HomeMy WebLinkAbout960488.tiff wRJ-5-Rev. 76 CO" MADO DIVISION OF WATER RESOL cS R,.,,�,�}, •
818 Centennial Bldg., 1313 Sherman St., Denver, Colorado 80203 �.t/���Yjj�+�J
PERMIT APPLICATION FORM SEP 0 61998
Application must -. ` .,. ,; '
be complete where 1 I ' ' 4 ' ( 14 A PERMIT TO USE GROUND WATER WHOP MS
applicable. Type or I ) (VI A PERMIT TO CONSTRUCT A WELL
print in BLACK 1 ≥}CEOF\: (V) A PERMIT TO INSTALL A PUMP S
INK.No overstrikes - cr ,
`
or erasures unless '11 ( ) REPLACEMENT FOR NO.
initialed 11 ) OTHER ._ --
-- WATER COURT CASE NO.
(1) APPLIICA{NT . mailing address FOR OFFICE USEONLY:4DO T„VWIRI NOTE IN THIS COLUMN
Pa
tty a l-/y Pia Receipt No. / zOt> i'.:.-.�/ _.
STREET 130A l T Lr
Basin Dist.
CITY frI e rC c_ c0 •61/t5U
(State) q (Zip) CONDITIONS OF APPROVAL
TELEPHONE NO. \ d3-1J7" , 35,2 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.
A) W 'A of the r1/ I.0_ 'G, Section 1/ ISSUANCE OF THIS PERMIT DOES NOT
/ / / —00NFER-A-DECREED-WATfiH�IIHT -
Twp. Rn g. (Q 6 A4_, (nli P.M.
'"'sI iE.WI 1) APPROVED PURSUANT TO CRS 37-92-602(3) (b) (II)
(3) WATER USE AND WELL DATA (A) AS THE ONLY WELL ON A TRACT OF LAND OF 40
ACRES DESCRIBED AS THE NW 1/4 OF THE NW 1/4 OF
SECTION 11, T8N, R66W OF THE 6TH P.M. , WELD
15J COUNTY.
Proposed maximum pumping rate (gpm) 7PM
2) THE USE OF GROUND WATER FROM THIS WELL IS
Average annual amount of ground water/ LIMITED TO FIRE PROTECTION, ORDINARY HOUSEHOLD
/to be appropriated (acre-feet): / car {�01- PURPOSES INSIDE ONE SINGLE FAMILY DWELLING THE
IRRIGATION OF NOT MORE THAN ONE ACRE OF HOME
Number of acres to be irrigated: / GARDENS AND LAWNS, AND THE WATERING OF DOMESTIC
ANIMALS.
Proposed total depth (feet): /�d 3) THE RETURN FLOh1 FROM THfi USE OF THE WELL
MUST BE THROUGH AN INDIVIDUAL WASTEWATER
Aquifer ground water is to be obtained from: DISPOSAL SYSTEM OF THE NON-EVAPORATIVE TYPE
WHERE THE WATER IS RETURNED TO THE SAME STREAM
PandSP1r- SYSTEM IN WHICH THE WELL IS LOCATED..- haw-7f .,
Owner's well designation
GROUND WATER TO BE USED FOR:
7
( ) HOUSEHOLD USE ONLY no irrigation (0)
( LA5OMESTIC (1) ( ) INDUSTRIAL (5) )-f ) k ,-
1 1 LIVESTOCK (2) ( ) IRRIGATION (6) r :
( ) COMMERCIAL (4) ( ) MUNICIPAL (8) z. EXHIBIT
( ) OTHER (9) APPLICATION APPROVED I -'
DETAIL THE USE ON BACK IN (11) 152442
(4) DRILLER PERMIT NUMBER
''Y
� DATE ISSUED SEP 2 2 1988
/Ct Name We// G4o/ /lany/J J-/t- EXPIRATION DATE SEP 2 2 1990
Street /V< /b Sr
•
SZ •
City (Crecky 1:72h)657 (STATE E E'ER)
/ (State) (Zip) A
BY 960488
Telephone No 50.57,7,5- ,Mc?- Lic. No. F5 1
I.D. 1 - O 1 rot IN.TY
(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. /
50 0 ft. from ti- sec. line
- + — .i — - — -+ — - — -+ — -+ — -IT (north or south)
I ." , ' !-4---1 MILE,5280 FEET '1 I jO0 ft. from sec. line
least or west)
+ + + ±
+ ± LOT BLOCK FILING *
+ _ - NORTH SECTION LINE — +
SUBDIVISION
I
X I (7) TRACT ON WHICH WELL WILL BE
I LOCATED Grn 2 Rer.-es e<'id
NORTH I + Owner: Pa f ' *f ig ref
+ z- — T — — — _y + + No. of acres 16 . Will this be
J
o m the only well on this tract? ye s
n
+ fi w I 5 1 (8) PROPOSED CASING PROGRAM
to z
co
r Plain Casing
-� "{— 3— — I — -nt + 6 in.from / ft. to /6(1-lft.
I I
in.from ft. to ft.
+ — H- _ I I _ — + - 4 Perforated casing
SOUTH SECTION LINE
6 in. from /00 ft.to /S0 ft.
-}- -fi + -(-- + 4 -k +- in. from ft. to .`t.
I (9) FOR REPLACEMENT WELLS give distance
and direction from old well and plans for plugging
-I- — -4- — -IT — + — I — H— — -i- — 4- — -In it:
The scale of the diagram is 2 inches= 1 mile
Each small square represents 40 acres.
WATER EQUIVALENTS TABLE (Rounded Flguresl
An acre-foot covers 1 acre of land 1 foot deep
-
1 cubic foot per second lcfsl .. .449 gallons per minute(gpm)
A family of 5 will require approximately 1 acre-foot of water per year.
1 acre-foot 43,560 cubic feet . . .325,900 gallons.
1,000 gpm oumped continuously for one day produces 4.42 acre-feet.
(10) LAND ON WHICH GROUND WATER WILL BE USED:
l
Owner(s): 6ree R kee✓QiS •No. of acres: 90
/
Legal description: iJ1x /Y !WA/ --.5e.Cr // ,g ' G/-' id /try pm
(11) DETAILED DESCRIPTION of the use of ground water: Household use and domestic wells must indicate type of disposal
system to be used. /
DcnuSlr,: zcu on-teG <- r'+na�- Ct
/2/ -i�,E7 ,4--e a e J! e a cCI
J1.yesa / SySreeh
(12) OTHER WATER RIGHTS 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
i NOfJE
(13) THE APPLICANT(S) STATE(S) THAT THE INFORMATION SET FORTH HEREON IS
TRUE T-----14D-O THE BEST OOF HIS KNOWLEDGE.
CG . _<if 9_ / d7»� k�' 'in' �a tea'
SIGNATURE OF APP7 N (S) / elf
950188
Use additional sheets of paper if more space is required.
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