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Home My WebLink About20252996.tiffForm No. GWg-25 APPLICANT OFFICE OF THE STATE ENGINEER COLORADO DIVISION OF WATER RESOURCES 916 Centennial Bldg., 1313 Sherman St.. Denver. Colorado 80203 (303) 688.9561 LR WELL PERMIT NUMBER ifiss6 - 1 62 DIV. CNTY. WD DES. BASIN MD Lot: MARGARET SPAIN 2021 WCR 27 FT LUPTON, CO 80621 303/659-8466 REGISTRATION OF EXISTING WELL Block: Filing: Subdiv: APPROVED WELL LOCATION WELD cowry SE 1/4 1/4 Section Twp N , Range 66 W 6th P.M. DISTANCES FROM SECTION LINES 119 Ft. from South Section Line 86 Ft. from East Section Line 19 ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT 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 and Pump Installation 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 17. 3) This well is recorded, and permit approved, in accordance with CRS 37-92-602(5) for historic use as indicated herein and described in CRS 37-92-602(1) (b), being a well producing 15 GPM and used for ordinary household purposes inside one single family dwelling(s), fire protection, the watering of domestic animals and poultry, and the irrigation of not more than 2,500 square feet of home gardens and lawns. 4) The average annual amount of ground water to be appropriated shall not exceed 1.0 acre-feet. `OM /9 I /�11�OVED: Receipt No. _ DATE ISSUED SEP 1 3 1991 E BY FORM , w g No.. '° STATE OF COLORADO OFFICE OF THE STATE ENGINEER MB Centennial Bldg.. 1313 Snowman St, Dancer, Colorado mew (303) M6 -35E1 For oioe um, only �� PEi11hT NUMBER r -AEC' ; 'D WC 2 9 '91 • WA► (EsouacU t sTAT �46uoMEER 0. R.o.ipt No. 94, ips-,4 C,1 FOR INSTRUCTIONS SEE REVERSE SIDE REGISTRATION OF EXISTING WELL 1. WELL OWNER t t NAME(S) Mailing City, Phone e. -10 C'C GtG 0'x`_(2_ 7 Address �p`alr St. Zip 14 _ Lk o t, n 7506Q i (303) 66Gf-7SLI il (D j 2. WELL LOCATION: COUNTY i)�el OWNER'S WELL DESIGNATION I la C (Address) ,.(�11 a L/4 of the 5. 1/4, Sec. 1R Twp. (City) (Stare) (Zip) E (Dip ❑ E. or © W. coll. P.M. I L N. or ❑ S., Range Distances from Section Lines 1 l cii Ft. '`lo i Ft. from NI E. or [:-.1W. Line. from ❑ N, or 13 S. Line, 3. The well has historically been used for the following 1 b purpose(s): fl\ e S1 ,' Q., 4. Water from the well was first used beneficially on ,5— a ll1 19 92. 4y the original owner for the above described purpose(s) 5. The total depth of this well is as' feet. 6. The pumping rate is 15 gallons per minute. 7. The average annual amount of water diverted is I, .0 acre feet. 8. The described o, as land area of home lawn and garden irrigated as: se . 5d! 5.eC IQ from this well is: R r] D O ❑ Acre or 53 Square feet, R (Number) IN, V (Q (i th toil' Pill . y J (ripar Subdivision Lot(s) Block Filing/Unit I (we) have read the statements made herein, know the contents thereof, and state that they are true to my (our) knowledge. [Pursuant to Section 24-4-104 (13)(a) C.R.S., the making of false statements herein constitutes perjury in the second degree and is punishable as a Class 1 misdemeanor.] 9. NamelTitle (Ti..s typo Or print) fYAursarel ti r - owner ignature r Date 3--14-Q 1 FOR OFFICE USE ONLY lit /, Y tF I Sttl. Engineer By Dat. Court Case No. Div. / Co. a- WD Q a Basin MD Use EXEMPT WELL DATA SHEET - DENVER BASIN, COLORADO APPLICANT: SPAIN RECEIPT NO. LOCATION: SE1/4 OF SE1/4 OF SEC. 19, T.1N., R.66W. (119 SSL, 86 ESL) PROPOSED AQUIFER: SURFACE ELEVATION: 4945 NUMBER OF ACRES IN TRACT: 2.5 IS PROPERTY WITHIN SERVICE BOUNDARIES OF MUNICIPALITY S.B.5 CONSENT MAPS? NO YES IF SUBDIVISION IS UNDER AUGMENTATION PLAN, CASE NO. IS , DIV. IF SUBDIVISION WAS RECOMMENDED FOR APPROVAL BY THE WATER MANAGEMENT BRANCH, DATE OF LETTER IS INFORMATION ON SUBDIVISION OR TRACT OF LAND/SPECIAL RESTRICTIONS: Ofaci 4' w� C can& - fr, -4., _ �..._ evaluated by JWB on AUGUST 8, 1991 AQUIFER ELEVATION DEPTH TO ANNUAL MET APPROP STATUS BOT. TOP SAND BOT. TOP A -F UPPER DAWSON LOWER DAWSON DENVER UPPER ARAPAHOE -•-- -•- LOWER ARAPAHOE 4652 4889 98 293 56 0.412 NNT LARAMIE-FOX HILLS 4007 4262 164 938 683 0.615 NT note: E indicates Location is at aquifer boundary and values may be more approximate. * indicates the proposed aquifer. All values are interpolated from the S.B.5 data base assembled in November of 1986. Ngrg itAza ..2e . x ZOCP - /egteet, ,P, c. cw.-Q-P — ^T C. �s-r dh /-O -G G So i 45 e .I _ W REASON FOR EMERGENCY COMMENTS: GWS-24 Rev 8/89 VERBAL EMERGENCY REQUEST INFORMATION Office of the State Engineer Division of Water Resources Ground Water Section TAKEN BY APPLICANT ]L .�!'.i �!' CONTRACTO ADDRESS ►��_ .1 _ •� 1..� LIC # EXISTING PERMIT # PHONE Gs? CASE# USE 1759 -/.5797 APPLICATION RECEIPT DATE CTY WetOll DIST V# /"327, File C# 179'74 CTY 6 .�-- Basin MD NAME OF CALLER DATE 2 d LOCATION S E 1/4 3& 1/4 , SEC n TWP ( ) RNG G Lc) PM �g DIST FROM SEC LINES 11 l (MC 53Cc (W) [REQ FOR DB & Kd/Kc] LOT BLOCK FILING SUBDIVISION $' r DIST & DIREC FROM OLD WELL ,44(..) 5Ock m DEPTH OF OLD WELL.„..0 ,(1 PROPOSED: DEPTH k- � ,CASING PLAIN PERF ,AQUIFER moo- 5unsL- DATE TO START MC AY FIELD INSP REQ? (Y (N) DONE? (Y N) BY? //4Y /,st ' 0f DATE REC OA( (NOTE: ATTACH CO OF WRITTEN - PORT OR VERBAL REPORT) ( cg1) DWR STAFF RECOMMENDATIONS 1k Lg 4 �F�'G 1yjp . ce 4O zi,, /p4 7D- '1lee€d 0v' f"ewe,/ .v� azi&1j a,Zc ) ,f,101640.6 .� ti « , 6G ,f e/ ?D 4 d' Ord Ael .rau 14 x• /load-) % 51, 4IQ / Q iJ�o L.j -‘---1/}13'.BY /}.'. (91 VERBAL APPROVED BY / --"BLICIPB14 DATE 8 - e -9/ CONDITIONS £yil r e c d7 4•1t1. ,,�u [ .a., 1I JJ VERBAL GIVEN TO L4r' BY DATE GWS-24A 8/89 APPLICANT OFFICE OF THE STATE ENGINEER VERBAL FIELD INSPECTION REPORT RPT TAKEN BY DATE APPL. RECEIPT NO.(If known) INSPECTED BY DATE DIST REPORTED BY WELL LOCATION 1/4 1/4,SEC ,TWP RNG DIST'S UNREGISTERED EXEMPT WELLS USE OF EXISTING WELL ( ) # OF SINGLE FAMILY DWELLINGS? ( ) WATERING DOMESTIC ANIMALS AND POULTRY ( ).WATERING LIVESTOCK ON A FARM OR RANCH, # OF HEAD? ( ) IRRIGATION OF SQUARE FEET OF HOME GARDENS AND LAWNS ( ) FIRE PROTECTION ( ) DRINKING AND SANITARY IN COMMERCIAL BUSINESS, DETAILS OF BUSINESS? DATE WELL CONSTRUCTED? EST. PUMPING RATE DATE FIRST USE FOR ABOVE PURPOSES DEPTH OF WELL TYPE OF WELL: DRILLED HAND DUG NO. OF ACRES IN TRACT? DEVELOPED SPRING ,ANY.OTHER WELLS ON PARCEL? ,#'S USED FOR NONEXEMPT WELLS OLD WELL PERMIT NO. CASE NO. # ACRES IRRIGATED LEGAL DESCRIPTION AUGMENTATION PLAN NAME OR CASE # USES OTHER THAN IRRIGATION ARE THERE OTHER WELLS WITHIN 600 FEET? WILL THE REPLACEMENT EE CLOSER TO WELLS WITHIN 600 FEET THAN BEFORE? IS THE REPL BEING MOVE MORE THAN 200 FT? WHY OTHER WELLS USED FOR THE SAME PURPOSE? PERMIT #'S SURFACE WATER RIGHTS USED IN CONDUCTION WITH THIS WELL COMMENTS NOTE: A WRITTEN REPORT MUST BE SUBMITTED GWS I S APPLICANT: Address: City: COLORADO DIVISION OF WATER RESOURCES FIELD INSPECTION REPORT WL 1 2`7 Phone No. Home 12 9 - 8 y (r (- Office Person contacted, if not applicant: 1. RECEIVED AUG07'91 WA1ER RCES PURPOSE OF INSPECTION; STATE �EER Late Registration Replacement /4 Abandoned Old Well Complaint Other Nature of Complaint LOCATION OF WELL: County IS 1/4S 1/4 Type of Disposal System Range d, , ownship Sec. j9 'et from (N and 840 eet from ((F)W) Section line. well is located a Lot Bik Filing Subdivision: Total number of acres in tract on Are there any other wells If yes, how many / Used for: PLEASE VERIFY THE HISTORIC USE AND THE CURRENT OR PROPOSED USE FOR LATE REGIS- TRATIONS (SEE BELOW) A. The use of the well described herein, prior to May 8, 1972, was: (t ORDINARY HOUSEHOLD PURPOSES IN 1 SINGLE-FAMILY DWELLING(S). (ice WATERING OF POULTRY AND/OR DOMESTIC ANIMALS. ( ) WATERING OF LIVESTCCK ON FARMS AND RANCHES. HOW MANY HEAD ? FEED LICIT ? YES NO (ice IRRIGATION OF NO MORE THAN ONE ACRE OF HOME GARDENS AND LAWNS I0. 8 @ O SQUARE-PEET. (V1 Firm PROTECTION. *( ) FOR COMMERCIAL WELL, SEE BACK OF THIS FORM. ( ) DRIER r (vr TYPE OF WELL (DRILLED, HAND DUG, SPRING WELL) 0ly-c ' fq� 419 I If spring well, give details on how and when developed 6. The current or proposed use of the well (If different than stated above): (over) n COMMENTS: (please add any additional information that might assist in the evaluation of this (these) application(s). x"12 r� t-A)-C-i J -e eel , . sD ` 6 , &" of - *CCWER IAL WELL: 1. Type of Business 2. Size of building(s) square feet. 3. Number of employees 4. Number of days per -week business is open 5. Does the general public have access to the facilities? If so, estimate average number to daily use the facilities 6. Pumping rate in gallons per minute 7. Is there any other source of water used in conjunction with the well(s)? yes no . If yes, explain: Signed '.t t4.ri4c.-0-r4 L., Water Commissioner, District Date e ` - 91 (use this space as needed -for additional comments) FORM NO. GUS -32 11/90 PUMP INSTALLATION AND TEST REPORT STATE OF COLORADO, OFFICE OF THE STATE ENGINEER 1. WELL PERMIT NUMBER - W: j27 - /&/.3-16 -A 2. OWNER NAME(S) manganef Spain Mailing Address 202/ U LYR 27 City, St. Zip Font Lupfon, Co. 80621 Phone. (. 30 3.) 659-8466 For Office Use only DEC 0 7 2007 WATER ArNIOURCES STATE ENGINEER COLO. 3. WELL -LOCATION AS DRILLED: 56 1/4 SC 1/4, Sec. / 9 Twp. / N ,Range 66 ti) DISTANCES, 'ROM SEC. LINES: ft. from J Sec. line. and 77 ft. from E Sec. line. (north or south) (east or west) SUBDIVISION: LOT BLOCK FILING(UNIT) STREET ADDRESS. AT WELL. LOCATION: 202/ WLR 27 4. PUMP DATA: Type Submen4.Lb.le Installation Completed moved rtom old welL, Pump Manufacturer 6nund joa Pump Model No. SP 4-8 Design GPM 15 at RP 3450 , HP 3/4 , Volts 230 , Full Load Amps Z' Pump Intake ,Depth L}. t- a Feet, Drop/Column Pipe Size [ y I( Inches, Kind <a' Q 4p U ADDITIONAL INFORMATION FOR PUMPS GREATER THAT 50 GPM: TURBINE DRIVER TYPE: ❑ Electric ❑ Engine ❑ Other Design Head feet, Number of Stages , Shaft size inches. 5. OTHER. EQUIPMENT: Airline Installed E] Yes In No, Orifice Depth ft. . Monitor Tube Installed ❑ Yes X No, Depth ft. Flow Meter Mfg. All/4 Meter Serial No. !VA rr(ct Meter Readout ❑ Gallons, ❑ Thousand -Gallons, ❑ Acre feet, ❑ Beginning Reading 6. 7. TEST DATA: ❑ Check box if Test data is submi a• on Supplemental Form. Date ; C Total Well Depth 50' Time xInb ST \ Static Level • J Rate (GPM) Date Measured Pumping Lvl. DISINFECTION: Type /1/1/ Gnanu.Laic Amt. Used / cup dLaao2ved in Ga.LIo /1/1,- 8. Water Quality analysis available. ❑ Yes 0 No 9. Remarks 10. I have read the statements made herein and know the contents thereof, and that they are true to my knowledge. [Pursuant to Section 24-4-104 (13)(a) C.R.S., the making of false statements herein constitutes perjury in the second degree and is punishable as a class 1 misdemeanor.] CONTRACTOR Spain'2. Service Tnc. Phone (303 ) 659-1584 Mailing Address 2021 WCY? 27 Ft. Lupton, L o . 80621 Name/Title (Please type or print) Tom W. Spain 1'nei.ident Signature SZS)/SUNNIN' Lic. No. 715 • Date )4f Jqf a 11/-3f - WELL CONSTRUCTION AND TEST REPORT STATE OF COLORADO, OFFICE OF THE STATE ENGINEER 9,_i _oror offfee w. onry •wp., s,rc.., ° 7 iF--O-7. tun) [~ SEP 2 3'91 Corr v LNni r �''lt" ' Wk. r-- ,L jk,STATE,:,r, 3 - ki` 1. WELL PERMIT NUMBER 91VE327 N OWNER Mailing City, Phone NAME(S) M g ret Spain Address 7021 w R 27 St. Zip Flat Lupton. CO. R0671 ( 303 1 659-8466 3. H WELL LOCATION AS DRILLED: SE 1/4 SE 1/4, Sec. 19 Twp. 1 N , Range 66 W DISTANCES FROM SEC. LINES: 81 ft. from S Sec. line. and 77 _ ft. from E Sec. line. OR FILING(UNIT) SUBDIVISION: STREET north or south) (east or west) LOT BLOCK ADDRESS AT WELL LOCATION: onTi to -R #27 4. GROUND DATE SURFACE ELEVATION ft. DRILLING METHOD cn Rotary COMPLETED R-14-9) . TOTAL DEPTH ft. DEPTH COMPLETED_so ft. 5. GEOLOGIC LOG: I Depth DeecriptIon of Material (Type. Size. Color, water Location) 0 1fi X11[-1 B. HOLE DIAM. (in.) From (ft) To (ft) 1 7 0 1 fi-ici rratlol Water -44-d1 Prow'>< Clay ..PLAIN CASING OD (in) Kind Wall Size From(ft) To(ft) 6o -_A��,—f'1 �.. �. r_r '.'e 48-50 Blue Stig1a PERF. CASING: Screen Slot 6" plastic 200 wall Size: 3/16" saw cuts 20 50 B. FILTER PACK: Material Pea crravel 9. PACKER Type Depth PLACEMENT: Size 3/8" Interval 20-50 10. GROUTING RECORD: Material Amount Density cement 30 Gal. gal/bag Interval 0-20 Placement pour REMARKS: added 5% Bentonite & 2% calcium chl9rifje._ to cement. ..7 Customer plugging old well. 11. DISINFECTION: Type Granular Chlorine Amt. Used 1 Cup dissolved in 5 Gallons water, 12. WELL TEST DATA: El EcHgEngliPtgli611i ill; iiiiiElfteVnttiOtrartr9Ffraili zone with air. 30 gpm. TESTING Static Pumping Remarks METHOD Jetting with air. Level 18' ft. DatefTime measured 8-14-91 2: 00Pm , Production Rate (hrs.) level jetting ft. Date/Time measured , Test length 2 hrs. at 50' 13. I have of false CONTRACTOR Mailing read the elalemsnle milde herein and know the contents thereof, and that they are true to my knowledge. [Pursuant to Section 24-4-104 (13)(a) C.R.S., the making statements herein constitutes p.rlury in the second degree and re punishable us a cram t mi.d.nnarwr.) John's Drilling Inc. Phone (303 ) 423-5246 Uc. No. 827 . Address Rt. 1 Box 640 Golden, CO. 80493 Name/Title (Please type or print) Lloyd John CWner Signature ,f`� '.'_ Date 9-20-91 Form No. GWS-25 APPLICANT OFFICE OF THE STATE ENGINEER COLORADO DIVISION OF WATER RESOURCES 818 C.nrnnld Bldg., 1313 Sherman SL, Denver, Colorado 80203 (303) 8863581 Lot: Block: Filing: Subdiv: MARGARET SPAIN 2021 WCR 27 FT LUPTON, CO 80621 303/659-8466 PERMIT TO CONSTRUCT A WELL 827 APPROVED WELL LOCATION WELD COTY 1/4 SE 19 1/4 Section Twp 1 N , Range 66 W 6thP M DISTANCES FROM SECTION LINES 81 South Ft. from Section Line 77 East Ft. from Section Line 1SSUANC OF THIS PERMIT DOES NOT CONFER A WATER RIGHT 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 and Pump Installation 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 17. 3) Approved pursuant to CRS 37-92-602(3) (c) for the relocation of an existing well, permit no. L 2 . The old well must be plugged and abandoned according to the Water Well Construction and Pump Installation Rules within ninety (90) days of completion of the new well. The enclosed well abandonment report form must be completed affirming that the old well was plugged and abandoned. 4) The depth of this well shall not exceed 50 feet or the base of the alluvium. 5) The Use of ground water from this well is limited to ordinary household purposes inside one (1) single family dwelling, the watering of domestic animals, and the irrigation of not more than 2,500 square feet of home gardens and lawns. 6) The maximum pumping rate shall not exceed 15 GPM. 7) The average annual amount of ground water to be withdrawn shall not exceed 1.0 acre-feet. 8) This well shall be constructed not more than 200 feet from the location specified on this permit. Note: Verbal approval no. 91VE327 was granted on August 8, 1991 to construct this well. gmoVED: Receipt No. _ 6Itlit DATE ISSUED SEP 1 3 1991 6,4, BY XP,fRATION DATE SE lo93 WRJ-5-Rev. 76 Application must be complete where applicable. Type or print in BLACK INK. No overstrikes or erasures unless initialed. COLORADO DIVISION OF WATER RESOURCES 818 Centennial Bldg., 1313 Sherman St., Denver, Colorado 80203 PERMIT APPLICATION FORM RECE v r,J AUG 29'91 111A1 Eli hta.: .� ( A PERMIT TO USE GROUND WATER STATEEMGINEER ( ) A PERMIT TO CONSTRUCT A WELL COW FOR: ( ) A PERMIT TO INSTALL A PUMP Dr: 1,k-e2� ��74e r X) REPLACEMENT FOR NO. CI / V d 3! )OTHER//�2t,f WATER COURT CASE NO.--�� as (1) APPLICANT- mailing address NAME STREET CITY 4LoYL ee3 f7L -os ! {State) (Zip) 7 TELEPHONE NO. (2) LOCATION OF PROPOSED WELL County ) �t[4 Y. of the 58 Two, 1 N , Rng, 4N,Si '''A. Section (E,W) iq P.M, (3) WATER USE AND WELL DATA Proposed maximum pumping rate (gpm) tb copra, Average annual amount of ground water to be appropriated (acre-feet): Number of acres to be irrigated: hlt5P1ft,Oldl Okna.`1 �trj {0 r Proposed total depth (feet): Aquifer ground water is to be obtained from: A Di Tv, Owner's well designation 1'0 GROUND WATER TO BE USED FOR: ( ) HOUSEHOLD USE ONLY • no irrigation (0) () DOMESTIC (11 1 1 INDUSTRIAL (5) ( I LIVESTOCK (2) ( ) IRRIGATION (6) ( 1 COMMERCIAL (4) ( 1 MUNICIPAL (8) ( ) OTHER (9) DETAIL THE USE ON BACK IN (11) (4) DRILLER Name Street City r OttU A aCcix,11%.. ouk c � Co . a)(10 (State) rr--(��ZIIP7) TelephoneP. q 3-6R(.140 Lic, No aC FOR OFFICE USE ONLY: DO NOT WRITE IN THIS COLUMN -43 3.2 ?6,5"6-6), Receipt No. 1 as Basin Disr. 9lv,.3_ 7 CONDITIONS OF APPROVAL 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 C.) T 1 , that no injury will occur to another vested watery r right or preclude another owner of a vested water i right from seeking relief in,a civil court action. ✓�' APPLICATION APPROVED PERMIT NUMBER DATE ISSUED EXPIRATION DATE (STATE ENGINEER) BY 1D J COUNTY Z cJ`- A (5) THE,'LOCATION, 'OF THE PROPOSED WELL and the area on which the water will be used must be indicated on the diagram below. Use the CENTER SECTION (1 section, 640 acres) for the well location. I 4- + - I NORTH 4— + T I 4- - --I- - '- - - - —� k .:4 � -- 1 MILE, 5280 FEET -----}I + + w z_ O U w N I- w NORTH SECTION LINE f + T I I - - + - - - + - — I � I - -�- - — - + - I I I x SOUTH SECTION LINE -F + I - rn In N rn m O r z rn �— -- -}- 4 The scale of the diagram is 2 inches = 1 mile Each small square represents 40 acres. (6) THE WELL MUST BE LOCATED BELOW by distances from section lines. U1' 7T ft. from ft. from LOT BLOCK FILING # (north or south) 1 (east or west) sec. line sec. line SUBDIVISION (7) TRACT ON WHICH WELL WILL. BE LOCATED Ow er: Lsre� I No. of acres 21 . Will this be the only well on this tract? A rr (8) PROPOSED CASING PROGRAM Plain Casing J) /� J 10 I$ in. from l J ft. to 1 ft. in. from ft. to ft Perforated casing II (0 in. from — ft. to�— ft. in. from, ft. to `t WATER EQUIVALENTS TABLE (Rounded Figures) An acre-foot covers 1 acre of land 1 foot deep 1 cubic foot per second ids) ... 449 gallons per minute (gpm) A family of 5 will require approximately 1 acre -loot of water per year• 1 acre-foot ... 43,560 cubic feet ... 325,900 gallons. 1,000 gpm pumped continuously for one day produces 4.42 acre-feet. (9) FOR REPLACEMENT WELLS givedistance and direction from old well and plans for plugging it: ID' q.30 07%.3& st_rirrurvd (10) LAND ON WHICH GROUND WATER WILL BE t..) ED: Owner(s) : Legal description: Se., Sec. I ) 74 4JJ R61.0, !0 fA _ Pa No• of acres: (11) DETAILED DESCRIPTION of the use of ground water: Household use and domestic wells ust indicate type of disposal system to be used. �v� hc� 11111)rr >1 , L e I`5SC (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. S I4PPLICANT(S) �GNATU E OF Use additional sheets of paper if more space is required. ROY ROMER Governor 1 9ar -5-pd;rn Paz / Vki, /2d a 7 gt eh) n' CO n/ 2 / f r - 03Z?18S3 OFFICE OF THE STATE ENGINEER DIVISION OF WATER RESOURCES 1313 Sherman Street -Room 818 Denver, Colorado 80203 (303) 866-3581 FAX (303) 866-3589 3-/3 -129.2-. RE: COMPLETION OF FILE FOR WFT .T PERMIT NUMBER - r¢ Dear Well Owner: The 6le for the subject permit is incomplete for one or more reasons indicated below. HAL D. SIMPSON Stets Engineer The conditions of approval for the subject permit require that the old existing well be plugged and abandoned within 90 days after construction. The well must be plugged according to the Well Construction and Pump Installation Rules. Our records indicate that an abandonment report confirming plugging of the old well has not been submitted to this office. Enclosed is a blank form for you to complete and submit to this office confirming that the well is plugged. If there are questions concerning plugging the well, please contact your well construction contractor or this office. This information should be submitted within 30 days of your receipt of this letter in order that we may proceed with completion of the file. Failure to plug the old well may result in orders to plug and abandon the new well and possible legal action. Pump Installation and Test Report has not been received. Please contact your pump installation contractor and have him submit the report. You should have a copy. If you installed the pump yourself, contact us to obtain the form necessary to report the pump installation. cc: Div Enclosures Sincerely, Si. A xis, Norman Hill Well Drilling Inspector 5316 DUE DATE: 1/20/2022 ACCOUNT NUMBER: 171287 BALANCE DUE: 45.12 STATEMENT DATE: 12/31/2021 12/3/2021 4667616 Beverage Order No 4667616 12/17/2021 4717511 Beverage Order No 4717511 12/18/2021 Payment Echeck 12/28/2021 4805588 Rental Invoice 12/31/2021 4825094 Paper Statement Fee Balance Forward: 120.42 0.00 37.77 -120.42 5.35 2.00 Dear Valued Eldorado Customer, We hope this message finds you, your family, and your employees in good health. We want to extend our gratitude for your continued patronage of Eldorado Natural Spring Water. If you ever have questions, or there is anything we can do to better serve you, please don't hesitate to contact us. We are here to support you. Thank you sincerely for your business. Warm Regards, The Team at Eldorado Go Green! Did you know you can receive your statements via email?? Email your customer service representative at: customerservice@eldoradosprings.com A SERVICE CHARGE OF 7% PER YEAR (11.5.8°4 per month) WWI RE CHpRGF1 ON Alt OVERD iF ACCOUNTS IIIIII1llll)llllll.III'llllIIlIIl11111111II.IIIIII1111I.IlIIIlI11 ******************AUTO**ALL FOR AADC 800 ADVANCED UNDERGROUND INC PO BOX 1063 BRIGHTON CO 80601-1063 III II IIIIIIIIIIIII II IIIIIII IIIIIIIII II II IIIIIIIIIIII111II II III ELDORADO ARTESIAN SPRINGS INC PO BOX 172526 DENVER, CO 80217-2526 T19 P1 23 5316 DUE DATE: 1/20/2022 ACCOUNT NO: 171287 BALANCE DUE: 45.12 AMOUNT ENCLOSED 00171287000451200000001231215 WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 1 555 North 17th Avenue, Greeley, CO 80631 www.weIdhealth.org Septic Permit - Final Application Number:SP-1700340 Owner Name:SPAIN & COMPANY LLC Site Address: 2021 CR 27 FORT LUPTON, CO 80621 App Type: Health\Commercial\New OWTS\Septic CHARLES SPAIN SPAIN & CO LLC 160 KAHIL PLACE FORT LUPTON, CO 80621 Parcel #: 147119000020-R6238886 Legal Desc: 15920 PT SE4 19 1 66 BEG AT SE COR SEC 19 N260' W335' S260' E335' TO BEG (2A M/L) EXC UPRR RES Work Description: SHOP EHS SEPTIC GENERAL: Number of Bedrooms 0 Number of Persons 0 Parcel Acres 2.0 Private Water Supply Permit Reference 276221-A Private Water Supply Permit Reference 161586-A Public Water Supply No EHS SEPTIC ACTUAL (FINAL): Septic Tank Size, gallons 2000 Absorption Bed, sqft 550 Design Type Sand Filter Dosing Yes Lift Station No Pump Size Yes Dosing Pump Chamber Size 500 Pump Specified 39 Application Status: Finaled Applied Date: 10/11/2017 Issued Date: 10/19/2017 Finaled Date : 12/18/2017 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 1O, 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 25-10-112(1)(b), C R.S. This permit is non -transferable and non-refundable. 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 Health and Environment. Katie Sall December 18, 2017 Environmental Health Specialist Adminisliol:on Vila! Recc. ds Public Heal h a Clinical Services Tole: 9?0 K:i4 6•42D Fa• : 9 '1:)-30.1-6.: la Date Environmcntol Health Sorelces Comrunirolion, EduCalion L Plonniny Fmoryoncy ProparodnQ S Respanso Public Health Change of Owner Name/Contact Information (for use by the well owner or the well owner's attorney/authorized agent) NOT COMPLETED. PENDING REVIEW BY DWR. Order 50984 Number: Date 12/11/2024 1:34:42 PM Submitted: eForm Change of Owner Name/Contact Information (for use by the well owner Name: or the well owner's attorney/authorized agent) go COLORADO Division of Water Resources Department of Natural Resources Permit 276221 -Receipt 3623914B Number: -A Number: Well Identification • Permit No 276221 • Suffix N/A • Replacement Suffix A Well Address • This is for information only and does not affect the permitted well location. Address • Address 2021 WCR 27 • City Fort Lupton • State Colorado • Zip 80621 Owners and Agents • Well Owners: # Name Mailing Address Phone Email 1 BOWTIE PROPERTIES LLC (HOUSTON, HARVEY) 2023 COUNTY ROAD 27 FORT LUPTON, COLORADO 80621 303-227-1255 HARVEY.HOUSTON@ADUGDD.COM • Authorized Agents or Attorneys: # Type Name HOFFMAN NIES DAVE & MEYER LLP (NIES, 1 ATTORNEY NICOLE R) Mailing Address 5350 S. ROSLYN STREET, SUITE 100 GREENWOOD VILLAGE, COLORADO 80111 Phone Email NNIES@HN- 7209749422 COLAW.COM Signature and Certification 1. I (we) have read the statements made herein, know their contents, and state that they are true to my (our) knowledge. Pursuant to Section 24-4-104 (13)(a) C.R.S., the making of false statements herein constitutes perjury in the second degree and is punishable as a class 1 misdemeanor. 2. I (we) claim and say that I am (we are) the owner(s), an authorized agent of the well owner(s), or listed attorney of the well owner(s) of the well permit described above, know the contents of the statements made herein, and state that they are true to my (our) knowledge. This filing is made pursuant to C.R.S. 37-90-143. 3. I (we) understand that filing a Change of Owner Name/Contact Information form is for contact information purposes only. This action does not convey real property. • I have read and agree to the Terms and Conditions listed above Yes • Organization: N/A • Name: Nicole Nies • Email Address: nnies@hn-colaw.com o N�, OFFICE OF THE STATE ENGINEER GWS-25 COLORADO DIVISION OF WATER RESOURCES 818 Centennial Bldg., 1313 Sherman St., Denver, Colorado 80203 (303) 866-3581 LIC APPLICANT MARGARET SPAIN 2021 WCR 27 FT LUPTON, CO 80621- (303) 659-1584 WELL PERMIT NUMBER 276229 DIV. 1 WD 2 ~ A DES. BASIN MD APPROVED WELL LOCATION WELD COUNTY SE 1/4 SE 1/4 Section 19 Township 1 N Range 66 W Sixth P.M. DISTANCES FROM SECTION LINES 171 Ft. from South Section Line 180 Ft. from East Section Line PERMIT TO CONSTRUCT A WELL UTM COORDINATES Meters Zone:13 NAD83 Fasting: Northing: ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT CONDITIONS F APPROVAL 1) This well shall be used in such a way as to cause no material injury to existing water rights. The issuance of this permit seeking relief in a civil court action. does not ensure that no injury will occur to another vested water right or preclude another owner of a vested water right from 9 2) The construction of this well shall be in compliance with the Water Well Construction Rules <. CCR 402-2, unless approval Contractors in accordance with Rule 18. of a variance has been granted by the State Board of Examiners of Water Well Construction and Pump Installation 3) Approved pursuant to CRS 37-92-602(3)(c) for the relocation of an existing well, permit no. 276221. The old well must be plugged in accordance with Rule 16 of the Water Well Construction Rules within ninety (90) days of completion of the new well. The enclosed Well Abandonment Report form must be completed and submitted to affirm that the old well was plugged. t) The use of ground water from this well is limited to drinking and sanitary facilities as described in CRS 37-92-602(1)(c ) for a commercial business. Water from this well shall not be used for lawn or landscape irrigation or for any other purpose outside the business building structure. p p e i) The total depth of the well shall not exceed 37 feet or the depth to the first confining clay/shale: series, whichever com first. es The well is approved as the only well providing water to this business, which is on 3 acre parcel, described as 2021 WCR Weld County. 7) The average annual amount of ground water to be appropriated shall not exceed one (1) acre-foot (325,850 gallons). 8) A totalizing flow meter must be installed on this well and maintained in good working order. Permanent records of all request. f}.I 2. i,,-1,/-o7 diversions must be maintained by the well owner (recorded at least annually) and submitted to the Division Engineer u on p APPROVED ADB Recei•t No. 36239148 State Engineer DATE ISSUED 12-14-2007 By DATE 12-14-2009 Hello