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Address Info: 1150 O Street, P.O. Box 758, Greeley, CO 80632 | Phone:
(970) 400-4225
| Fax: (970) 336-7233 | Email:
egesick@weld.gov
| Official: Esther Gesick -
Clerk to the Board
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STATE OF COLORADO rOFFICE OF THE STATE ENGINEER of 747 . Division of Water Resources Q s4'�s� Department of Natural Resources 2 iIS) 1313 Sherman Street, Room 818 Denver, Colorado 80203 "- Phone(303)866-3581 FAX 13031 866-3586 Hill Owens Governor www.water.slate.co.os November 8, 2002 (.;mg E.Watcher Executive Director Hal D Simpson.PE. Fred Becker State Engineer 4375 Hwy 52 Roggen CO 80652 RE: Monitoring/Observation Well Permit No. 245751 Dear Mr. Becker: As discussed in my letter of October 23, 2002, the provisions of CRS 37-90-105 allow for one well in one commercial business. Since Well Permit 132426 was issued to the church for commercial use in the church and school another permit for commercial use cannot be issued. Well permit no. 245751 was issued to Christ Community Church for the construction of a well for Monitoring and Observation purposes. According to your letter of November 1, 2002, the church plans to sell the parcel with the old church and the wells with permit nos. 132426 and 191940. Once the sale is complete, please submit the enclosed Change in Ownership Forms (GWS-I 1). At that time, according the Rule 14.2.2 of the water well construction rules, you may apply to change the use of permit no. 245751 to commercial purposes. The evaluation of the new application will be subject to statutes, rules and policies of this office that are in effect at the time of application. Enclose are copies of rule 14.2.2 and blank forms for your convenience. If you have questions, please contact me at (303) 866-3581. Sincerely 11.x14 _ Sandy Johnson Engineering Techni. tarter' Designated BF'ns<Team 2003-0497 • Form No. OFFICE OF THE .i FATE ENGINEER GWS-25 COLORADO DIVISION OF WATER RESOURCES 818 Centennial Bldg., 1313 Sherman St., Denver,Colorado 80203 (303)866-3581 765 WELL PERMIT NUMBER 2.35 -S, - APPLICANT DIV. 8 WD 1 DES. BASIN 5 MD 9 APPROVED WELL LOCATION WELD COUNTY SW 1/4 SW 1/4 Section 6 FRED C BECKER Township 2 N Range 62 W Sixth P.M. CHRIST COMMUNITY CHURCH DISTANCES FROM SECTION LINES 301 FRONT ST. 728 Ft. from South Section Line ROGGEN, CO 80652- 340 Ft.from West Section Line (303)849-5234 UTM COORDINATES PERMIT TO CONSTRUCT A WELL Northing: Easting: 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 assure the applicant 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) The construction of this well shall be in compliance with 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 accordance with Rule 18. 3) Approved pursuant to CRS 37-90-105(1)(d). Use of this well is limited to monitoring water levels and/or water quality sampling. 4) This well must be equipped with a locking cap or seal to prevent well contamination or possible hazards as an open well. The well must be kept capped and locked at all times except during sampling or measuring. 5) Sampling is limited to the alluvium of Lost Creek or its tributaries. The depth of this well shall not exceed 140 feet or the depth at which sandstone or shale is first encountered,whichever comes first. 6) Records of any water level measurements and water quality analyses shall be maintained by the well owner and submitted to the Lost Creek Ground Water Management District and the Division of Water Resources upon request. 7) Upon conclusion of the monitoring program the well owner shall plug this well in accordance with Rule 16 of the Water Well Construction Rules. A Well Abandonment Report must be completed and submitted to the Division of Water Resources within 60 days of plugging. 8) The owner shall mark the well in a conspicuous place with well permit number(s)and name of aquifer as appropriate, and shall take necessary means and precautions to preserve these markings. 9) This well must be constructed within 300 feet of the location specified on this permit. 10) This well must have been constructed by or under the supervision of a licensed well driller or other authorized individual according to the Water Well Construction Rules. 11) A Well Construction and Test Report(Form GWS-31), including lithologic log must be submitted by the individual authorized to construct the well. For non-standard construction,the report must include an as-built drawing showing details such as depth, casing, perforated zones,and a description of the grouting type and interval. • APPROVED 1 1 SMJ State Engineer ,� fi By ( F,, Receipt No.0499760 DATE ISSUED EXPIRATIO , DA' E ->,- WELD COUNTY DEPARTMENT OF PUBLIC HEALTH& ENVIRONMENT 1555 NORTH 17TH AVENUE, GREELEY, CO 80631 PHONE: (970) 304-6415 FAX: (970) 304-6411 WEBSITE: WWW.CO.WELD.CO.US APPLICATION/RECEIPT Expires: 11/27/2003 Initials: DYC Permit Number: SP-0200540 Receipt Number: HAP-02538 11-27-2002 Amount: $350.00 Payment Method: Check Notation: 6015 & 5808 Owner Name: CHRIST COMMUNITY CHURCH OF ROGGEN Applicant Name: BECKER FRED C Parcel Number: 130106300029 Site Address: Location: TBD FROM I-76 ROGGEN EXT S ON CR 73 .5 M Total Fees: $350.00 Total All Payments: $350.00 This Payment: $350.00 Balance: $0.00 Account Code Description Amount 2560-41400-4221-4203 New Septic Permit $350.00 2560-41400-4221-4203 Repair Septic Permit $0.00 2560-41400-4221-4203 Vault Permit $0.00 2560-41400-4410-4203 Potable Water $0.00 Description: CHURCH Commercial: (Y/N) Y Residential: (Y/N) N Acres: 5 Number of Persons: 150 Basement Plumbing: (Y/N) N Number of Bedrooms: 0 Bathrooms: Full - 0 3/4: 2 1/2: 0 Water Public: (Y/N) N Water Supply: Water Private: (Y/N) Y Cistern: (Y/N) Well: (Y/N) Y Well Permit Number: 245751 NOTICE Applicant acknowledges receipt of the individual sewage disposal system guide and that the completeness of this application is conditional upon further mandatory and additional tests and reports as may be required by the Weld County Department of Public Health and Environment to be made and furnished by the applicant or by the Weld County Department of Public Health and Environment for purposes of the evaluation of the application; and the issuance of the permit is subject to such terms and conditions as deemed necessary to insure compliance with rules and regulations adopted under article 10, title 25, CRS as amended. The applicant certifies theat the proposed system will not be located within 400 feet of a community sewage system. The undersigned hereby certifies that all statements made, information and reports submitted herewith and required to be submitted by the applicant are, or will be, represented to be true and correct to the best of my knowledge and belief, and are designed to be relied on by the Weld County Department of Public Health and Environment in evaluating the same for purposes of issuing the permit applied for herein. I further understand that any falsification or misrepresentation may result in the denial of the application or revocation of any permit granted based upon said application and in legal action of perjury as provided by law. This application expires one year from then signature dates X Owner/Applicant 1 Date- 2_7 —© L— FEB-15-2002 FRI 11 :16 AM pVIR0N HEALTH SERVICES 9703046411, P. 04 PLEASE DRAW A MAP TO YOUR PROPERTY 17141 Ro6GWt4 Exit ie 6 3 e - 70 El} 5 t AtSEs CHORC!ii PSu1LDW G SITE
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