HomeMy WebLinkAbout20123160.tiff WATER SUPPLY INFORMATION SUMMARY
Section 30.28.13344 C.R.S.regimes that the applicant vomit to the County,Adequate evidence that a water supply that
is sufficient in tents of quantity,quality sad dependandty will he available to ensure an adequate supply of water.
I.NAME OF DEVELOPMENT AS PROPOSED
Prospect Valley Grain, LLC
2.LAND USE ACTION Grain Storage and Handling Facility
3.NAME OF EXISTING PARCEL AS RECORDED Prospect Valley Grain, LLC
SUBDIVISION FILING BLOCK LOT
4.TOTAL ACREAGE 69 5.NUMBER OF LOTS PROPOSED One PLAT MAP ENCLOSED DYES
G.PARCEL HISTORY•Please attadi copies of deeds plats or other evidence or documentation.
A.Was parcel recorded with county prier to June 1. 19727 IT YES 0 NO
B. Has the parcel ever been part of a division of land action since June 1, 19727 0 YES Col NO
If yes,desmle the previous action
7.LOCATION OF PARCEL•Include a map defmiaung the project area and tie to a section corner.
SE 114 OF SW 114 SECTION 27 TOWNSHIP 1 LAIN ❑ S RANGE 63 ❑ E WW
PRINCIPAL MERIDIAN: 0 6TH 0 N.M. 0 UTE 0 COSTIl1A
8.PLAT•Location of all wells an property twat he plotted and permit mashers provided.
Stowyara plat ❑ Yes IM No If not,scaled hand drawn sketch ❑ Yes ❑ No
9.ESTIMATED WATER REQUIREMENTS•Gams par Ow ar Arts Fat par Yoe 10.WATER SUPPLY SOURCE
❑ EXISTING 0 DEVELOPED @.NEW WELLS
WELLS SPRING regr� .tn�
HOUSEHOLD USE►_of units GPO AF WELL PERMIT NUMBERS 7=umunt o wan.ants
❑Doer warm O toem UMW
COMMERCIAL USE p of S.F. GPO AF o am mane o moaner Roane •
❑setsm a OCR
o urn Wee omna maa®am aaarlea
IRRIGATION$ of acres GPO AF t
STOCK WATERING A of head GPO AF 0 MUNICIPAL
❑ ASSOCIATION WATER COURT DECREE CASE NO.'S
OTHER Office&Restroom - GPO 1.5 AF 0 COMPANY
❑ DISTRICT
TOTAL GPO AF NAME
LETTER OF COMMITMENT FOR
SERVICE ❑ YES ❑ NO
11. ENGINEER'S WATER SUPPLY REPORT 0 YES 0 NO IF YES,PLEASE FORWARD WITH THIS FORM.(nil May be maid baton oar mt.a is magkcadl
12.TYPE OF SEWAGE DISPOSAL SYSTEM
❑ SEPTIC TANKILEACH FIELD 0 CENTRAL SYSTEM •DISTRICT NAME
❑ LAGOON 0 VAULT•LOCATION SEWAGE HAULED TO
❑ ENGINEERED SYSTEM attars.spy at mien Sip) 0 OTHER
COLORADO DIVISION OF WATER RESOURCES Office Use Only Earn GWS-45(07/2009)
DEPARTMENT OF NATURAL RESOURCES
1313 SHERMAN ST,RM 818,DENVER,CO 80203
phone
(303)88&3589 httpiNniftwater.stete.co.us
fax
GENERAL PURPOSE
Water Well Permit Application
Review Instructions on reverse side prior to completing form.
The form must he completed to black or blue Ink or typed.
1.Applicant Information 6.Use Of Well(check applicable boxes)
a=era= /'L Attach a detailed description of uses applied for.
I f�j r* Qn 11tL1 ! T€prui Lc( 0 Industrial 0 Deoatermg System
fang 1/� n ,J ❑Mun thPol ❑Geothmnal(❑production or❑reinjection)
i l�l11`I l/_ le 1' ❑Irrigation 1 �YYL or (ZS5 dr erLfl
dtr ®Otlter fdesrnbeh i-u- ,dsciteiThe1 u:fiic,-rn�c.
State _2 ❑Commercial ( - ( ad - 1 ,r Gt Y .Fr. 4,r.r.�,.� .
fo;j1')Lli I ao( l D fit(r\I J 7.Well Data(proposed) "
Naoirr,l`r� vanamWf mm Ammer or benMlldmw
rep-3)43S' :Psis I kiCeN m^, 0, tcM,.1\k T ' C Sam 1%5 acre-feet
Type Of Application(check applicable boxes) Tad 9999
al Construct new well 0 Change source(aquifer) 9cc bet I3r1\u.r1 1
❑Replace existing well 0 Reappuas0on(expired permit) 8.Land On Which Ground Water Will Be Used
❑Use erds(h(g well ❑COGCC Web
❑Change or Increase use 0 Other. Legal Description(may be araAvad no en mmlmrerur
3.Refer To(if applicable) �u > uC I"- pc Siia 14 t�1c5(?Ct1T�191
Wm pane a POWs Cmareama tai west of -the
I IA TDwfS "-P i I3 rtn , `Z eJ
oavwraemn0mammmo„a ' ssetnmnema in Y.IZt. SC\'-iii C�� hiC5`�fCt LC�5rYL�1
uIR I k3 R In
4.Location Of Proposed Well(Important]See Instructions) Nased irrigation.attst a scaled map ma shows irrigated area)
County A. aAoaa a Getter
1/emPa 'N Pic alt' L1a1l-“, COM1 ,La:
yam, Tip ,N1 RL Ear�W,/ I Ruda+ C. �� �mcVmriShb urea on aia rmrt
I r�J❑ I u3 o VJ I Lo-"n C
oblmvcmaevasmamewaa(r�msem me gpina�rmnmaOaMmal J..`n� icli� Lt kW -eft Mitt * r)rleiR et,
13l CN Ft tea❑N❑S a ems❑E❑W 9.Proposed Well Driller License*optional):
Fm roodemnarn was only-dtwaa and temente earn oN me to menea 90.Signature Of Applicant(s)Or Authorized Agent
13 IA feet direction The making of false statements herein constitutes perjury in the second
Wm mourn 8991918(trirkideCIY.as DPI O rawruAwe address msome ea In ern I. degree,which Is punishable as a doss I misdemeanor pursuant to C.RS
24-4.104(13)(a). I have read the statements herein,know the contents
A\'I y� thereof and state that they are tore to my knowledge.
Iv '1 san Rae(eAetm wtgmmaigOme) I Mao
epaovat GPS well location edonnatton In t°R a format You must check GPS unit for /1
required settings as foams: , 17•30-/2
909119119.19!GUMI Pre mane S We
0 Zeno 12 et D2mot3 aiding Cbo rV 2 be/a•-a- tin Rr.N6G C.
Ins must be Worn Office Use Only
Saban Mat be NA= jl Nothing
te sea Sw e ace ragS. USGS map nameDWRvom nm Surface day.
Unit mere be am e ace north
Was on wa thecetira abate/ ❑YES I Renramberto sat Datum to NAU83
5.Parcel On Which Well Will Be Located Receipt area only
(YOU MUST ATTACH A CURRENT DEED FOR THE SUBJECT PARCEL)
A. Legal Dsalpbon(ay be provided m on mMamecmaf
�IIt c &C AA o)1-
�LUi 1' c� '-hit. 31/4.31
TTCWiI.:*1L1; I tCc�.•\in , 1'(ir1SC_ Lea L•_•r'it Of
1-tic Lerrs .Iti1. .5oa l\ iii Wespf:t Lc Acl ri1
B. am awls inpond C. Cane /1 AGUAMAP
93 TieDf ll• Oatic' 4f,ra\-,,tic WE
D. weet es en mum well meets mean❑TE.s IONOrerm-rmtaamr¢rJ'a) Wit
CWCS
Erne`Cdie,l l.ufI1- 1?“NI 1 t it 'L)igFP TORO
&rat 911(9992999
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