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2001-2709
WRJ-S-66
. - "AT£ OF COLORADO r,,� II� «l. .s' .,,:.-.,‘. , / ``. ,
/ A PERMIT TO USE GROUND WA) li`:,J 1 1 in66
/APPLICATION FOR: / A PERMIT TO CONSTRUCT A WELL'' '.'" ' F,V�; �' .- �
I1 OTHER iL.,, v,"„ . +iLf+ i, ..,:c2. ,
Application must be completed satisfactorily before acceptiinteEo≤u Er COL015S.0
LUTE£ !:
PRINT OR TYPE LOCATION OF WELL
APPLICANT 7_-;-.,r,-)1 71 "!1 F,7 COUNTY ::eld
Street Address 4 nx -1_;-A4- k. sec. 6
City E. State : o ; ,-, -4. _ n n_ T. 2 , R. ;7:r , fi P
Use of ground water ",-.,rl:,q+„i nrl Ground Water Basin —<..�.�=:=- �-
Owner of land on which well Water Management
is located -,- `'t,; C..n`^ District
Number of
acres to be i rr i c ,ted* z_.0 USE, DIAGRAM _ON. THE $6CK Of.THIS SHEET TO
Legal description of LOCATE WELL.
irrigated land n_^ ,cr°: of
Other water rights on f G• C_ iv,q,4,, $
this land -,.,.,� Driller f 'j�,.-1.-- :.<'.., . ^,.• No. /,'/ii
owner of irrigated DriIler's j
N land - •- -,- .• :.,1 -:-. Address 1t�.�a�X i jfldlirir ie, i4^tG •
Aquiferls) ground water is to be obtained
from ,: ,-,7,----. _. .'L .
ESTIMATED WELL DATA Signature of Applicant
Est. quantity of ground water to be claimed: CONDITIONS OF APPROVAL
Est. Max. Yield p-)-1 GPM or CFS
Est. average annual amount to be
used in acre-feet c--.;-‘i
Storage capacity AF
Anticipated start of drilling ,:;;:,t . 19 •';6
i
Foie Diameter :
\ / i - arr. from ft. to ft.
�f in. from ft. to ft.
Casinc :
Plain in. from ft. to ft.
in. from ft. to ft.
Perf. in. from ft. to ft.
in. from ft. to__-,__'__f t.
PUMP DATA: Out 1%,/
%,
Type HP Size :,,
r
' This application approved This application approved
1iPERMIT NUMBER .1 .1..$-.,, ,,.. t., s
"'
CG'JDITIONAL PERMIT NO.
1 ! (Permit good for one (1 ) year after date
i DATE i SSUED b - ._ 0 i Ou j of issuance)
t DATE ISSUED
I r
Stu'ce, cngi-veer i
f Chairman Ground Water Commission
Well and Water Usage Agreement
Harold E. Nelson agrees to allow L. Blake Nelson to use his well and
water for agricultural use on parcel number 131106000057 for as long as
they are adjacent property owners.
Usage includes irrigation and livestock watering. No household usage is
permitted.
x p ve,12.6,1 x of- gioule �--
Harold E. Nelson L. Blake Nelson
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