HomeMy WebLinkAbout20102181.tiff WA SUPPLY INFORMATION SUMAY
satin 30.29.13344. C.N.S. r.,..e that the "ePimat aiadt n the Csy7A+..i..r sides that a watr apply Mat
is Skis it tors d watiq. pit►ad depailiy oil be rabbi to mss a adyeate apply of rater.
1. NAME OF DEVELOPMENT AS PROPOSED
1,111d West A azC
2. WO ME ACTION Sett Sect, t. Qevclopne..t Plan l Use. hY Sit pzcuie'-+
3.NAME OF maw PARCH.
,
ARCH.AS RECOIL ,o/L,,)rear \&.t);n 0 % NcaAiLcr ICI W knead
moms= NIA FIRE /1//A BLOCK /1/14 LOT
4. TOTAL ACREAGE 2.41,131 S. NUMBER OF LOTS PROPOSED NSA PUT NAP ENCLOSED 0 YES
& P*aca HISTORY-Plow attach espies d ask Plate wither siam ate Mrs.wuat
A.Was Pars)ceded with mato pier to Jam I. 1972?XYES 0 NO
B.Has dm pd sr lea pt d a ease d w make sites Jae 1. 1972? $YES ❑ NO
If yes. Suitt A.Praia aka P.cco aed EFcp4;on — 7 WI
7. LOCATION OF PARCEL.-Incl pie a Imp JILL de project was d tie to a wipe ante.
NW 114 OF NF 114 SECTION 3lo TOp11Sne Z 1,tra ❑ S RANGE dos ❑ E 0,91
nw..rAL mamma Xam ❑ kM. ❑ UTE ❑ COSRIA
!NAT•Leads d al pre popery
y he Platted a g ra d permit ins. .i4.&
SnaM S Plat 'Ys a ❑ Ns Bat sated Yd draw slat b ❑ Ys ❑ Ns
9. ESTIMATED WATER REQUIREMENTS-Gin ear Off I MO Fat per In 10.WATER SUPPLY SOURCE
EJUSfNG ❑ DEVELOPED I ❑ NEW WELLS-
SPRNG •• ra_sas-eaaa
HOUSEHOLD USE/ at ads GPO AF WELL PERMIT FOUNDERS o auaa ❑ell a a.a
❑r.ar 13 .aaaaa ar.
COMMERCIAL USE/ d SF. GPO Al a sa wee ❑ ASM teCOMMERCIAL teat
1836Z - - A 0Ina °""r"
NMGATIDII l Own GPO AF IRIM
10 1 Lei - - O
1►1ZS - F -
STOCK WATERING t d Aced GPO AF ❑ MUNICIPAL
❑ ASSOCIATION WATER COURT DECREE CASE Mn
OTHER GPO AF 0 COW►ANY
❑ DEDUCT
CT
TOTAL GPO AF NAME
LETTER OF COMMITMENT FOR
SERVICE ❑ YES ❑ NO
11. ENGIEEWS WATER SUPPLY REPORT 0 YES NON EYES.PLEASE FORWARD En THIS FORM. as.q e.reared to.a nit..aaar.tedJ
12.TYPE OF SEWAGE DISPOSAL SYSTEM
❑ SEPTIC TANKREACII FED 0 CBITRAL SYSTEM • DISTRICT MAW
❑ LAGOON ❑ VAULT•LOCATION SEWAGE HAIRED TO
�
O ENGINEERED SYSTEM was.an d apiary wrl WOTHER acAo,\p\c ccskeer\ un�+s 4 c all avant 5
- _-- 2010-2181
Colorado's Well View Web - VDetails: Receipt 0466320A • Page I of 2
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Permit Constructed Help Last Refresh:3/17/2010 12:02:10 AM
Receipt 0466320A Division: 1
Permit#: 230317-- Water District: 1
Well Name/#: County: WELD
Designated Basin: Management District:
Case Number.
WOW:
[-] Applicant/Owners History
Date Range Appllnnt/Owner Name Address City/State/Zip
Unknown-Resent WRLARD KEVIN 13030 WCR#20 FORT LUPTON,CO 80621-
[-] Location Information
Approved Well Location:
Q4O Q16O Section Township Range PM Footage from Section Lines
NW NE 36 2.0N 65.0W Stith 825 N 3150 W
Northing(UM y): 4438909.6 Feeling(UTN x): 533208.9
Location Accuracy: Spotted from section lines
Physical Address
City/State/Zip
Subdivision Name
• Filing Block Lot
Parcel ID:
Acres in Tract: 35
[-] Permit Details
Date Issued: 12/04/2000 Date Expires: 12/04/2002
Use(s): DOMESTIC AqeiferAll UNNAMED AQUIFERS
Spedal Use: (s):
Area which may be irrigated:
Maximum annual volume of appropriation:
Statute:
Permit Requirements: Totalizing Flow Meter Geophysical Log Abandonment Report
No No No
Cross Reference
Pennit(s):
Permit Number Receipt Description
Comments:
[-] Construction/Usage Details
Well Construction Date:06/05/2001 Pump Installation Date:07/25/2001
Well Plugged: 1st Benefdal Use:
Elevation Depth Perforated Casing(Top) Perforated Casing(Bottom) Static Water Level Pump Rate
47 20 47 12 15
• Lk# Name Address Phone Number
Driller 690 GLOVER JONATHAN M. 7261 W.CR.31 FT LUPTON,CO 80621 303-857-2041
Pump Installer 696 GLOVER JONATHAN M. 7261 W.C.R.31 FT LUPTON,CO 00621 303-857-2041
http://www.dwr.state.co.us/WellViewWebNiew.aspx?receint=0466320A 3/17/2010
Colorado's WellView Web - Vi i Details: Receipt 0466320A Page 2 of 2
• It-1 Application/Permit History
Pump Installation Report Received 08/06/2001
Well Construction Report Received 08/06/2001
Pump Installed 07/25/2001
Well Constructed 06/05/2001
Permit Issued 12/04/2000
Application Received 09/11/2000
[-] Imaged Documents
Document Name Date Imaged Annotated
Well Construction&Test 12/01/2007 No
Pump Installation&Test 12/01/2007 No
Original File 12/01/2007 No
WtllYiew 'Nth Le.*W C«s
Copyright O 2009 Colorado Division of Water Resources.All rights reserved.
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http://www.dwr.state.co.us/WellViewWebNiew.aspx?receipt=0466320A 3/17/2010
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