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Home My WebLink About20101155 Form No. OFFICE OF THE ATE ENGINEER • GWS-2„ • COLORADO DIVISION OF WATER RESOURCES 818 Centennial Bldg.,1313 Sherman St., Denver, Colorado 80203 (303)866-3581 • LIC WELL PERMIT NUMBER 215742 - -_ APPLICANT DIV. 8 CNTY. 62 WD 1 DES. BASIN 5 MD 9 Lot: Block: Filing: Subdiv: APPROVED WELL LOCATION WELD COUNTY SE 1/4 SE 1/4 Section 29 RAYMOND W & CAROLYN A GEISLER 7199 WCR 65 Twp 2 N RANGE 63 W 6th P.M. KEENESBURG CO 80643- DISTANCES FROM SECTION LINES (303)7324617 400 Ft. from South Section Line 150 Ft. from East Section Line PERMIT TO CONSTRUCT A WELL 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 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 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. 4) Water from this well may be used for domestic purposes inside three (3) single family dwellings. 5) The maximum pumping rate shall not exceed 15 GPM. 6) The annual withdrawal of ground water from this well shall not exceed 0.97 of an acre-foot. 7) The irrigated area shall not exceed 1 acre of lawn and garden. 8) Production is limited to the Laramie-Fox Hills aquifer. Plain casing must be installed and grouted from ground surface to a minimum depth of 440 feet to prevent diversion of water from other zones. The depth of the well shall not exceed 700 feet, which is the estimated base of the Laramie-Fox Hills aquifer. 9) This well must be constructed within 300 feet of the location specified on this permit. 10) This permit has been approved with a change to the permit application form from that applied for by the applicant. You are hereby notified that you have the right to appeal the issuance of this permit, by filing a written request with this office within sixty (60) days of the date of issuance, pursuant to the State Administrative Procedures Act. (See Section 24-4-104 through 106, C.R.S.). 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. 2010-1155 • APPROVED JDW A heta Stele Engineer ° BY EB 16 2001 Receipt No. 0440836 DATE ISSUED FEB 161999 EXPIRATION DATE • • Form STATE OF COLORADO For Office Use Only No. OFFICE OF THE STATE ENGINEER GWS•I I 818 Centennial Bldg., 1313 Sherman St., Denver, CO 80203 6/2003 (303)866-3581 Fax(303) 866-3589 • CHANGE IN OWNERSHIP/ADDRESS CORRECTION OF THE WELL LOCATION Insert the Well Permit Number al 5 1 l . Name, address and phone of the person claiming ownership of the well: NAMES) rwr:. •_ \rl �C7�vv�rS Mailing Address 7t, i- R . (,S City. St. Zipscc.»�,► � C i - <71O -% Phone -5C3)1 13'D - ` L4 O`-1 U 515/0 83� This form is filed by the named individual/entity claiming that they are the owner of the well permitted as referenced above. This filing is made pursuant to C.R.S.37-90-143. WELL LOCATION: County . Li w..k. A Owner's Well Designation r _53 c l� 5 t��a,�s4,.) ^,1 La...) 5i oL'13 (Address) (City) r (State) (Zip) • • ,5S 1/4 ofthe≥g1/4, Secc%3...,Twp. c.,Z 14 N. or D S., Range , '; ❑E. or W., P.M, • Distance from Section Lines 9 OO Ft. From ❑ N. or�S., _ Ft. From E. or O W. Line. Subdivision Name Lot , Block , Filing/Unit The above listed owner(s) say(s) that h , she (they) own the well described herein. The existing record is being amended for the following reasons: Change in name of owner O Change in mailing address ❑Correction of location for exempt wells permitted prior to May 8, 1972 and non-exempt wells permitted before May 17, 1965. Please see the reverse side for further information regarding correction of the well location. I (we) claim and say that I (we).(are) the owner(s) of the well described above, know the contents of the statements made herein, and state that they are true to my (our) knowledge. Please print the Signer's Name&Title Signature(s)of the new owner. Date +\ ^n M. VJ _ Mil.:•� _ c_ ..•� 'w•�u.1 J M�,�vi 11 I rt IOC It is the responsibility of the new owner of this well to complete and sign the form. Signatures of agents ere acceptable if an • original letter of agency signed by the owner is attached to the form upon its receipt. • For Office Use Only h z . • State Engineer By Date • I 'd QtS :OT 90 02 mew na•' WEt.L CONSTRUCTION AND"EST REPORT For Dieos to ally 04 STATE OF COLORADO, OF THE STATE 94G*EFR I 13 13 Shannon St_ Ant Stt Dafte C0_80203 r I. . eal PERPAW NUMBER .Qtrilt4a OWNER Address Cie AMER MasYry Address 1 a • k o. Cky.St.Zip 1cEF Lr%& r\ TiY1ts►Ci . � Phone(WS) l — Lktsf ` wELL LOCATION As DRILLED: Sk is 4E 1/4,Sec. act; TwP.` a N .Rage ta,3 _ u.) . DISTANCES FROM LINES: ; f 4t)t> t from I�rm Sec. lint and )aTh t gram sec. one.OR SUBDIVISION: ' ' LOT BLOCK^�_,�„FIUNG(UNIT) STREET ADDRESS AT WELL LOCAf1Of�k GROUND SURFACE ELEVATION I. t DRILLING.METHOD __ __ I DATE mains b ' $ _1 A . TOTAL DEPTHrt _tt.DEPTH COMPLETED USD t . GEOLOGIC LO@ 1 t.HOLE pIAtit On.) From(R) To pl) Dspb Da Mbn of MSS(iypo.44Calm Warr Coat oal I ' Y.) - ele� F ta — t I : , L14 7 r ��c r _ F K ' OD Orly) IGnd . Well Size From To(it) 5- .i VS--- CS I �_ • I" ! 4&{\ftn a AOC; WitSt%a C !_ nn—e. •.3"l _ a, �P ACE u1L SfwtD •} Ste_ Ip iQat�Ll _t C '.ail . .1 - `I K acre .&ri �f 5110 f,go_ �ti- ck W IL SeS: —r - .K CIC i Le-it; wk. *Met St ALTER PACK S.PACKER PLACEMENT: ' ILsL. r Tim NAPA) Sze; • Mona) Depth SSC 10. 'GROUTING RECORD: ' WSW Amount Dernity humeral Lama • s REMARKS: r �' it a m Ep t DISINFECTION: Type H TH Aria.Used 1 G1p • I WELL i rag,DATA: O Check�rest Data is submitted on FaNa.Form N GINS 39 Supplemental Weo Test TESTING METHOD 7It • Static Leret 1 t Datelfime measured G]C C i 1. 49 ,Production Race 15 Apm. Pumping level Ala t Date/Time Snared -c )cis ! .Test length pars) <Q . Remarks ig - • 3. I tiara sad to absmaif.mode basin as l}mow to wants tbuad,and s Ray antams knosAsdeo.[Pno*ntJo saw ar•r,1Dt Iua s C.RS.aw dyY.�slramals bask;-- .. paiuyis tb.a: 4 _and ispt6abSasada,tmisdarnar.) coN RAC 1aCJl� gvs��C� t R- ' 4-4531 Lic. No.qn - IrEAddress L3(Y L l*s.Ii 1 i (Plesae type or prYrQ ; F Dew • .� D Ftsr Q i PUMPINSTALAATTON AND TEST REPORT For arm.Use c* • STATE OF COLORADO,OFFICE OF THE STATE-ENGINEER c 1 PEFMAtT Ntli+BER 4 c�, +5-1V a . • 2 OWNER NMIE(S) i la lit � tEt Mating Address Q• I'` ;irea Olt 4�� .Clity.St.Zip Phone (XS) -i3 -fit 4 ` a WELL LOCATION AS DRM r ED: ir 1/4 St 1/4,Sec. Twp. a N_ ,: teaw . DISTANCES FROM rp. UNESt :I t.ro•Win horn t sac.line.and ISD ft..from E ST Sec. Woe.tam :e. • eIaDNISlON: +aw LOT 8L0CK i FIUNG(U iT) STREET ADDRESS AT WELL L CAT1Ort �. 4. PUMP DATA:Type s2`•'� °nump Model No Corollotode Pump Manufacturer 4 f) 3fe � Vats eodelN Fy�LoadAmps I Design GPM to at RRM .HP ['la 1 . . pump flake Depth LIaD Feet Drop/Coka n Pipe Sae '. 1 • kic<wa. Krd Rz.s/ • I ?kMPDITmONAL INFORMATI FOR SNAPS GREATERTHAT SO GPM: TURBINE DRIVER TYPE Stmt 0 Engine 0 Mar; • i padgrt Head Took; Number at Stages k ' , Shaft size itches. S OTTER EQUIPMENT: • A1rarsttstated0Yes0 No,Citce Depth ft. • Mciptor Tube Installed Oyes O No.Depth ft. . Met r Mtg. MeterBede!Na .Readout0 Gallons.0 Gallons.0 Acreta t,0 Reading t • 6. TEST DATA 0 Check boot I Teat dela is Cell .pplen ntat Font : Dee Taal Wet Depth Tyne_ Date Measured al '1 49 Pumping Let 31st • )7. DISINFECTION: Type i . < ri -Ql Amt.Used i `'" "l' " 1 . Water away analysis avalaoIei 0 Yes t)No . ' i i IL Remarks P _ I I • i i 10 hare read the statements mafie herein and know the assents thereat, and that they are Due to my knowledge. [Pursuant to Section 244-104 (19)(a) C.R.S.,the making alse stamen herein.cor+stliutes perjury in the second degree and is punished!as a class 1 misdemeanor.] I ; CONTRACTOR ) �� \ 4 t t v"T�k�ats 45.3 i tic. NaLA . Mang Address . I QA;( to 1Q5 Olt e"me type or p sicpp "si; e6` 1 ; • WELD COUNTY HEALTH DEPARTMENT - 1517 16TH AVENUE COURT, GREELEY, CO 80631 • (970) 353-0635 EXT 2225 FAX (970) 356-4966 Permit # : SP-9800088 Sec/Twn/Rng: 29 02 63 Status: SS Permit Type : RNEW C=commercial, R-residential + NEW, REpair, VauLT Applied: 03/12/1998 Parcel No: 1303 29 000014 Issued: 03/16/1998 Finales: S/iqhY9er Location: 7033 WCR 65/29-02-63 Legal Desc : 7279 ALL 29 2 63 EXC UPRR RES (16R) SECT, TWN, RNG: 7199 WCR 65 MEL APPLICANT ANDREWS LARRY Phone : (970) 539-4000 2907 13TH AVENUE, GREELEY COLORADO 80631 OWNER GEISLER RAY/ANDREWS LARRY Phone : (970) 732-4617 2907 13TH AVENUE, GREELEY COLORADO 80631 SEPT-INSTL GRAYLINE INC Phone : (303) 732-920J 9703 WCR 59, KEENESBURG CO 80643 Description: HOUSE Commercial (Y/N) : N Residential (Y/N) : Y Acres : 5 . 00 Number of Persons : 5 Basement Plumbing (Y/N) : Y Number of Bedrooms : 4 Bathrooms-> Full : 2 3/4 : 1 1/2 : 1 walker Public (Y/N) : Utility Name : r Private (Y/N) : Y Cistern (Y/N) : Well (Y/N) : Y 71.rWater Permit No : 207974 Percolation Rate : 50 . 8 Limiting Zone : >08 ft 00 in Desc : a Ground Slope : Dir: Soil Suitable (Y/N) : Y Engineer Design Req' d (Y/N) : N • In 100 Yr Flood Plain (Y/N) : N Minimum Installation Septic Tank: 1250 gal Absorption Trench: 1400 sq. ft . Absorption Bed: 1840 sq. ft . Actual Installation Septic Tank: VW gal Absorption Trench: I da sq. ft . Absorption Bed: 1 sq. ft . Design `^F W 7,aLVU�Type :(l � nL es"mn. Y� 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 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. Pom Environmental Specialist ate 1`ad • Yl* rn E 4 90c PAAAr 'kothA, t2 1 k It) 2-) (2, L (b, © o 0._ I MD fskixtv_ tclet A.Cut k2 1. • gg et" s thcimAt6 1JWtL1. 401 elAciAbiLs 0 Improverent Location t ertificate 0 Graphic Scale 1"-SIP B!1 f/ r #5 RFfAR W/A ALL.CM' NS 29281Ill li- N 0Q'30'03"E 466.00 I //j7'j >/// % 1 n 1 N o x M �, C w OM Sa "t ��i, SINGLE S TORY a FRAME HOUSE d ►t`� 77 e' t ,. LC C I /1 METALS — WELl. • DARN • a s;, 8h GO- ;e• r ,3• ,. ANIMAL MENUS • NOT SHOWN -, . `j - O' PI x MS REBAR W/A L _- • .--_ —at _ _.._._ — , ... �-• ...� �,...._.. .— #-- --- _...i ALL.cAp NA 28283 10r RIGHT-OF-WAY S I Lit S 0(1'9003'W 464.00' SOUTHEAST CORNER SEC.29,T.2N.,R.61.W. 7033 WELD COUNTY ROAD 65 JIMMIE &TAMARA JAMES LEGAL DESCRIPTION PROVIDED BY: THE TALON GROUP, r ORDER NO.FC25062692, LOT A OF RECORDED EXEMPTION NO. I303-29-4-RE2158, ACCORDING TO THE MAP RECORDED MARCH 25, 1998 AT RECEPT THE ION NO.2601661,BEING A PART OF THE EAST 1/2 OF SOUTHEAST 1/4 OF SECTION 29,TOWNSHIP 2 NORTH,RANGE 63 WEST OF THE 6TH P.M.,COUNTY OF WELD,STATE OF COLORADO. I hereby certify that this improvement location certificate was prepared for � COLORADO TENDERFOOT. ti � that It is not a land survey plat or huprover eat survey p1st,and that it is motto he Hello