 County '
Contact and
Date Initial, Number REMARKS ,
Scanning Cover Sheet
for
Septic Permits
Permit# G19721139
Permit Type: Health/EHS History/EHS Conversion History
Situs Street Address 9700 CR 26
Situs City, State,Zip
SecITown/Range: 22-02N-67W Application Status: Finaled
Application Dab: 03/11/1996
Parcel # (12 digits) 131122000013-R5419286 .
Owner Full Name: GOODSELL D C JR
Owner Address: 5515 TUCON
,80200
Owner Phone#: 303 3438438
Contact Name:
Contact Address:
Contact Phone#
Information above has been Verified in Accela by employee noted below
x r April 09, 2009
Processed Date
Report ID: EHS00024v003 Page 1 of 1
Print Date-Time:4/9/2009 1:23:21 PM
2 • • 0.)
WELD'COUNTY HEALTH DEPARTMENTC 1%
1555 17th Ave. g
• Greeley, Colorado•
No.la"� /
Application for Permit to Install, Construct, Alter or Repair Individual Sewage Disposal System.
own or Spun Address Phone yn
Address of Site MW i' A/-4*
y. at-.S,-v 'R , 1 1'
Mailing Address, _� ', r ise%ee.. a.� '�" 7ati aln — 4enacctJ, �rrr..
9-,..,..., Q.
General Information Septic Tank 3
1. Living Units I 1. Liquid Capacity GWOns
2. No. of Bedrooms • 'f� 2. Dimensions W L D
8. No. of Baths --S 3. Material. �A� J
4. Basement Drain — — C' 4. Type Inlet
6. Automatic Dishwasher Type Outlet
6. Garbage Disposal
7. Automatic Laundry Secondary Treatment
8. Size of Lot
9. Type of Soil • Field an Bede
10. Percolation T±Efra±- - '
1. No.of disc i fl lin
11. Water Supply 2. Trench: Widt •
12. Lot Grade 8. Type Filler Material
18. Water Table Depth •, AO
14. Other 4. Depth of Filler Material
5. Gravel Size /—.
6. Type Tile 4"c" a- . or�.,a /
7. Depth of Cover D
• 8. Other at'mss Ar•t- " -iTeirsac'ee
The Permit is to remain in full force and effect for six (6) months from date,until revoked for non-compliance.
This system will be constructed in accordance with the above specifications and regulations governing non-
municipal sewage disposal systems, in accordance with Regulation No. 1 of the Weld County pealth De-
partment. :J.! )
Date: a �€/�
� ' Applicant: in..:,),
6
The plans and specifications as shown are approved, pending paymen of er •t f e.
Sanitarian. ,
Date:
The above system • ted and found to comply with th n and description.
Installed by• i # 4 --. DataDf,,% i g / 912-
a O . •
•
• Sanitarian: J " • LAN ••
....
PERMIT FEE
Received by • ...13.42a•-•—t .�` Date �C of — / �"
Please use reverse side fo of Plan or use sparate sheet of paper. r
'/2-
i
1
r ,
u
t,
/
- try "
(S.:11.
�1 DEPARTMENT OF HEALTH
1516 HOSPITAL ROAD
(0!
so
GREELEY,COLORADO 80631
ADMINISTRATION (303)353-0566
ll
HEALTH PROTECTION (303)ZS 'l5
COMMUNITY HEALTH (303)353-0639
WiiO LOAN APPROVAL
COLORADO a Request No: 071-88
COLORADO Date Received: 5/05/88
Date Forwarded: 5/18/88
Fee Paid: $50.00 Date: 5/16/88
TO WHOM IT MAY CONCERN: Review and inspection report regarding water and the sewage
disposal system for an existing dwelling:
SEND TO: DAVID C. GREMEL PHONE S 825-5263 WORK
9700 WCR 26, FT. LUPTON, CO 80621 785-6208 HOME
INFORMATION: Address . 9700 WCR 26, FT. LUPTON, CO 80621
Legal: PT pry)4 , PT NE4 , Sec 03 , T 02_, R 67 W, Age of House 1972
Subdivision -, Lot , Blk , Filing -
Property Owner GREMEL. DAVID C. Original Owner Goodsell, Dudley C. Jr.
Tank Pumped on 5/4/88 By _ Bob's Sanitation
DEPARTMENTAL-RECORD -SEARCH: Peimit ft-721139 Name Goodsell, D.C. , Jr.
Bathrooms 2-1/2 Bedrooms 4 Total Acreage 1
Tank Capacity 1000 gals. Field Size 504 sq. ft. Water Supply Central Weld
Date of Final Inspection October 18. 1972
INSPECTION COMMENTS: Date of Inspection May 17. 1988
Soil Conditions: Dry g Saturated Snow—covered
Residence: Occupied g Vacant
FINDINGS: Sewage Disposal System: Satisfactory g Other
Bacteriological Water Test: Acceptable g Other
a
COMMENTS: •
DATE: may 18. 1988 SIGNATURE: Mb
Environmental Health ecialist
Neither the County of Weld nor any of its agents or employees undertake or assume any
liability to the owner of the above property, to any purchaser of the above property or to
any lending agency making a loan on the above property in connection with either its
'nomination of the property or in the report.
This inspection was conducted solely for the purpose of detecting health hazards observable
at the time of inspection, and does not constitute a warranty that the system is without
flaw or that it will continue to function in the future. Inspection requested during
periods of snow cover and high soil saturation may be of questionable value to potential
buyers due to adverse conditions. Water sample reports reflect the bacteriological quality
of the water supply at the time the sample was taken.
•
. K +I
SPECIALIST!B►INSTRDCTIONS:
NEED: 1. C•-�-, _ i,
2. CLOSING DATE ✓ .A / t.
3.. MAIL OR PICK-DP POO
NEW LOAN OR RE-FINANCE MI0
LOAN Armour.
k Request No: ��17I"ca-
0 ) Date Received: li-z-?•'
COQ-
ate Date Forwarded:
�C, Fee Paid:'!s.6L Date: = I' Yc
TO WHOM IT MAY CONCERN: Review and inspection report regarding water and the sewage
disposal system for an existing dwelling:
SEND TO: t(1‘1111 Ca. (11/.01 # PHONE o ✓�s— ;:
a'uw W tit �bQ, 4t ov*ui�r'u ��//II-- t :.
INFORMATION: Address TRIO Lo (,R 0,11) , j. }\u j.4�V
Legal: PT 14W. PT Nat. Sec 3 . T , tall, Age of House i'i'1i -
Subdivision , Lot . Blk , Filing
•Property Owner %mid G• (arefie.1 Original Owner V.W7Iu4 C• C e.:00 _t.iL . :f
)Tank Pumped on 57-4.0 By _ lOob'S •
•
DEPARTMENTAL RECO SEARCH: Permit o 'i..li fn Name .,rc ;.. C . 2_
Bathrooms Bedrooms Total Acreage 1 ac..r .
r
Tank Capacity' ' gals. yie4d Size eq. ft. Water Supply CWCttM
Date of Final Inspection /N i -AZ
•
INSPECTION COMMENTS: Date of Inspection /741Gfeg
Soil Conditions: Dry )( Saturated Snow—covered
Residence: Occupied N Vacant _
•
FINDINGS: Sewage Disposal System: Satisfactory JC Other
Bacteriological Water Test: Acceptable / Other
=COMMENTS: n •
1'ti&jQ
DATE: • 17g SIGNATURE:
Environmental Health Specialist
!either the County of Weld nor any of its agents or employees undertake or assume any
liability to the owner of the above property, to any purchaser of the above property or to
any lending agency making a loan on the above property in connection with either its•
examination of the property or in the report.
This inspection was conducted solely for the purpose of detecting health hazards observable
at the time of inspection. and does not .constitute a warranty that the system is without
flaw or that it will continue to function in the future. Inspection requested during
periods of snow cover and high soil saturation may be of questionable value to potential
buyers due to adverse conditions. Water sample reports reflect the bacteriological quality
of the water supply at the time the sample was taken.
•
12. I 1 2Y G.
DEPARTMENT OF HEALTH
PHONE(303)3530840
TT 1518 HOSPITAL ROAD
GREELEY,COLORADO 80631
RequC. Date
eRecei 32—85
Received: 2-21-85 •
COLORADO •Date Forwarded:
Fee Paid: $30.00 Date: 2-21-as
TO WHOM IT.MAY CONCERN: Review and inspection report-regarding water and the sewage disposal
system for an existing dwelling. •
•
Send to: Kay's Realty Service
3528 Central, Evans, co 8062n
INFORMATION: Address: 9700 WCE 26. Ft. Lupton. CO 80621 •
Legal: Pt NWit , Sec 3 , T 2 N, R67 W, Age of house 1972
Subdivision -•- , Lot , Blk , Filing
Property Owner: - pudley & Janet Goodsell Original Owner-: .Goodsell
Tahk Pumped on: 2-12-85 '. By: Slim's Santation
DEPARTMENTAL RECORD SEARCH: Permit Found: #1139
Tank capacity too° gals. Field Size 50O sq. ft. Water Supply CWWWO
Other
INSPECTION COMMENTS: Date of Inspection: 2-22-85
Soil Conditions: Dry X Saturated Snow-covered
Residence: Occupied x Vacant
FINDINGS: SEWAGE DISPOSAL SYSTEM: Satisfactory X Other
BACTERIOLOGICAL WATER TEST: . AcceptableX Other
•COMMENTS: __ • _ •
—
DATE: 2-22-85 SIGNATURE: tV1cu —Vo i,s,gp,
Environment Health Specialist
Neither the County of Weld nor any of its agents or employees undertake or
assume any liability to the owner of the above property, to any purchaser of the above
property or to any lending agency making a loan on the above property in connection
with either it's examination of the property or in the report. '
This inspection was conducted solely for the purpose of detecting health hazards
observable at the time of inspection, and does not constitute a warranty that the
system is without flaw or that it will continue to function in the future. Inspection
requested during-periods of snow cover and high soil saturation may be of questionable
value to potential buyers due to adverse conditions. Water sample reports reflect the
bacteriological quality of the water supply at the time the sample was taken. '
Hello