HomeMy WebLinkAbout20031372.tiff 02-06-03 1I:03AM FROM-DI VISIQ&OF WATER RESOURCES 3033662223 T-70! P.02/10 F-200
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tilit 3.Rr..76 • COLORADO DIVISION OF WATER RESOURCES
,u-• , 115 comma 6114,tats Shenaan St.,Denver.Colorado 80203
' PERMIT APPLICATION FARM ROOD. 1
,application must
, be complete where I I A PERMIT TO USE GROUND WATER eltia Q 22.44
appllcable. Type as (al APERMIT TO CONSTRUCT A WELL fie
print in ��A�S FOR:Mill A PERMIT TO INSTALL A PUMP
Vic,No ouara & F esar men unless ('M1REPLACEMENT FOR N0. 0 4 47÷7
mili•1ad ( !OTHER X
WATER COURT CASE NO. I-6-64 410
(1)AP.PtiCCrAN iT T•mailing address FOR OFFICE USE ONLY; GO NOT WRITE IN THIS COLUMN
-- . ..NAME r` ins . ! a NomNo. ,639 7 4A A
STREET an
t3 J gds oC Satin • Din.
CITY f'en was) yaJ QONDITIONSOFAPPROVAI
TELEPHONE NO. 4S1 ,008 This well tall be used in such a way as to Hoye I'
no material injury to existing water rights. The
(2) 6OCATIPN OF j?ROPQSED WELL issuance of the permit does not assure the applicant
that no injury will =air to another umbel water
61 right or preclude another owner of a vaned water
County right from Peking relief in a civil own action.
s'6 1L of me P a A,Section led 1) APPROVED AS PPAPP CATION FOR A WELL DRILLED
TINDER MOM E. 190117-BT.
Twp._I__ 1s,Roe.-kit.W. __ _ P.M.2) ran ANZAZ APPROfl&TION OS TICSNNELL
INA tamp ' TOWS= WITH ASS =ACE IE$R MOPES UMW ON
(3)WATER USE AND WELL DATA TESS 1AIQ1 S*JZ $1T SICEEP 100 ACB$-E'ER yea TEE
IBEIGMEON or 40 AC$E8 IBA TART OS Si ON Mt,
Pronoun'maximum pumping rate ISpml 400 20, T.U.a R.66W MD MIMIC PETRRIIW PURPOSES.
3) a TO*ItZW ?IOW 146TJSR MUST BE TNMM= ON
AVarage annual amount of ground was too T)Es' WRId, AISCEAROE WREN ME FATES T8 PIT! TO 03UNE-
to be appropriated (ewae-faetl: PIOUS = TO II9 SUER TER ABNQAJ. AMOURP OF OJOUIW
p WATER APPROPRIATED. DIVERSION RECORDS S..41, SE:
Numbs'of acres to be irrigated: 6UMCTTZD TO TIE DIVISION or RARER RESOURCES; UPON
Proposed total depin Ifeetl; qo RIICEZST, (Lew
Aquifer grourw wiser ism Oa obteinad from;
Jh
Owner's well demtpatran
GROUND WATER TO BE USED FOR:
I I HOUSEHOLD USE ONLY•no irrigation(DI F
( 1 DOMESTIC 111 1 J,INDUSTRIAL(91
.-Llk biNiSTOCK.121 - P.IRRIGATION IM . ..._ . .—_. _ - -.
i I COMMERCIAL(41 I I MUNICIPAL(SI
I I OTHER 191 APPLICATION APPROVED •
DETAIL THE uSE ON SACK IN(111
l41 WCLLt R PERMIT NUMBER �/90
`f yes"
F.
DATE ISSUED !_ AR `r 'r,�"'rrrttt
Name 4 .7 'p �'Afr& yes Jrerlfra F*PIRATION DATE M �R �{ 7 smut �d . Cut •city istwa9J ' ka E�,ir' '.
YYYorK Liss.No. !fl#? BY
Telephone No.
I.D. /- 02 COUNTY F 4
i
•
2003-1372
02-06-03 11:03AM FROM-DIVISIPALOF WATER RESOURCES 3038662223 .-. T-T09 P.03/10 F-290
H
a •
IS)1-14E LOCATION,_,OF THE PIOPOSED WELL and the area on 0,1 THE WEL44 MUST RE JOCATED fiELOIM.
. v4dchthe water 11 ba idea mot Pe',Ideated on the 4Nigram below. bydiataneafrom section lines.
Lea the CENTER SECTION 11 person,IMO ewes)for the will location. �
,^ t — SI- — „f" —. -I- — -I-— -I- — + — -1- —' "I- 11430 ft from reVi. saline
1.41 .-.-t Mil-t,am Pert I ./510 ft.from Ora ms's lot.line
t + + t 1- •t. 1 + t WITS,cads
LOT BLOCK _ FILING r
I
4„ -, -1- —
T — -h — t SUBDIVISION
(7)TRACT ON WHICH WELL WILL BF
-moan" _ ` _ ) — LOCAIEO over -rift C L.S
t r No.ofacrn 144 .Willthls be
5 . I I i the only we on MB t(eetf Ara -
� + 1 a -I- " +
1 I all INIC Eb CASINd PROARAM
C I Plein Casing
+ -I f
in.from_a__rt:•to -$4, ft.
I I 1 I in.from ft.ro ft.
-4- — -t• - -- -l- — -. Perforated celna
I I I $S in.from >O ft.to J40 it.
+ '' + 1 't' . '.+. .,.rl• -.. . -J- .. . + + t.from ft.to :i.
. .. ! .'.• ' I: t _ . L . ' - '� I 101 ind J RE LitEMENT WE
�- - I d r on f rn old trod anti for plugging
ante
-. 0 , .fit —7*-._ +r r ..L + "i.-i_ '+_ -- -^ T it: ¢ P g9in9
._ , -r ' -The gals of M.aiajam'ii 7'inalr-i mile- - J b f $ J
..r_ ' ,6:1”rnsitolaro iortcurTs.. : :, . - --- -'.tee r
✓P rr ,r C
WATad SouI4-INTi'AIM'( wn...44 en) IAn mrrlPoi cowry teas et lend ee raet gir nh1 i..44 mesa.per rts IeaMr
•£.moot. trines rtapSYTTime.NSWBiaWarywatar par ynr,
Le i. 1p�mduPieep IM*61.0@@dMNM
I. , lei I podgprn bumped sennuutu ay IOt aM4APprgnittreaftettAt.
(10) LAND ON WHICHQROUND WATER•�1SJei1. RE Usgp•
Ownsr(si: -lest 1C .4 /uses aG &
��r��ry.... � P T � Nd.aT area.
Legal Aa3c'rlp?k Mi. RW y. .G,t.I0 TN? I K nu il G f'7Y]
111) UTAH-ED DESCRIPTIQN of Ma use of ground water; Household use end domestic wells neat Indian Wm of dlsposel
snow to be out
�� rs 1 f t rcL Mrd ,dw�+.asti<a,rw••+
(12)DTHFR WATER RIGHTS used on umland, including walls. Oho Registration and Water Court Case Numbers. '
Type or right Used for(purpose) Description of land on*pion dad
• Sec tsid'1ts,
(13)THE APPLICANTS) STATEISJ THAT THE INFORMATION SET FORTH HEREON IS
TRUE TO THE BEST OF. HIS KNOWLEDGE. -
VONl rune Of A/ILIC•rNTOJ
Use additional Melts of paper ii more space Is required.
n
02-05-03 11:04AM FROM-DIVISID+L.OF MATER RESOURCES 3036662223 T-705 P.04/10 F-290
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Thtm C Rev. STA Dg COLORADO MINUTE
R
-- S-62klSt.- APPLICATION FOR: PA ERMIT TO CONSTRTO USE UCT AND WATE AUG281964
� /1 GOWN WATER SE'
Applicant 4Ve�cA ef,a £a LOCi,��F�WELL C(ILORADO
Punts (f Q11�F1161NEER
P.O. Address Qaja Lei-dr L.ahef,At,cf AX S
Quantity npp11 stmt gp7 rler -_._. .o of sect•..°, Twp•,�,
/19elo'._. At Storage
pq lige., __ (, - P.M. OR
Used for C04•leRciai Purposes
on/at et - Street Address or co A-Sock-No.- - —
(legal description of land s te)
Total acreage irrigated and star rte. 175
Town or Subdivision
ESTIMATED WA OF WEB
Hole mite in.to it. � i
In.to tt. li i
Casing P0tin.J,in. from C tons kft. �0° '-- I L
- - _ Locate
in. from to ft. 16 well in
Open or Yerfa
ln. fram-4to v ft, it I I 40 acre
,--_1n. from,_ :to it. 7 0 0 E (small)
PUla —Met °+ I i square
DATA; Type .IIP a Site 24 - - - -- I w near
as possible.
Use initiation date . f 7-18 t I .. Urge square
Use Supplemental pages ios iriogal sd i is one section.
(� trE s
125.00 tee required for ut+ea other
THIS APPLICATION APPROVED than Domestic or Livestoak.
PERMIT NO. 60 89 —F Applicant .a4eL- 653-Iii
s
ISSUED: Ag
DATE AUG 281964 19 Driller( [ J£ ,�(k No. 5S7
I Addreu/t/.≥04e4.4 re-s0.) Q k,
NOTE - SATISFACTORY COMPLETION REQUIRED FOR APPROVAL OF APPLICATION
,---
02-05-03 11:07AM FROM-DIVISIOA-OF WATER RESOURCES 3036662223 T-706 P.05/10 F-260
Si
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r"
inpr C Rev. STA OP COLORADO paunasit
`1_6271o>d' APPLICATION FOR; A PERMIT TO USE GROUND WATER SEP 211984
P��L..JII A PERMIT TO CONSTRUCT A WILL Np WAIN in
Applicant Don cone, WLOCATION or W8 ,app
County im
P.O. 'Address 9000 W th Ave. -Denver L MIS
applied tar MO ({pm or 3A * of NW}of sect. 20 , Twp.tint od .
AF Storage
Aetton Purposes
W Rte. R66W 4,, P.34. 4.$.
Used for Irrt
on/at sea �
14 Street Aeae or Lot ii Block No.
{legal description of lanai site) 0
VS town or SubdivIlon
total acreage irrigated and other rts.
RSTIMAT;D DA A OF viz Lt. Na,,MI N
Hole size_min.to _ I '
- _ ia.to R. g i * ; ;
Casing Plait; 12 tn. from 0 to St.4 t. i° ,. ; Locate
in. from to ft. ; I well to
Open or Perl in. frommta lift. t ; 40 acre
tn. from,L„_to ft. R , S (small)
PUMP '"'filet Al.^ ' square
DATA; Type Turbine .HP Bias So - 1 _ _ _ _ - as near
Use Initiation date Sept. 161 19 6bi►i�.
a as possible.
e
(Use Supplemental pages for 1st
Obit} 3 , is one segcdion.
6,z4 $26.00 fee required for uses other
THIS APPLICATION APPROVED than Domestic or Livestock.
PERMIT NO. 617'3 ~ F Applicant Don 0iDq
Agent or
SUED:IS 5E. 21 1868 19 Driller Bolden A going No. 1
Address Soriano, Colorado
NOTE — SATISFACTORY COMPLETION REQUIRED FOR APPROVAL OF APPLICATION
I_-_____ _.. ._. ._ i
02-05-03 11:07AM FROM-DIVISID".OF WATER RESOURCES 3038662223 . T-706 P.06/10 F-280
i I
11365-R66.76 COLOR ADO DIVISION OF WATER RESOURCES RLtJ�IV• l/
ly,•i. 8,l unsmWN md*,1313 81uwnwn et.,Dunnt.Colorado 80808 iR712 8'%8
e sApplitation must PERMIT APPLICATION FORM ,pse, Isa1FA
be complete where 1 I A PERMIT TO USE GROUND WATER in Eel
pplica le.Type or IX )A PERMIT TO CONSTRUCT A WELL PREV. REC. 04-17-T8 RR
print in BLACK FOR;IX)A PERMIT TO INSTALL A PUMP
ME,No ChriartikaS
or assert unlas IX I REPLACEMENT FOR NO, 19n13R-F
in(tlalae. ( I OTHER
WATER COURT CASE NO, to--6370 wailX
234/
(1)APPLICANT- mailing address FOR OFFICE USE ONLY: DO NOT WRITE IN THIS COLUMN
Mr. Xidtteig;h, Agent
NAME?≥tDla G Llvgstocl_Colapany Roosipt No. 92217 /
STREET P. 0. Sox 116 ,
Satin Dist.
CITY Brighton Colorado 80601
irking Tool CONDITIONS OF APPROVAL
TELEPHONE NO.- 659-1001 This well shall be used in ouch a way as to cause
no materiel injury to oxisting water rights. The
(2) LOCATION OF PROPOSED WELL Nuance of the permit does not assure the applicam
that no injury will occur to another vatted water
County Held right or preclude another owner dt a vestal water
right from seeking relief in a civil court action.
8H K of the NW y saebon 20 1) APPROVED AS REPLACEMENT OF WELL PERMIT NO.
19048-F. THE EXISTING WELL MUST BE PLUGGED AND
Twp._J. a o.Roc. 66 .21._, 6th p.a(IIBANDONED ACCORDING TO THE REVISED AND AMENDED
RULES AND REGULATIONS FOR WATER WELL AND PUMP
i3)WATER USE AND WELL DATA RNSTALLATION CONTRACTORS. THE ENCLOSED AFFIDAVIT
GIST BE SUBMITTED WITHIN SIXTY (60) DAYS AFTER THE
Proposed maximum Pumping refs;aim) 17 :ONSTRUCTION OF THE NEW WELL. AFFIRMING THAT WELL
g0. 19048-F WAS PLUGGED AND ABANDONED.
Marage annual amount of ground ouster 2 2) THE AVERAGE ANNUAL APPROPRIATION OF THIS WELL
-- to be apwopriatea(aersree l: SHALL NOT EXCEED 2 ACRE—FEET FOR COMMERCIAL ANA
Nwmbar of ante m a Unsaid: 1 DOMESTIC USES PURSUANT TO THE DECREE GRANTED 8Y
AIV. I WATER COURT IN CASE NO. W=6340, WELL NO. 1.
Propped total depth Mitt: 50 3) A TOTALIZING FLOW METER MUST BE INSTALLED ON
THE WELL DISCHARGE WHEN THE WATER IS PUT TO DEN!-
Aquifer°round waxer N IQ te:Malawi from; FICIAL USE TO MEASURE THE ANNUAL AMOUNT OF GROUND
dFTER APPROPRIATED. DIVERSION RECORDS SHALL BE
�/ #I ../ W-• yn SUBMITTED• THE DIVISION WATER RESOURCES UPON
Dwnr'a van l daesnatiae .9 r/
•
IBADLIND WATER TO BE USED FOR;
I I HOUSEHOLD USE ONLY•no',Mission(0)
(X I DOMESTIC(1) 1 I INDUSTRIAL(61
I I LIVESTOCK (2) I )IRRIGATION(61
(X I COMMERCIAL 141 I 1 MUNICIPAL 181
( IOTHER III APPLICATIONAPPROVEP
DETAIL THE USE ON BACK IN Ill) ///
(I{) DRILLER
PERMIT NUMARR is c otria
DATE ISSUED UN
Name Match° & Holden EXPIRATION DATE TUN 011972.
Sweat P A Par 1RR •
qty Hudean, Colorado 806132 ,.
ram) (us) a
TOaphona No.536-1(1+31 -Lic.No. 1 BY
I.P. 1-DE COUNTY 62
02-06-03 11:08AM FROM-DIVISI'IF WATER RESOURCES 3038662223 .-. T-706 P.07/10 F-290
• r 1
(5) THE LOCATION OF THE PROPOSED WEIJ, and therm on (6}TH.k WELL MtJS BE LOCATf,DeeryV
which the water will re wad muss be heated on the diagram Slow. by distances from Nolan let,
Use t n CENTER SECTION (1 Notion.840 acres)for the well!anion. �i
'^ 1- -. '-f- — - 'I- — 14--- -+ — -F — + - 4- v61 ft.from nard,ur wulsi see.fink
I Lf-r^^1 MISC.MP nn----yl i I —J6o ft.from Wpt etc.line
tees a woolt 4- + t + t -t' + +
• LOT BLOCK FILING•
I I I I
i- - -(- - Nonni S.,n - ₹ — ..I- SUBDIVISION
• (7)TRACT Opt WKwp WEI L WILL RF
1 I I
tNOPTH+ �" - + - - + t I LOCATED Owner: Triple 0
w t No.of acres 110 . Will this be
I +I V. I I I the only well on this tract? No
I IB)PROPOSED CASING PROGRAM
ti- .
I Rain Caringy,�1��''e
-}-I - — �' — - + +I ... L'f i' n.fran 0 ft,tO—..-3.9—•IL
I I I I
+ -' + - I - • Pitt0iated c in,from ft.to h.
I I I I 5 t rcw-orn 30 ft.to 50 ft.
+ 4- t 4 .4- 4 + 4 + in.from tt.to 4.
I I I I I (a) FORA EPL EM ENT WELLS giya distance
+, -^ + — T Ind direction hem old well and plant for plugjin0
The scale of the diagram n 2 inches-1 mge Offset
Each wall square remnants 40 sass Plug addarding to rules and
WATER EOsnVALENTS TABLE IMOu/mwl Figural
An acre-foot own I acre Or ILW 1 fact ONn rcgui at i0na
�.� 1;Wile
foot proonq Idol...449 willow per minute.lepnl
A Array of 5 yti11 rpuwa approximately I wrest=of wasr per yew.
1 onfeot. .%5.660 cubic felt. .325.000 11111109$.
1.000 epn pwmpo caminsw•y for one ay proawes 4.4 aae-teat.
(10) LAND ON WHICH GROUND WATER WILL RE USED'
Ownerfslt Triple G Livestock Cowan( No.of war 40
Legal descnptioni NI` •
(11) DFTAILED DESCRIPTION of the use of wound water: Houuihold use and domestics with must Indicate typo of disposal
• gstsM toama. Tomaatid WFA ix18g1trrotxl Tier decree- --- - - . .
(12) OTHER WATER RIGHTS used on tna Is* I./eluding wells. Give Ragietration and Wafer Court Cass Numbars.
Type or rot Used for Iporpowl Description at land on which used
W-6340 Stook 86 Comalaraial 2O-1W-66W
(13)THE APPLICANT(S) STATE(S) THAT SSE INFORMATION SET FORTH HEREON IS
TRUE TO THE BEST OF HIS KNOWLEDGE.
- /,
SSGwATYR or rCAMfa1
We ad0hldnal shots of paper if morn epaeo is required.
02-06-03 11:08AM FROM-DIVISIY1-OF WATER RESOURCES 3038662223 ^ T-706 P.08/10 F-280
Form No. OFFICE OF THE STATE ENGINEER
RWS.28 . COLORADO DNISION OF WATER RESOURCES
"^ 011 leentrinisle t Bldg.,tete Sinew Ong,.,t .Camrm&o a t=
dee657
WSS PERMIT NUMBER /41,062.6- j
AP,pUCAMT DIV. 1 CNTY. 62 WO 2 DES.BASIN MD
Lee apes: flaw: ease:
APPROVED WELL LOCATION
WEED COUNTY
MANUEL&ANITA M BALDEWS 9W 1/4 NW 1/4 Section 20
2732 Cat 27 Twp i N RANGE 66 W 6th P.M.
FORT LUPTON CO 80621-
(3eri)e64 f�2 jgJBTANCE5 ff9OM SEQTION LINES
1370 Ft.from North Sealon Line
PERMIT To RONWIF81CT A WELL
245 Ft.from Weat Section Line
ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT
COJhiInotfs 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 the
permit does not assure the applicant that no injury will occur to another vested water right or preclude another
owner oft vested water right from seeking relief in a civil court action.
2) The construction of this well eMUl be in complanoe wfth the Water Well Construction Rules 2 CCR 402.2, unless
approval of a variance has been granted by the State Board of Examiners of Water Well construction and Pump
Installation Contractors in armordance with Rule 18.
3) Approved pursuant to CRS 3742-602(3)(c)for the relocation of an existing well,permit 4606E The old well must
be plugged end sealed acceding to the Water Wall Construction Rules within ninety (90)days of completion at
the new welt The enebeed Wet AAwtdo11n1ent Report faro must be Bom(tlsead end er3xnited to an that the
old ghat was properly pugged mid eased.
4) The use of ground water from this wet la limited to ordinary household purposes Inside one (1) single tamlly
dwelling and the irrigation of not more then 5,000 square feet of home gardens are lawns.
4) The depth of this well and not exceed 40 teat or the first confining clay/shall, whichever comes first and which
corresponds to the base of the Bharat aquifer.
6) The maximum pumping rate shaft not exceed 15 GPM.
7) This wet stud be constructed not mere than 200 feet from the location specified on this permit.
8) The ground water from this well shall not be used In the auto shop or for any other purpose without first getting
a permit for that use.
Note: Emergency verbal approval 88-VE-246,wee given on Jun.17, 1998,for construction of this wet
rr 99
APPROVEDRAN aild Y
fun
Ort ow JUL 2 9 1998
Receipt No. 0431740 DATE ISSUED EXPIRATION DATE JUL 2 92000
02-05-03 11:09AM FROM-DIVISIOWOF MATER RESOURCES 3038662223 T-7)6 P.06/10 F-290
WEINO
Wa.r5. . . MB Coollumbine woo., 1846 Skewer St.LORADO DIVISION OF WATER Denver,Colorado 80208 'rip 1hl6
ts
• PERMIT APPLICATION FOIM tactRf^'°
tact
Application must Salt
be complete where 1 A PERMIT TO USE GROUND WATER Ric, April 12, 1976 Z.3rI
applicant*. Type or PERMIT TO CONSTRUCT A WELL
print in BLACK FOR: A PERMIT TO INSTALLA PUMP e..•.•
INS No overstrikes
or erasures unite (4REPLACEMENT FOR No Not Rea
initialea. I 1OTHER
WATER COURT CASE NO. 6t) PH the 1 1 not C`r tw. ]tsetict e
(1) APPLICANT-mailing address FOR OFFICE USE ONLY: DO NOT WRITE IN THIS COLUMN
5.00 /os a lc
NAME Off•iple-G Livestock Co. Receipt No.. 69304 /
STREET 110-Y 3-3-6
Basin Dist.
CITY Brighton, CO 80601
lama) Pip) OONgSTION6 OF APPROVAL,
TELEPHONE NO. 659-1000 This wall shall be nand in such a way as to cauad
no material injury to existing water rights. The
(2) LOCATION.OF PROPOSED WELL iauanceof the permit does not assure the applicant
that no injury will occur to another vested water
right or preclude another owner of a vatted water
County right from seeking relief in a civil court action.
—Si---.-X of the theaS K,Section an
WOW Two. 1 N__,Rn 66 6th p AS A RE3CEMENT OE WELL N4,
e. 2M.,*q�TINGWU MUST SE PLUGGED AND &
tw.si Irma ACOORO(Ne TO THE REVISED AND AMENDED RULES AND
(3) WATER USE AND WELL DATA. REGULATIONS FOR WATER WELL AN:.PUMP INSTNjATION
CONTRACTORS. THE ENCLOSED AFFIDAVIT MUST SE
Proposeo maximum pumping rate lgpm) 15 UDMITTED WITHIN SOFTY(60)DAYS AFTER THE
..... CAM STRUCTION OF THE NEW WELL,Ai N1M THAT
Average annual amount of ground water y WELL NO. t i teta WAS PLUGGED AND I�IVN0a w,
to be appropriated (acre•teet):. I APPROVIa'0 POSSUM TO CRS 1973, 37-92-602(1)(4)
manner of acres TO be irrigated: None FOE DRI211CTNG AND SANITARY FACILITIES ONLY AND F;
ROTIOTION IN A FE�1 II, OF THE TRIPLE O. LIVE—
Proposed total depth Dear 4 s
O TOCE COMPANY, �J'Y(
Aquifer ground water is to be obtained horn: ,
Surface
Owner's well dnignatlon
ARrltjh(f7 WATER TO BE USED POR'
HOUSEHOLD USE ONLY-no irrigation(0)
( ) DOMESTIC 111 I I INDUSTRIAL(5)
1��(1 LIVESTOCK (2) ( 1 IRRIGATION(8)
(>4COMMERCIAL(41 ( I MUNICIPAL 181
( I OTHER I9i APPLICATION APPROVED
DETAIL THE USE ON BACK IN(111 r ajra d-4
(4) DRILLER PERMIT NUMBER APR E8
1978
• DATE ISSUED
Name Kenneth L.Butt EXPIRATI TE Jp].��•�
Sueet.. 8108 Turnpike Dr. ���+ � � ��
g�q (((App •
City Demirel natal- en IS 41 1'ri (z1 )
Telephone No. ir22. 0+164 Lie No. 9 BY h
LO. 1/ 'O! COUNTY 4�
/^ I� .-._... . . _ .... _.. . .. ... .....
02-05-03 11:09AM FROM-DIVISION QF WATER RESOURCES 3038662223 T-706 P.10/10 F-290
it
(6) THE LOCATION OF THE PROPOSED WELL and the tree on (6)THFT WELL MUST HE LOCATED BELOW
which the water will be used must W indlated on the disarm below. to/4ounces from section Tina
Use the CENTER SECTION (1 action,640 ec nl for the well location.
i — t — - .{ — .� + _.. 1 2200 ft.from North see:line
- + T mann et=MIA '
I IA---- •1Mrtse,a3SOM T—._r 1 �...ft.from West
leas or weWl sec.line
t + + + + t •j, + t
i LOT BLOCK FILING •
l
act — t t SUBDIVISION_
I
II 1 (7) TRACT ON WHICH WELL WILL r
�NORTN+ + _ _ — LOCATED Ow,nar
I:1" t ± Na.Qf acres 40 Will this be
1 g I i le
le
_ m the only well on this tract? Tin
4- t 6
I S I — t (6)PROPOSED CASING PROGRAM
Plain Cadre
5/8 in.from 0 {no 40 ft,
I I I
' ' + - in.from ft.to _ft.
SOUTH -- -- ,- —I- ,Sl�rm�ed atiry
1 __sO ft.
I I In.from_ 30 ft.to
I + ± + 4 4 -4 4 + in from ft,to ft.
r..,.. I I futz044 i (9) FOR REPLACEMENJ WELLSaivedistenct
0 , :,r.;r •.` + _„ + ''3 7i — anddirection from-old wall and plans to plugging
The scale of pea diatom is 2 inches-1 mite • 33' atilt of old bole. 014 bolt
Each smell square represents 40 tun.
TNT' wATSR IOulvALSNTle TAIIA iliewaad Fawn) will be Dlt7¢4eQ ttCoorditlti to NA,
AP aramfoet caws I ea familiar.
s of lima I fae.p
•„^ ,73 .,
Nabic faro oar atap.a 10.1...449 worm to minas woo
A tamely of a will Tessin appwa!Nrav l aerate of of mots par rear
I Opont,..a7.aatl seals far. asaab whwa.
IAaplaan p,Mpea cmtiaowslv tot armory produce 4.42.a.•farc-
(10) LAtID ON WHICH GROUND WATER WILL HE USED;
0wner(s1: I'iP e'C T4YEPtoc)c.Q0. No. of acres: )Hl
Legal description: 1-6'W`—y, Pa^ 20; `h+6. 1M; Bras 66W. -
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(1 J AI ED p RI ION of the use of qround water: Household use and domestic wells must indicate type of
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Fire oa'ohection
(12)fTHFR WATFR elGtITS used on this land, including wells. Give Registration end Water Court Case Numbers,
Type Or right Used for!purpoul Description of arid on which used
W-63 0 adi wade Slime
(17) APPLI NT 1 ATE(S) 'PRAT THE IN ORMATION SET FORTH HEREON IS
TO E OF HIS FNOWLEDGE.
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I Um additional sheets of paper if mare space Is required.
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SANITARY SEWAGE DISPOSAL
Industrial users will be required to conform to the current Weld County Department of
Health and Environment regulations in place for individual septic systems.
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WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
1555 NORTH 17TH AVENUE
GREELEY,CO 80631
PHONE(970) 304-6415 FAX(970)304-6411
Permit#: G19879018 Sec/Twn/Rng: ?? Status: FINAL
Owner: TRIPLE G LIVESTOCK Applied: 04/01/1987
Applicant: TRIPLE CU LIVESTOCK Issued: 04/01/1987
Permit Type: C6—Commercial,R-Residential+NEW,REPair,VAULT Fineled:
Parcel#: 1471-20- - -
Location: 2602 WCR 27 FT. LUPTON, CO 80621
Installer:
Description:
Commercial: N Residential: Y
#of Persons: 2 Basement Plumbing: N
ft of Bedrooms: 2 Bathrooms: $1.00
Water Public: Water Source:
Water Private: Cistern: Well: Well Permit#:
Percolation Rate: 0.003 %Ground Slope: 0
Dir: Soil Suitable: (Y/N) S
Engineer Design Required: (Y/N) N In 100 Year Flood Plain: (Y/N)
Actual Installation
Septic Tank: 1000 gallons Absorption Trench: 0 square feet
Absorption Bed: 0 square feet
Design Type:
NOTICE
The issuance of this permit does not imply compliance with other state,county or local regulatory or building requirements,nor shall it
act to certify that the subject system will operate in compliance with applicable state,county and local regulations adopted persuant to
Article 10,Title 25,CRS as amended,except for the purpose of establishing final approval of installed system for issuance of a local
occupancy permit persuant to CRS 1973 25.10-111 (2).
This permit is not transferable, The Weld County Department of Public Health and Environment reserves the right to impose
additional terms and conditions required to meet our regulations on a continuing basis. Final permit approval was contingent upon the
final inspection of the completed system by the Weld County Department of Public Health and Environment.
x
Environmental Health Specialist Date
Fran:H„PLAN
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