HomeMy WebLinkAbout20092709.tiff ForrnNo. . OFFICE OF THSTATE ENGINEER
GWS-25 COLORADO DIVISION OF WATER RESOURCE!
818 Centennial Bldg..1313 Sherman St,Denver,Colorado 80203
(303)866-3581 •
LIC
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WELL PERMIT NUMBER a 3a a It 9 _
• APPLICANT DN. 1 WD 2 DES. BASIN MD
APPROVED WELL LOCATION
WELD COUNTY
NW 1/4 SW 1/4 Section 22
JEFF&CINL1I KLOSE Township 2N Range 66 W Sixth P.M.
6828 HIGHWAY 66 DISTANCES FROM SECTION LINES
PLATTEVILLE,CO 80651- 2760 Ft.from North Section Line
770 Ft.from West Section Line
(970)535-9425 UTM COORDINATES
PERMIT TO CONSTRUCT A WELL Northing: Easting:
ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT
CONDfTIONS OF APPROVAL
1) This well shall be used in such a way as to arose 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 horn 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 37-92-602(3)(b)(1)and policy of the State Engineer under the following conditions.
4) The use of ground water from this well is limited to ordinary household purposes inside one(1)single family dwelling,the
watering of four large.non-commercial domestic animals,and the irrigation of not more than one(1)acre of home gardens
• and lawns.
5) Production from this well is restricted to the Law n:e-Fox Hills aquifer,which corresponds to the interval between 565 feet
and 865 feet below the ground surface. Plain casing shall be installed and grouted to prevent production from other zones.
6) The depth to the top of the Laramie-Fox Hills aquifer is approximate. To ensure the exclusion of poor quality water from
zones immediately above the aquifer,plain casing and grout shall extend through the lowermost coal and/or carbonaceous
shale that overlies the Laramie sand portion of the aquifer.
7) The maximum pumping rate of this well shall not exceed 15 GPM.
8) The annual withdrawal of ground water from this well shall not exceed 2.57 acre-foot.
9) The return flow horn the use of this well must be through an individual waste water disposal system of the type so that not
less than 2%of the total amount of water withdrawn is returned to the same steam system in which the well is located.
10) This well shall be constructed not more than 200 feet from the location specified on this permit
NOTE:The ability of this well to withdraw its authorized amount of water from this non-renewable aquifer may be less than
the 100 years upon which the amount of water in the aquifer Is allocated,due to anticipated water level declines.
NOTE:To insure a maximum productive life of this welt perforated casing should be set through the entire producing
interval of the approved zone or aquifer indicated above.4rt
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APPROVED .
SCC ���dddrGG •Gi �Engineert �
• Receipt No.0472948 StateDATE ISSUED MAR 2 2 LWI PI- TION DA MAR 2 2 2003
2009-2709 ■
WELD COUNTY DEPARTMENT'PUBLIC HEALTH AND ENVIRONI,NT
1555 NORTH 17TH AVENUE
GREELEY,CO 80631
PHONE(970) 304-6415 FAX(970)304-6411
Fineled
"Lit#: SP-0100124 SeclTwn/Rng: 22 02 66 Status: ISSUED
Owner: KLOSE JEFF& CINDI Applied:03/21/2001
Applicant: KLOSE JEFF&CINDI Issued: 03/26/2001
Permit Type: RNEW Commercial,R=Residential+NEW,REPair,VauLT Finaled: ^
Parcel #: 1309-22-0-00-045 fL
Location: 8436 CR 31 22 02 66
Legal Description: 16185-H PT W2SW4 22 2 66 BEG 1555.94N O
F SW COR SEC S75DE 1
Installer: ((i ice
Description:( MODULAR
Commercial: N Residential:Y Acres: 11.66
#of Persons: 3 Basement Plumbing: Y
#of Bedrooms: 4 Bathrooms -Full: 3 3/4: 0 1/2: 0
Water Public: N Water Source:
Water Private: Y Cistern: N Well: Y Well Permit#: TED
Percolation Rate: 33.5 Limiting Zone: 8 ft 0 in Description
% Ground Slope: 0 Dir: Soil Suitable: (Y/N) Y
•gineer Design Required: (Y/N) N In 100 Year Flood Plain: (Y/N) N
Minimum Installation Chambers
Septic Tank: 1250 gallons Absorption Trench: 1488 square feet
or Absorption Bed: 1935 square feet
Actual Installation,,a�O
Septic Tank: gallons Absorption Trench: I`><g square feet
Absorption Bed: square feet
Design Type: A• t&iJc1tf
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 1973 25-10-111 (2).
This nermit is not transferable, The Weld County Department of Public Health and Environment 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 Department of Public th and Enviro at.
dad atilt— X17O/
vironmental Health Specialist Date
Forth.S_FINAL S I S
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