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Home My WebLink About20040183.tiff 09/26/2003 14:32 30366575's LTS GLASS �-. PAGE 02 Form No. OFFICE OF THE STATE ENGINEER QWS-25 COLORADO DIVISION OF WATER RESOURCES 818 Centennial Bldg.,1313 Sherman St., Denver, Colorado 80203 (303)888.3581 EXST WELL PERMIT NUMBER 232966 - APPLICANT DIV. 1 WD 8 DES. BASIN MD APPROVED WELL LOCATION WELD COUNTY SW 1/4 SW 1/4 Section 6 LOYD &SHEILA SCHLICHENMAYER Township 1 N Range 88 W Sixth P.M. 5090 WCR 1 DISTANCES FROM SECTION LINES ERIE, CO 80516- 400 Ft.from South Section Line 100 Ft.from West Section Line (303)828-3013 UTM COORDINATES REGISTRATION OF EXISTING WELL Northing: Easting: ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT 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 in accordance with CRS 37-92-802(5)for historic use as Indicated herein and described In CRS 37-92-802(1)(b),being a well producing S GPM and used for ordinary household purposes Inside one single family dwelling,fire protection,the watering of domestic animals and poultry,and the irrigation of not more than 500 square feet of home gardens and lawns. - - 4) The date of first beneficial use,as claimed by the appllDecember 31, 1989, t t ,05 K HPPROVED JLV z _ 4„,„, State Engineer B Receipt No.0514655 DATE ISSUED 09-19-2003 � 1J ,/4 PIRA ION Wert 2004-0183 18/26/2003 19:24 3036657' LTS GLASS "` PAGE 02 / Nolen" I STATE OR C01.0lgpp Q , WPCS OP TINS STATE Q �Ot�.etls AI> [1.i._.____.........._.__as:ln1)1 Mi.INt Fajt«�jag Danvs Co 50703 REGISTRATION OF EXISTING INEu"-� I Ntmhzyck MJ ra ig 1. osizi y WOO*ea_„_0 40 6 _.lALCcia 1 �T Phew* LW i .igirt _sic jeasiii.L_BaLlarintai Cart Th,..... *SS wet Coots______r.„_______ l.I 2 s �$W rota)e► Ifs, lr....,, trp. -- N art E R1fl9u tar Wi 3}Q� w, / ' (,c_►,M. aimanamiaa yQ. It.Fran D N.Ma. _Latin.memDt a Zw.un•- Ws mil too tdso leepyMa used Nr Ae wtt. :.�p Itm- .(■k ae -----si .[;vv sr u-. • - wtlptr font the out von Mt wood Mara*by YM er OS~or*Ito above deeitod p.t}a.ea anpL 7VV Irrlft Si Y i A_5 , r i Tito sum dos.of+ueYMIr_39.___ _Os iTM pumping nano wan_Y WHIM Mr TMga f me ewer @ aatan '.,ne vac~so a_ _to1Mf. The land ung•Ud Pan to,lye tom he no in_tat? M.Y or Xi Sea Mt. rriNed Y: erw_ N! )9 —�_r r my)al tw)al'my EMI M , N a.l a.a..K.ya/a Mf d�.attw Nun ew arrr.Ys ri.Bwa.wr mods hw.w,as w.+NarMwaw Pie trrM IM moon Nom a TNr 1 M Mr w. �_Eta_ ( ~. Per Okla Uliiaw Nt�'I�jIN • EXHIBIT C , 08/25/2003 19: 24 3036657 LTS GLASS ^ PAGE 03 FIELD INSPECTION REPORT PhoaaapeIS Iberia na AOPL a DOTEIOn! WATERDISTRICT 6 a(a�- DATE OFnNSPECfnD7I: YA2(e pcj,,nin CFo tAT8R80. X mm APPLICANT: e f-.SAei1`_ satiates.MN7 e� paa aaa �1 /s n / awdod iFaotopplia� ADn ≤D9r N+h+-l� � garfrd / W.C.asapis 467.4) &r;e Co 8D5/.L 303 8513-0 sc./2 PHONE,: -3v3- )Z-2fs -,fie13 lozWII NO WELL LOCATION: TwP. / Al fln a J ,6a PM DUG 400 ^ to*moan hes Sae Nog COUNIy tn/../se (ilnplaaraaoL give direr ad ----•bmitt w.ww Mac C2RCLI 7'YPB or WELL• Den Ince swum WELL, GALLANT nu, Q1tAYE[.Pn; 0774! ANY OIBEn watts LOCA78DON TIES PARCELS No IP YES&_,HOW MANY?__(pang M.ems a,se .26 n wtc PSTIMATED DATE WELL CONSTRW!TED lit hkap h DAM OP nut inw ,rttownmiletnanD Memo RATA 6 TOTAL N op Ann IN Ste ]]'�TRACTTARCEL; 3 ACM Addax&rpwn OfdlegillW Applies Sim* AdaWaa,andNith ,.,,j idankw A/srng IdaaainIMS hareptictitvyr s) NAME OE ELAN? c MEI WELL:ru dpaa4yadsi�MioaaYri(gembo aaiwadt nib ape oawa hone,Aa.) R a arisatiatack�1i1 ay w le4einem Red i me Ise two blWli�► O aiet dYaaadlQ !�jr-• OdarPeasela C° NON ANS �sal* daoi io'ooraaaf'aatlm) nem it was TS ITS(one cazialbamonllerwrfaPRaTouAYi.en, tan W ANY GRANDE IN 774 REMO WE GIP 77m MILLDAM DAS OCCURRED NRNCS.MAY a,1972 PLEASE I NDICATE1111 DATE.)17s DiE CHANGED AND DU NNE iuie=ANON ANDIOR&RENO[ON OF THE CURlw nOR MOUSED CHANGES IN us tI)hown-UC17GN Or MU PGRM °ta pon i paaoa war NON4DOSMI CT MEL a•uanaaire aneoa bbw(ialoiaoo ILW ease Meld May .•J) Lip.- t,u- na —�]w AR Daai eat,/v3 /n1 AMISS oaaaaal*i umia: t.-;p Q µ,r�/ * W e l ( 6(z watk nv `T'a f t 7 a 'le s1 rxX +i rr1 *l Lo se /d t ) $ 2Cse z known —1ivew srrKcTwre bu;LT' i h 42e.or -�a11/+�+il 4-�`io•, trn,-0 � u ni) AlAomE Ow»r- S_h.7/ la/'p�(� 121212.k c i v�?kd Kc2c.J rKr�Te-ye JfJJ�i- /ivn '/ maaas*man oat Se on LOCATION: /3 7 0 ' -9 >; Nes Boyd SaM apy alas tat iK tert A #v3 ri3L tafataEfCO IDSla -A co lD]pI (/ 0B/26/2003 1924 3036657 LTS GLASS ----.. PAGE 04 STANDARD BACTERIOLOGICAL WATER TEST 5605 N Gate BOULDER COUNTY HEALTH DEPARTMENT MEMEWNE MI SR TenT BOULDER,CO 10307 LABORATORY SERVICES 303-473. --._ -.. _.. _ __ 7q6 DIRECT DAZE SAMPLE LO -. _I_....._.. --. _ , TAKEN i /9.O3. N y�54i,, NAME0F 5JTI' I/9' VERIFIED -.—....-- .... ^,,, • ._— .—. CANNER ,chum osat --- ��)) .....—. MOST PROYECE OUNTT ..�.O T LE +f5 CHLORMPA ... �--- UMEER iE71 . .. _.. TAKEN a. —/. . -- RESIDUAL —_ — NBA pH _ --_i 0,.. IIr HOUR N .'—__ ._ ...-. ,/ �a NOUR c I i COMMUNRY GUPI'.Y ( 06 •'—•"- - s V = ATE(IL HARED it a y ...____.� ___-. O I ) NON COOWUNfM1 NELL DEPTH IN FEET '�, PRIVATE I 1 1 GEAR W.ER ( ) PURLI0;NICER SUPPLIER IS, -- : ._ ..T.`_— Aoageaa !1a90 c,t S E� — J T — — -- 64 p LNDA ---- 1 T _ ___• -G i360N1SiON`/ WATER TE6TREUR.T • {t j*1 y`' p/ nouns . ..._..—_ _ ____ l ,/ C�/. -.�_— TOdL COIIFORM I �/#T ~ RETURN TO_,.lD.yd___Ahej:S•ff," t✓ ..._. _. . . _ 1100 Mt I / ADDRESS _ 5090 W _ y ___eis _ra moot'', 4 �` ... PRONE d� O/3-, --- -_....._. '�.. __ -- -- crM1TSTATl _GL C---C 2.- zP _ Osl40 ----'---" - �' k� SEE REVERSE FOR SAMPLE INSTRUCTIONS ANC OEF NITIONahlit lit ISUM OF MAGNET; a IReT TOW NTTII MMRIYE O QOUF NJI I'l SLLNOARON / STATE OF COLORADO For o use only OFFICE OF THE STATE ErVr'4EA / -8 .S 16 C.nm Bldg.,1313 Shaman Deaver.Colorado $0203. • / (303)866.1511 /NOR TO COMPLETING FORM, tC:: SEE INSTRUCTIONS ON REVERSE SIDE cC HA E IN OWNERSHIP/ADDRESS / LOCATION ! '! J 81996 WE 'ERMIt•, UVESTOCK TANK OR EROSION CONTROL DAM nA tan A::::.4.9..__ STATE£tit_^r:.`.'a 1. NEW OWNER NAME(S) _.-Ll.. ._ ..L .Q. .._ !_..A1.I.L.+.-1 ._[).rnye( . Mailing Add ..._Op._ .��'tt 1.43 � _ City, a ZIP-.. ... .. .. .. ...E ,�Cl...._._.. ... _cos-7 iQ ( . Phone (......._... ) ._ .. .......-16..i disli . ...n.._.. ✓16 ;s- � n t 1iT 0 2 THIS CHANGE IS FOR ONE OF THE FOLLOWING: on Lit II R l vtt' 0.%t -f'l M e ® WELL PERMIT NUMBER...---._Z675J....................__....._...._....._. __. 0+ h OW C.d pa the-It. CO‘An-i COO el not 4'A LIVESTOCK WATER TANK NUMBER on 1 i € I f t, to-try) it ❑ EROSION CONTROL DAM NUMBER..._._._ ___.._______, 3. WELL LOCATION: COUNTYWirrep__..._...,.._.._ _• ......._.... OWNER'S WELL DESIGNATION ..__._D.Q 1Z8X1C_____.. .__..._5090__ YLD....00IRCII3nAH 11 23.1H..........._--..---_._._....._.._.00..___._.._30515_..__. (Address) , (Cky) (State) Wv) ., SR-,,,,. wens_SW_.1/4, Sec. 6 Twp, 1 ®N. or S., Range ¢8 ❑E or ®W. 6TH P.M. Distances from Section Lines,_.__.._.......__.. Ft. from❑N. or❑S. Line, Ft from❑F. or❑W. Line. S RHATION WAS NOT PROVIDED WELL Syt�QivisiD _._.._....._......_._._...._.._...___....._ L°di THE OBI�i`3Ek Pm:ERing (unit) 4. LI.“STOCK TANK OR EROSION CONTROL DAM LOCATION: COUNTY 1/4, Sec. .. Two,. ❑N. or❑S., Range.._...._...... ❑ E. or❑W. ._....._._._ P.M. 5. The above listed owner(s) say(s) that he (they) own the structure described herein. The existing record is being amended for the following reason(s): ® Change in name of owner. ❑ Change in marling address. ❑ Correction of location. 6. I (we) have read the statements made herein, know the contents thereof, and state that they are true to my (our) knowledge. [Pursuant to Section 24-4-104 (13)(a) C.R.S., the making of false statements herein constitutes perjury in the second degree and is punishable as a class 1 misdemeanor.) Name(Pleasg tyRq r rir ) SLg rr n Dffie 2/ S i cherir - pol E_ele �Jp..,> 5-00"47 FOR OFFICE US ONLY ' ACCEPTED AS A CHANGE IN OWNERS13IP AND/OR MAP NG ADDRESS. _•i.2 v . MAY 19 1988 State Engineer Dare Court Case No. Div. I Co. WD asin MD Use 12] • •Schnchmmayer WELD COUNTY HEALTH DEPARTMENT . • 15th Street and 17th Avenue �f - 6 P. 0. Box 1227 ,• No. (� �/ _ acs- 96/3 Cosign, Colorado ��Zc7 �vr1 Application for Permit to Install, Construct, Alter or Repair Individual Sewage !spent •a 'G(�€ Owner e Ph e Li •Address of SiteL/f'� -r r,.� �g ,,.,s-Co Mailing Address �J -General 1 formation r ^ ele qpq �,�•Sept c Tank ase 1. Living Units 1. Liquid Capacity .0n 2. No. ..1 Bedrooms -5 ] 2,, Dimensions W ?Bons 8. No. of Baths --7--" . 8, .Material ' 4. Basement Drain 4. Type ;islet • 5. Automatic Dishwasher i Type Outlet ' ' 6. GarLage-Disposal . • 7. Automatic Laundry / 1Secondary .7reasineak 8. Size of Lot •.8. Type of Soil' • Field © B 10. Percolation Test f e"' ��'ti-r.- • .� • f 11. Water SupPly 1. No.of distrib on e y 12. Lot Grade 2. Trench: Widtl. � Lengtb �J1,04 18. Water Table Depth 3. Type F'il Flaterial . 14. Other: 4. Depth of Filler Material - 6. la'raveI Sine 6. Type Tile • 7. Depth of Covet • • - a. 'other '' , The Permit is to remain in full force and effect for six (6) months from date, until revoked for non-compiisnee. Tbie.system will be constructed in accordance with the above specifications and re alations governing non- municipal seWago disposal sysLeuus, in accordance with Regulation No. 1 of the I eld County Health De- partment. .-. Date:''f7?6y-v �'�.; -" p ppiicant, �r • y� sjgzi . The plans and sdfications as shown axe approved, pending payment t f ~. • Sanitarian: s9AL ' r • Date: • /2 -s The above aye . inspected d fo to cp ply with the plan and description. - • .Installed r' !'• G ter p „�, Sanitarian: • � ,-RERMTT PPF r- ' - ' eeeived by a s' � ' Please use reverse aide for Plot Plan or use separate. shut of pcb, 4r . a .1 se enmity .400a'•1RIBUN! . t a FROM :SLICK r• FRY NO. :3038283013 ^.ScN. 08 2003 06:39PM P2 - - .- _ . .7 . 11011WCRII - : ' Erle.00 • • .303 P -5on . . .1 - , 1 \ / • • • C-, Q -re „Sajc , C ` • • • s. , ., . • i <. ; • .. �. 3 Hello