HomeMy WebLinkAbout20081392.tiff !- •
RECEIVED'
gli4,_y • COLORADO DIVISION OF WATER RESOURCES JUL 7 ��� RECENEI
OR . 818 Centennial Bldg., 1313 Sherman St. WATER RESOURCES
PRINT.jN BLACK INK.
COPY OF ACCEPTED Denver, Colorado 80203 um ENGINEER ,uN231�STATEMENT MAILED a
ON REQUEST. STATE OF COLORADO AFFIDAVIT
SS. WATER RfSOUP
COUNTY OF Weld son Ofatu
calk
STATEMENT OF BENEFICIAL USE OF GROUND WATER
AMENDMENT OF EXISTING RECORD
K LATE REGISTRATION rl O
PERMIT NUMBER 91886 LOCATION OF WELL
THE AFFIANT(S) M4t teihr12:ne county d-VA 144
whose mailing 202.0,1.6B PT SEL, 9 2 67 BEG 30's ,From E4
I address is /Ul"7S , /9' i NE , of the/ SFs %, SecTion -- 41
/ / / 7L
yn / Cor S18 0117 W272' N1801 E272' to BEG (1a
City r�/". /—r-r i/l/L� �.c17Cl /J OGO/ TwP.�c _ . Rng. AD_ .C.&-- P M(C
(e,RT[I Itl Pl sl E OR
being duly sworn upon oath, deposes and says that hehe (they) is (ore) the owner(s) of the well described hereon; the well is
located as described above, ot distances of ,lal feet from the South section line and 445'130 feet from the
WORTH oR aoUTnl
Fast section line; water from this well was first applied to a beneficial use for the purpose(s) described herein on the
u.ST OP wcsTi
day of May , 19 L7 ; the maximum sustained pumping rate of the well is 15 gallons per minute, the pumping
Ste claimed hereby is - 15 gallons per minute; the total depth ofthe well is 5O feet; the overage annual amount
of water to be diverted is 1 acre-feet; for which claim is hereby mode for Domestic--Septic tank and
leech fiE1d3 insta led put ose(s))''' the legal description the land on which the water from this well is used is
$&I.1. `Se Ng- aCt .vwP ao w."--,„ till 4W- to-C3te.W',( tt
2O2d.6B FT SELL 9 2 67 BEG 3O'S from Eh Cor 818 0117 W272' N1801 E272' to BEG (1A) of which
1 acres are irrigated and which is illustrated on the map on the reverse side of this form; that this well was completed in
compliance with the permit approved therefor; this statement of beneficial use of ground water is filed in compliance with law; he
(they) has (have) read the statements made hereon; knows the content thereof; and that the same are true of his (their) knowledge.
(COMPLETE REVERSE SIDE OF THIS FORM)
" Stgnature(s) n'?e - -£r0aslr%r✓ g a_.f7Q-
Subscribed and sworn FOR OFFICE USE ONLY
to before me on this 22 day of June , 19_22.
Cour, Case No.
My Commission expires: J'LLlV 19, 19E0
mrul Prior Mo. Day Y..
'/ lA. wi'
NOT ARr Pus IC Div Cty.
ACCEPTED-FOR Fti.ING BY THE STATE ENGINEER OF COLORADO
PURSI ANA TO THE FOLLOWING CONDITIONS: Sec. 'A. IA.
-.-,,-;/--:,-, _ Well Use
J V r Dist. __ Bosin
r 2008-1392
-
attweistatisEXHIBIT
JUL 2219 7 _ 9
DATE STATE ENGINEER BY
•.` WR>:5-K>.. a COLORADO DIVISION OF WATER RESOURCES
818 Centennial Bldg., 1313 Sherman St.,Denver,Colorado 802Q,3.n�' p RECEIVED
• .. PERMIT APPLICATION FORM �,((�tll�, [`LV rc
��06-3
. .Application must , )L 7'77
be complete where ( )A PERMIT TO USE GROUND WATER 'AA 23L
applicable. Type or \ (X)A PERMIT TO CONSTRUCT A WELL WATER RESOURCES RESOUJ
print in BLACK FOR: (X) A PERMIT TO INSTALL A PUMP S ATE earl whit BIND
INK.No overstrikes sir,Ems,
'S'
or erasures unless (X) REPLACEMENT FOR NO.
initialed. ( ) OTHER PP-WATER COURT CASE NO.
1) APPLICANT-mailing address FOR OFFICE USE ONLY: DO NOT WRITE IN THIS COLUMNA
NAME Mike Eckstine Receipt No. Sz (17C)6 /
i STREET 10475 Rd 19 Basin Dist.
CITY Fort Lupton Colorado 80621
(State) (Zip) CONDITIONS OF APPROVAL
TELEPHONE NO. 785-2110 or 785-2P01 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.
20246BJT SE4 9 2 67 BEG 30's From E4 Cr 518
—' c '4 of the ...-- Sc %,Section/
01171'1272' N180' E272' to BEQ� (1A L APPROVED AS A REPLACEMENT OF WELL ND.
ag
Twp. .e 2. ,„,a Rng./lorl „Al) ,' P,M. THB EWING WELL:MUST BE PLUGGED AND
(N.s1 IE.W) ACCORDING TO THE REVISED AND AMENDED RULES AIN
• (3) WATER USE AND WELL DATA REGULATIONS FOR WATER WELLANJPUMPINSTALLATI
CONTRACTORS. THE ENCLOSED AFFIDAVIT MUST BE
Proposed maximum pumping rate (gpm) 15 SUBMITTED WITHIN SIXTY(60)DAYS AFTER THE
CONSTRUCTION OE THE NEW WELL,AFFIRMING THAT
Average annual amount of ground water 1 WELL110. 9/n4 was PLUGGED AND ABANDON
to be appropriated (acre-feet): -
Number of acres to be irrigated: 1 PERMIT EXPIRATION DATE EXTEND
III
Proposed total depth (feet): 50 TO 2z , ( 1 Fn it , Q,./,. f71
Aquifer ground water is to be obtained from: e"'"�
Alluvium
_..._0wner'swelldeSign4tiaa ___.—_._. _._
GROUND WATER TO BE USED FOR:
( ) HOUSEHOLD USE ONLY -no irrigation (0)
(X ) DOMESTIC(1) ( ) INDUSTRIAL (5)
( 1 LIVESTOCK (2) ( ) IRRIGATION (6)
( )COMMERCIAL (4) ( ) MUNICIPAL (81.
( 1 OTHER (9) APPLICATION APPROVED
DETAIL THE USE ON BACK IN (11) p / 4/
PERMIT NUMBER //qqO
(4) DRILLER JUL 22
DATE ISSUED
Name Johnson Well and Irrigati'n EXPIRAI� ATE
��w, . ��
Street 7,C. Box 98 T`�
• City Wiggins Colorado 80654 1ST T •
rENGI EEJ,i)/
(State) (Zip)
BY
Telephone No. 483-7354 Lic.No. 957
LD. / ' COUNTY 6 'R
• .
a
(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. ,a5d1
II 1 I (SR)ft.from South sec.`lint
47 — — T — T — ._4_ — T — 4 — 4 — + (north or south)
I i=1.4----1 MILE,5280 FEET / t4 IWa ft.from East sec.line
1 (east or west)
f + + - + -F- + - t + I LOT BLOCK FILING *
-1- — 4 — , NORTH SECTION LINE I _ + — 1
SUBDIVISION
1 I
(7) TRACT ON WHICH WELL WILL BE
I I + LOCATED Owner: hike Enkstine
-� NORTH- -I-L
- — -I- -- - — — -m + t No.of acres 1 . Will this be
I to
I m I the only well on this tract? Yes
n
f
I ( 'o — + (8) PROPOSED CASING PROGRAM
( 2
I I r II Plain Casing
+ '— — T - - - t - +.i
I 5 in,from n ft.-to- 3f1 ft.
I I I
in.from ft.to ft.
_ I I ) 1 Perforated casing
+ — + SOUTH SECTION LINE r — + I
1 I I I 5 in.from 30 ft.to 50 ft.
+ 4 -F + -(- + .+ 4- + in.from ft.to ;t.
• I I I -1? I (9) FOR REPLACEMENT WELLS give distance
and direction from old well and plans for plugging
-h - 4 — + — + - + - -1- -F- — -+- — 4. it:
•. The scale of the diagram is 2 inches=1 mile New well will be n oved 25' north
Each small square represents 40 acres. Old well will be capped and rlug ed
WATER EQUIVALENTS TABLE (Rounded Figures)
An acre-foot covers 1 acre of land 1 foot deep according to existing ground rules
1 cubic foot per second Ids) ...449 gallons per minute(glum)
A family of 5 will require approximately 1 acre-foot of water per year. and regulations
1 acre-foot...43,560 cubic feet...325,900 gallons.
1,000 gpm pumped continuously for one day produces 4.42 acre-feet.
(10) LAND ON WHICH GROUND WATER WILL BE USED'
Owner(s): Mike Eckstine No.of acres: 1
-1)246B PT SE4 9 2 67 BN 0's Fsom Cor 318 0117 't+ 7 ' T; 180' E272' to BE%r(1.
Legal description: !lg q 'Icy
(11) DETAILED DESCRIPTION of the use of ground water: Household use and domestic wells must indicate type of disposal
system to be used.
•
Domestic--Septic Tank and leech field already installed.
(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
(13) THE APPLICANT(S) STATE(S) THAT THE INFORMATION SET FORTH HEREON IS
TRUE TO THE BEST OF HIS KNOWLEDGE.
—74 4;0/' r 47f:i4e
SIGNATURE OF APPL ICANTIS)
Use'additional sheets of paper if more space is required.
WELD COUNTY HEALTH DEPARTMENT
1517 16TH AVENUE COURT, GREELEY, CO 80631
• (970) 353-0635 EXT 2225 FAX (970) 356-4966
Permit # : SP-9600291 Sec/Twn/Rng: 09 02 67 Status: ISSUED
Permit Type : RREP c commercial, R=residential + NEW, REPair, VauLT
Applied: 05/31/1996
Parcel No: 1311 09 000060 Issued: 06/13/1996
Finaled:
Location: 10475 WCR 19 FT LUPTON 09-02-67
Legal Desc : 20246-B PT SE4 9 2 67 BEG E4 COR S210 ' W272 '
10475 19 CR WELD
APPLICANT STALCUP RICHARD D & CYNTHIA A
10475 WELD CO RD 19, FORT LUPTON CO 80621
OWNER STALCUP RICHARD D & CYNTHIA A
10475 WELD CO RD 19 , FORT LUPTON CO 80621
Description: HOUSE
Commercial (Y/N) : N Residential (Y/N) : Y Acres : 1 . 31
Number of Persons : 4 Basement Plumbing (Y/N) :
Number of Bedrooms : 4 Bathrooms-> Full : 1 3/4 : 1 1/2 :
Water Public (Y/N) : Y Utility Name : CWCWD
Water Private (Y/N) : Cistern (Y/N) : Well (Y/N) :
•Water Permit No :
Percolation Rate : 33 . 0 Limiting Zone : >08 ft 00 in Desc :
°s Ground Slope : Dir : Soil Suitable (Y/N) : Y
Engineer Design Req' d (Y/N) : N In 100 Yr Flood Plain (Y/N) :
Minimum Installation
Septic Tank : 1250 gal Absorption Trench: 1100 sq. ft .
Absorption Bed: 1425 sq. ft .
Actual Installation
Septic Tank : p J gal Absorption Trench: sq. ft .
Absorption Bed: )'Jq7 sq. ft .
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 19'13 25-10-111 (2) .
This permit is not transferable. The Weld County Health Department 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 Health Department.
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• my CENTRAL WELD COUNTY WATER DISTRICT
2235 2nd Ave. Ph.970-352-1284
Greeley.Colorado 80631
WATER BILL
PREVIOUS PRESENT PREVIOUS PRESENT
DATE - DATE READING READING
10/01 11/01 389 3921
Pa o line all WWW. CWIWD . COM
I 31
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1 Q,24ewo i 221 ASSECPa20
Thy sands o`Gal ons THIS AMOUNT
ir
ACCOUNT NO. 'I ..•..-gr.a.�
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