HomeMy WebLinkAbout20110512.tiff Form No. OFFICE OF THE STATE ENGINEER
GWS-25 COLORADO3DIVISION O F WATElorado RoRESOURCES
818 LR
(303)866-3581 1
• WELL PERMIT NUMBER 283983 - -
JI
DIV. 8 WD 1 DES. BASIN 8 MD
APPLICANT `
Lot: B Block Filing: Subdiv:RE-0211-29-0 RE 4538
APPROVED WELL LOCATION
WELD COUNTY
SE 1/4 NE 1/4 Section 29
Township 11 N Range 62 W Sixth P.M.
BUR HEATH PROPERTY LLC DISTANCES FROM SECTION LINES
BURTON KRESS MGR
608 E HARMONY ROAD SUITE 203 2247 Ft. from North Section Line
FT COLLINS, CO 80525- 100 Ft.from East Section Line
UTM COORDINATES(Meters,Zone:13,NAD83).
(970)231-1430 Pasting: Northing:
REGISTRATION OF EXISTING WELL CONDITIONS OF APPROVAL
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
does not ensure that no injury will occur to another vested water right or preclude another owner of a vested water right from
seeking relief in a civil court action.
2) Construction details for this existing well have not been provided to this office;therefore, it is not known if the construction
of this well is in compliance with the Water Well Construction Rules,2 CCR 402-2. The issuance of this permit does not
relieve the well owner of responsibility or liability in the event contamination of the groundwater source results from the
construction or use of this well,nor does the State Engineer assume any responsibility or liability should contamination
occur.
This well is recorded and permit approved pursuant to CRS 37-90-105(4)(2). The use of this well is limited tot e
historical use as recorded with this office and by the terms of CRS 37-90-105, being a well used for the watering of
livestock on range and pasture,for domestic purposes inside 1 single family dwelling(s),and irrigating no more than 1/4
acre of lawn and garden,with a maximum pumping rate of 15 GPM. The total depth of the well is estimated at 78 feet.
4) The date of first beneficial use,as claimed by the applicant,is July 1, 1948.
NOTICE:This permit has been approved with a change to the permit application form from that applied for by the l the issuance of this applicant.icast You are hereby sity notified of the date of issuance,purs that you have the right to uant to the State Administrative Procedures Act.t,by filing a written request
(See
with this office within sixty(60)
Section 24-4-104 through 106,C.R.S.)
i // I Q MI
APPROVED d� Wlt re
SMJ �
State Engineer DATE ISSUED 09-10-2010 By
EXPIRAT•I P h,
Recei•t No.38467848
2011-0512
,m STATE OF COLORADO For Office use Only
I OFFICE OF THE STATE ENGINEER
>W-11 818 Centennial Bldg., 1313 Sherman St., Denver, CO 80203
'006 Phone-Info: (303) 866-3587 Main: (303)866-3581
Fax: (303)866-3589 http://www.water.state.co.us
• CHANGE IN OWNERSHIP/ADDRESS
CORRECTION OF THE WELL LOCATION
Review instructions on the reverse side prior to completing the form.
ame. address and phone of the person claiming ownership of the well
AME(S)
ailing Address:
ity, St. Zip:
hone ( ) -
is form is filed by the named individual/entity claiming that they are the owner of the well permitted as referenced above.
is filing is made pursuant to C.R.S. 37-90-143.
ELL LOCATION Well Permit Number: Receipt Number:
Owner's Well Designation (optional)
iunty
(Address) (City) (State) (Zip)
1/4 of the 1/4, Sec. , Twp. O N. or 0 S., Range ❑ E. or O W., P.l
stance from Section Lines Ft. From 0 N. or O S., Ft. From 0 E. or 0 W. Line.
Lot , Block , Filing/Unit
ibdivision Name
,e ve listed owner(s) say(s)that he, she(they)own the well described herein. The existing record is being amended for thi
(lowing reasons:
] Change in name of owner ❑ Change in mailing address 0 Correction of location for exempt wells permitted prior to May
, 1972 and non-exempt wells permitted before May 17, 1965.
lease see the reverse side for further information regarding correction of the well location.
(we)claim and say that I (we) (are)the owner(s)of the well described above, know the contents of the statements made hereir
nd state that they are true to my(our)knowledge. Date
ignature(s)of ow r Please print the Signer's Name &Title
760r<-4 VP. ///t/°
is the responsibility of the new owner of this well to complete and sign the form. Signatures of agents are acceptable if an
iriginal letter of agency signed by the owner is attached to the form upon its receipt.
For Office Use Only
• State Engineer By Date
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