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Home My WebLink About20231025.tiffWELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 1555 North 17th Avenue. Greeley, CO 80631 v.-.,;w_weldheoIth,org Septic Permit - Final Application Number: Owner Name: Site Address: App Type: Parcel Number: Legal Desc: Work Description: SP -2100363 WELLS STEVEN 37442 HWY 392 WELD, CO Health\Commercial\New OWTS\Septic ANDREW WEST AGPROFESSIONALS 3050 67TH AVE GREELEY, CO 80634 071325000019-R0150989 7801-C PT 25 7 63 & PT 30 7 62 BEG SW COR OF SEC 25 E5311.85' TOE LINE SEC 25 N01D12'E 935.6' W1678.73' N943.99' N66D54'W 526.37' N79D18'W 840.73' TO E R/W HWY #392 S46D38'W 3221.85' TO W LN SEC 25 S29.96' TO BEG & BEG SW COR SEC 25 E5311.85' TO E LINE SEC 25 N01D12'E 935.6' TO TRUE POB W1678.73' N943.99' N66D54'W 526.37' N79D18'W 840.73' TO E R/W HWY #392 N46D38'E 1310.47' E3355.48' TO E LINE SW4NW4 SEC 30 S01 D07'W 435.83' TO E LINE NW4SW4 SEC 30 S01 D07'W 1347.45' TO S LINE NW4SW4 SEC 30 S89D48'W 1275.61' TOW LINE SEC 30 S01 D12'W 418.95' TO BEG AS DESC IN REC #2173101 EXC UPRR RES SEC 25 (11R SEC 25) AGRICULTURAL BUILDING EHS SEPTIC GENERAL Application Date Associated Building Permit Associated Disaster Permit Basement Plumbing Full Bathrooms Location Description Manual Expiration Date Entry Number of Persons Parcel Acres Private Water Supply Private Water Supply Permit Reference Public Water Supply Septic Permit Expiration Date 10/05/2021 No No No 1 N/A 1 317.54 Well 11580-R No 12/29/2023 Application Status: Finaled Applied Date: 10/5/2021 Issued Date: 10/13/2021 Finaled Date: 12/29/2022 Health Administration Vital Records Tele: 970-304-8410 Fax: 970-304-6412 Public Health & Clinical Services Tele: 970-304-6420 Fax: 970-304-6416 Environmental Health Services Tele: 970-304-6415 Fax: 970-304-6411 Communication, Education & Planning Tele: 970-304-6470 Fax: 970-304-6452 Emergency Preparedness & Response Tele: 970-304-6470 Fax: 970-304-8452 Public Health EHS SEPTIC ACTUAL (FINAL) Septic Tank Size, gallons Absorption Trench, sqft Chamber Model Number of Chambers Installed Design Type Dosing Lift Station Pump Size 2000 2400 Quick4 Plus Standard 200 Chambers -Trench No No No NOTICE This permit is granted temporarily to allow construction to commence. This permit may be revoked or suspended by the Weld County Department of Public Health and Environment for reasons set forth in the Weld County Individual Sewage Disposal System Regulations including failure to meet any term or condition imposed thereon during temporary or final approval. The issuance of this permit does not constitute assumption by the department or its employees of liability for the failrue or inadequacy of the sewage disposal system. This permit is non -transferable and non-refundable. Before issuing final approval of this permit the Weld County Department of Public Health and Evnironment reserves the right to impose additional terms and conditions required to meet our regulations on a continuing basis. Final permit approval is contingent upon the final inspection of the completed system by the Weld County Department of Public Health and Environment. Bill Fritz December 29, 2022 Environmental Health Specialist Date Health Administration Vital Records Tele: 970-304-6410 Fax: 970-304-8412 Public Health & Clinical Services Tele: 970-304- 420 Fax: 970-304-6416 Environmental Health Services Tele: 970-304-6415 Fax: 970-304-641i Communication, Frlunation it Planning Tele: 970-304-6470 Fax: 970-304-8452 Emergency Preparedness & Response Tele: 970-304-8470 Fax: 970-304-6452 PubticHealth Application Number: Owner Name: Site Address: WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 1555 North 17th Avenue, Greeley, CO 80631 www.weldhealth.org Septic Permit New SP -2100363 WELLS STEVEN 37442 HWY 392 WELD, CO App Type: Health\Commercial\New OWTS\Septic ANDREW WEST AGPROFESSIONALS 3050 67TH AVE GREELEY, CO 80634 071325000019-R0150989 7801-C PT 25 7 63 & PT 30 7 62 BEG SW COR OF SEC 25 E5311.85' TO E LINE SEC 25 N01D12'E 935.6' W1678.73' N943.99' N66D54'W 526.37' N79D18'W 840.73' TO E R/W HWY #392 S46D38'W 3221.85' TOW LN SEC 25 S29.96' TO BEG & BEG SW COR SEC 25 E5311.85' TO E LINE SEC 25 N01 D12'E 935.6' TO TRUE POB W1678.73' N943.99' N66D54'W 526.37' N79D18'W 840.73' TO E RNV HWY #392 N46D38'E 1310.47' E3355.48' TO E LINE SW4NW4 SEC 30 S01 D07'W 435.83' TO E LINE NW4SW4 SEC 30 S01D07'W 1347.45' TO S LINE NW4SW4 SEC 30 S89D48'W 1275.61' TO W LINE SEC 30 S01D12'W 418.95' TO BEG AS DESC IN REC #2173101 EXC UPRR RES SEC 25 (11R SEC 25) Work Description: AGRICULTURAL BUILDING EHS SEPTIC GENERAL: Parcel Number: Legal Desc: Application Status: Final Pending Applied Date: 10/05/2021 Intake Person: JBEEBE Permit Expiration Date: 10/05/2022 Application Date Associated Building Permit Associated Disaster Permit Basement Plumbing Manual Expiration Date Entry Parcel Acres Private Water Supply Private Water Supply Permit Reference Public Water Supply Septic Permit Expiration Date 10/05/2021 No No No 317.54 Well 11580-R No 10/05/2022 EHS PERC TEST (SITE) : BOH Variance Required Health Administration VIIaI Records fele:970- 04.6410 Fax: 970-:X34.6412 Public Health s Clinical Services fete: 970 304 6420 Fos,: 970-304 6416 No Env'uonmenlal Heollh Services Twle: 970-301-9.115 Foe: 970 304.6411 Communication, Education & Planning Tele: 970-301-6470 Fox: 970-304 6452 Emergency Preparedness it Response fele: V!13-304-640) Fox: 970-301-6152 Page 1 of 3 Public Health Engineer Design Required Engineer Evaluation Received Engineer Letter Received In 100 Year Flood Plain Limiting Zone Feet Limiting Zone Qualifier Long Term Acceptance Rate Profile Pits Soil Description Soil Type Soil Type Suitable Treatment Level Variance Required No No No No 8 Greater Than 0.3 2 Sandy Clay Loam 3A Yes Level 1 No $EPTIC. SIZING INFORMATION: From the application information supplied and the on -site soil percolation data the following minimum installation specifications are required according to the Engineer's evaluation: Engineer's Specified Installation Recommendations; Absorption Trench Dosing Specified Engineer Design Chamber Specified Engineer Design Number of Chambers Specified Engineer Septic System Design Type Specified Lift Station Specified Pump Specified Septic Tank Size 2400 No Quick4 Plus Standard 200 Chambers -Trench No No 2000 CONDITIONS: Description: New OWTS Comment: Onsite wastewater treatment system must be 10 feet from property line. Install the soil treatment area within 50 feet of the soils test location. Construct onsite wastewater treatment system according to Engineer design. Septic tank must be at least 50 feet from any well. Soil treatment area must be at least 100 feet from any well. Sewer line to septic tank must have at least 1/8inch/ft. fall. Effluent line from septic tank to distribution box must have at least 1/8inch/ft. fall. Distribution lines shall be installed into the top hole of the chambers used. Install inspection ports at the ends of each trench or corners of each bed. An engineer approval letter approving system as installed per engineer design is required. Engineer designed OWTS must be inspected by the design Engineer prior to backfilling. All Weld County regulations are applicable. INSPECTION RESULT: Description: Site Status: Approved to Issue Comment: NOTICE This permit is granted temporarily to allow construction to commence. This permit may be revoked or suspended by the Weld County Department of Public Health and Environment for reasons set forth in the Weld County Onsite Wastewater Treatment System Regulations including failure to meet any term or condition imposed thereon during temporary or final approval. The issuance of this permit does not constitute assumption by the department or its employees of liability for the failure or inadequacy of the sewage disposal system. This permit Is non -transferable aug non- retundah-le• Before issuing final approval of this permit 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 is contingent upon the final inspection H4olih Administration Vital Roe orris ''In:9/0-30A 5410 770-204-6412 Public Health Z Cllnkai Ss tykes fete: 970 304 6470 Fr]i: 970-Y34-5416 Envlronmonlal Health Sorvlcot I.1.9 970-304-6415 FOC: 970304 6411 Communication, Education A Planning Tele: 970-304.6470 Fax: 970 304.6452 Emergency Preparedness I Response le0-:'1/0 304.64)u Fox: 970-304-6452 Page 2 of 3 Public Health of the completed system by the Weld County Department of Public Health and Environment. Alex Clemments October 13, 2021 Environmental Health Specialist Date Health Adminlstselion Vllal ;:ccads l€,:970-304-6410 Fax; 9/0.304.6412 Envtronmenlal Health Swvlees Tele; 970.304.6415 Fax: 970-304-641 I Communlcollon, Edueallan A Manning Tele: 970-304.4470 Fax; 97Q-304-6452 Emergency Preparednen i Itesponso Tele: 970.304.6470 Fax: 970-104.6452 Page 3 of 3 PU410 Health MAGPROfessionals ■I DEVELOPERS OF AGRICULTURE Water Supply Documentation Prepared for Steven Wells The subject property has five permitted wells on site, 78267-A, 11577-R, 11578-R, 11579-R, and 11580- R. See attached well permit documentation. An application for a commercial well permit is expected to be submitted to the Colorado Division of Water Resources as a condition of the Use by Special Review permit. ENGINEERING, PLANNING, CONSULTING & REAL ESTATE HQ & Mailing: 3050 67th Avenue, Suite 200, Greeley, CO 80634 1970.535.9318 office 1970.535.9854 fax Idaho: 213 Canyon Crest Drive, Suite 100, Twin Falls, ID 83301 1208.595.5301 www.agpros.com '� f'° miss ter%i+ STATE OF COLORADO - OFFICE OF THE STATE ENGINEER 316 CA++.�� Bldg.. 1313 611rrin.n $Bd L, OM. Cgiorn 60900 (3d3) 8064501 For office Use orgy + ' "-7:.: T II�� AnAnC 7 /� Z! •Eers �;,•�;;:::,: ; `: 08-28-9© 111 : O A ''• u. 1;13187 3 .00 TTi_ 3,18. CHEQUE. n il 1 CL -I 107'242 PRIOR TO COMPLETING FAA, SEE INSTRUCTIONS ON REVERSE SIDE CHANGE IN OWNERSHIP / ADDRESS WELL PERMR, LIVESTOCK TANK OR EROSION CONTROL DAM 1. CURRENT OWNER 4 J. Andrews NAME(S) Mailing City, Phone Harold L. Andrews and Wilma Address 37442 Wlorado Hwy, 392 St. Zip Briggsdale. CO 80611 ( 3°3 ) - 2, 1HIq CHANGE 1$ FQ�OIA,QF THE FOLLOWING: 12WELL ED ❑ PERMIT NUMBER 2-11578 R LIVESTOCK WATER TANK NUMBER - EROSION CONTROL DAM NUMBER a Y2aU, LOCATIQI : COUNTY J .1b OWNER'S WELL. DESIGNATION - _1111/4 Distances (Adaare) /4 crew SE 1/4, Sec.Twp. (My; ' Mew) 3 El E. ar (LP) 7 El N. ❑ S., Range til W. M _&.5.... from Section Line$ Ft. Ft. from ❑ „ ^P. from El N. or II S. Line, Lot. Block E. Of . W. Line, Subdivision Filing (Unit) - 4. LIVESTOCK TANK 9R EROSION CONTROL, rthfilil N. COUNTY or ❑ S., Range 1/4, Sec. Twp, Ill N. Ill E. or ■ W. ,P.M. 5. The above listed owner(s) say(s) that he (they) own the structure described herein. The existing record is being amended tor the following reason(s): la Change in name of owner. ❑ Change in mailing address. s, 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 244 104 (13)(s) C.R.S., the making of•false statements herein constitutes perjury in the second degree and is punishable as a class I misdemeanor.] Name/Titie (Please type or print) Harold L. Andrews Wilma 3. Andrews Signature • 1/141) n.671 Date isugust 23, 1990 FOR OFFICE USE �,. • •'� a•• � vhf 5 'r' 'i�:. 4KP' I ■ ` L]/ NIB 3 0 0* Court Case No. Div. / Co. & . WD Basin_ MD Use _/ RECEIVE,j , Signature( s) Suiracribed and Sworn"' to before me on this My Commission expirws•. (;r AL I TYPE OR PRINT IN BLACK INK. COPY OF ACC EPTTG STATEMENT MAILED ON REQUEST, STATE OF COLORADO COUNTY OF WELD x COLORADO DIVISION OF WATER RESOURCES 818 Centennial Bldg., 1313 Sherman St. Denver, Colorado 80203 55 V;11.:),32 '81 WATER RESOUktrUl AWE EN0JN AFFIDAVIT STATEMENT OF BENEFICIAL USE OF GROUND WATER AMENDMENT OF EXISTING RECORD TO SHOW NEW OWNER LATE REGISTRATION PERMIT NUMBER 11578-R IHE AFFIANT(S) Harold W. Law and Betty J. Law whose mailing . address is 1,621 1a,Ider Aveause SW y al the City . Greeley Colorado 8O631 (s�Arel Lew' being duly sworn upon oath, deposes and says that klte NC means No County LOCATION OF WELL MAY WELL NO. 2 Weld SE Section 25 Rng. 6 W 6th P.M W I,they)M81are) the ownerl1s) of the well described hereon; the well is Change from Original Data located as described above, at distances of NC feet from the NC section line and NC feet from the 111019111 OR sa,,11.1 `r�}T NC section line; water from this well was first applied to a beneficial use for the purpose(s) described herein on the NC day of NC rate claimed hereby is r 19_ NC the maximum sustained pumping rate of the well is NC gallons per minute, the pumping NC gallons per minute; the total depth of the well is of water to be diverted is NC acre-feet; for which claim is hereby made for purpase(s); the legal description of the land on which the water from this well is used is of which NC NC NC feet; the average annual amount NC acres ore 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 Iawpcisas (theyc(have) read the statements made hereon; knows the content thereof; and that the same ore true of iric(their) knowledge. /...qtP ys -+fig /a4 S-qg xr Pu ACCEPTED FOR FILING BY THE STATE ENGINEER OF COLORADO PURSUANT TO THE FOLLOWING CONDITIONS: ACCEM Csa 14Z COKER= Di`l (0/,/‘419 1101/30 198? Assistant WRIRV FOR OFFICE USE ONLY Cou.r Case No, prior r Ma Day Y. Div, L Cry_ — Sec. _.- 'A. 'A 'h well Use _Co_f Dist. _i2. Basin Man Dir , DATE STATE ENGINEER BY Well drilled by NC Lic. No. NC Permanent Pump installed by NC Lic, No, NC Meter Serial No. NC Owner of land on which water is being used NC ❑ Flow Meter Date Installed NC THE LOCATION OF THE WELL MUST BE SHOWN AND FOR LARGE CAPACITY IRRIGATION WELLS THE AREA ON WHICH THE WATER IS USED MUST BE SHADED OR CROSS -HATCHED ON THE DIAGRAM BELOW. NORTH This diagram represents nine (9) sections. Use the CENTER SQUARE (one section) to indicate the location of the well, if possible. I + - I .._ - I + - 1 + ! + - -- -I + --• E -F -- ! -I + - NORTH SECTION i + LIME f + - { ! + f WEST SECT -I- — 4 +- - ION L1t4E - - U ui - -- w . + + _... SOUTH SECT + " ION LINrE _ + V. + I — ! THE .+ i —# SCALE OF THE — + _ I H DIAGRAM IS + --- ll Mile TWO INCHES E + I UALS ONE -MILE + --- + WATER EQUIVALENTS TABLE (Rounded Figures) An acre-foot covers 1. acre of land 1 foot deep, 1 cubic foot per second (cfs) ... 449 gallons per minute (gpm). 1 acre•foot , , . 43,560 cubic feet , . . 325,900 gallons. 1,000 gpm pumped continuously for one day produces 4.42 acre.feet. 100 gpm pumped continuously far one year produces 160 acre;feet,, (WHITE AND PINK COPY TO BE FILED WITH THE STATE EMQ1$EER PINK COPY WILL BE RETURNED TO OWNER) 1 Registrant f STATE OF COLORADO DIVISION OF WATER RESOURCES {APR 141960 OFFICE OF THE STATE ENGINEER, GROUND WATER SECTND WATER� US 78 COLORADO REGISTRATION NO. OF WELL w -,2 - STATE April 12 19 60 William May P.O. Address Briggsda.le WELL DATA Depth 30 ft. Diameter 140 in. Casing : 15 ft. Plain; is ft. Perfor. Static Water Level 15 ft. from top Yield 200 (gpm)(cfs) from 28 ft. Used for Irrigation on/at Part E, Sec. 25, Twp. 7 N, RI;e. 63 W ( ega description of land or site) Water conveyed by Pipe , size PUMP DATA Type Turbine Size 6 inch Driven by 10 H.7. hiec . at 1.760 RPM Well was first used May- , 19 Sl cfs for Irr1_4ati on using 200 gpm Well enlarged _ deepened 8 a.nch , 19 to (gpm)(cfs)(ft) LOG SHOULD BE GIVEN ON REVERSE SIDE IF AVAILABLE Colo. Date SIB WELL LOCATION County } NW tin_ Section 25 Twp. 7 N , Rge. 63 laj 6 PM N 1 1 T I I I E I 1 I I 1 I I 1 I i S WELL TO BE LOCATED AS ACCUR- ATELY AS POSSIBLE WITHIN A SMALL SQUARE WHICH REPRESENTS 40 ACRES; OR IF IN A TOWN OR SUBDIVISION FILL IN THE FOLLOW- ING: Town or Subdivision Street address or Lot and Block The above well (Iti a) (has not) been registered in the Office of the State Engineer prior to May 1, 195.7. If Registered give Filing No. If NOT Registered prior to May 1, 1957, a $5.00 filing fee accompanies this form. The above statements are true and correct to the best of my knowledge and belief. Subscribed and Sworn before me WILLIAM MAY this , day of My commission expires )/, ITb/ (SEAL) ataxy Public Located in i-I BY: c72.‘7' Registrant FOR STATE ENGINEERS USE district, u,14,/4 County for Registration No, 1 2c≥ in on _ IRRIGATION • 141-• .r STATE OF COLORADO - ` OFFICE OF THE STATE ENGINEER 010 Gonlwth'Md Bid¢, 1313 Shannon $L, Dewar. Colorado 5GOO (30.91 .0e-3651 - For moo U.. only r _..... , I'M£ -, '90 ,:1: d 133107 ;i-k'0 i.',HE0LIE CHI 11. 90 ITH I CL --3 .A724 -h PRIOR TO COMPLETING FORM, SEE INSTRUCTIONS ON REVERSE -SIDE CHANGE IN OWNERSHIP / ADDRESS WELL PERMIT, LIVESTOCK TANK OR EROSION CONTROL DAM 1. OFIRENT OWNER NAME(S) Harold L. Andrews and Wilma J. Andrews Mailing Address 37442 Colorado Hwy. 392 City, St. zip llriggsdale, CO 80611 Phone ( 303) 2. THIS. 0144141JS FQR ONE OF THE FOLLOWING: WELL PERMIT NUMBER 3-11577 -- R O LIVESTOCK WATER TANK NUMBER ❑ EROSION CONTROL DAM NUMBER _ 3. Y11 LOCATION: COUNTY ei WELL DESIGNATION _OWNER'S (Addis.) Pi) ' Mule) NI) 1/4 of iha 1/4, Sec. 25 Twp,,„ O N. a ❑ S., Range A3 O E. or caul W. W. 6, P.M -^^ Distances from Section Dines Ft. from ❑ N. or ❑ s. Line, Ft. from II E, or In W, Line, Subdivision Lot Block Filing (Unit) 4. LIVESTOCK TANK OR EROSION CONTROL DAM LOCAT1QN: COUNTY 1/4, Sec. Two. 0 N. or ❑ S., RangeO Ear ❑ W. _P. . 5. The above listed owner(s) say(s) that he (they) own the structure described herein. The existing record is being amended for the following reason(s): lEt Change in name of owner, 0 Change in mailing address, 6. 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.] Name/Trile (Please type or print) Harold L. Andrews Wilma J. Andrews Signature Date August 23, 19" FOR OFFICE USE eN �^ — 6-1.11; AUG 30 !990 By - Dills Court Case o. Div.Z_ Co._ WD I Basin MD Use TAPE OR PRINT IN ALLA CK 1NR. COPY OF ACCEPTED STATEMENT MAILED ON REQUEST, COLORADO DIVISION OF WATER RESOURCES 818 Centennial Bldg., 1313 Sherman St. Denver, Colorado 80203 STATE OF COLORADO COUNTY OF WELD SS. RECEIVED 02'81 AFFIL ___ _ STATEMENT OF BENEFICIAL USE OF GROUND WATER X.--. AMENDMENT OF EXISTING RECORD TO SHOW NEW OWNER . LATE REGISTRATION PERMIT NUMBER 11577—{, _ LOCATION OF WELL MAY WELL NO. 3 THE AFFIANT(S) Harold W_ Law and Hutt•y Lxw whose mailing address is 1621 Elder Avenue City Greeley County Weld y, of the SE %, srtction 25 Color do- 80631 Twp. 7 , ,__ N Roo. 63 E 6th P M 1llrl 'l a 5lE un WI being duly sworn upon oath, deposes and says that isli (tIi )�ange froowner(s)Oof tl Da well described hereon; the well is NC means located as described above, at distances of NC feet from the NC _ section line and NC feet from the loon TN ow sour H) NC section line; water from this well was first applied to a beneficial use for the purpose( s) described herein on the ,NC lE•,► v• WEll) � day of ._Y NC.., , 19 NC ; the maximum sustained pumping rate of the well is NC gallons per minute, the pumping rate claimed hereby is _ NC_, gallons per minute; the total depth of the well is NC feet; the overage annual amount of water to be diverted is NC acre•feet; for which cleim is hereby made for NC purpose(s); the legal description of the land on which the water from this well is used is NC of which NC 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 Iow;*oe (they)1 x(have) read the statements made hereon; knows the content thereof; and that the same are true of]#ttx(their) knowledge. (COMMPLETE REVERSE SIDE OF THIS FORM) Sig oture(s) ' , • 144A,/ ti�Cl�fjs t{ Subscribed and sworn �7 197 to before me on thi day o My Commission expires: Isc•.y - f. '•GTAgY y„a LIC ACCEPTED FOR FILING BY THE STATE ENGINEER OF COLORADO PURSUANT TO THE FOLLOWING CONDITIONS: ACCF 3 m,$ cm= QE oiluaismi ONLY Nov 3 0 1981 e/ PATE 5TAt.. BY /x.4,10-6-48 Din,. Cry. j 52 _ Well drilled by NC Lic, No, NC Permanent Pump installed by NC Lic, No, NC Meter Serial No. NC , , ❑ Flow Meter Date Installed NC Owner of land on which water is being used NC THE LOCATION OF THE WELL MUST BE SHOWN AND FOR LARGE CAPACITY IRRIGATION WELLS THE AREA ON WHICH THE WATER IS USED MUST BE SHADED OR CROSSHATCHED ON THE DIAGRAM BELOW. This diagram represents nine (9) sections. Use the CENTER SQUARE (one section) to indicate the location of the we 1, if possible. NORTH I -I- -"' I + -4- I -I- - 1 -I- I + -+ 1 + ---- + — + -- + — NORTH SECTION + LItlE -1- — f - 3 WEST SECT . .jii i i — + ..^ SOUTtFI SECTION -+ — LIIIE + f -i- THE SCALE OF THE — + ,. , .1'" DIAGRAM IS — - - --1 ' M I TWO INCHES E - , + i i e-*" l UALS ONE -MIL + -- E + WATER EQUIVALENTS TABLE (Rounded Figures) An acre-foot covers 1 acre/of land 1 foot deep. 1 cubic foot per second (cfs) ... 449 gallons per minute (gpm). 1 acre-foot . , , 43,560 cubic feet . , , 325,900 gallons. 1,000 gpm pumped continuously for one day produces 4,42 acre-feet. 100 gpm pumped continuously for one year produces 160 ocr.e-feet. (WHITE AND PINK COPY TO BE FILED WITH THE STATE ENGINEER 'PINK COPY WILL BE RETURNED TO OWNER) ■OW. 1 Yield 150 /5M Registrant .‘..STATE OF COLORADO •,:� L. DIVISION OF WATER RESOURCES OFFICE OF THE STATE ENGINEER, GROUND WATER SEC TIth1 R 141.960 GROUND MO SECT. COG" APIER4 M REGISTRATION NO.7ZF WELL 7111 William May Date P.O. Address Brij?.ge<inie . Colo. WELL LOCATION WELL DATA County Weld Co Depth 32 ft. Diameter 48 in. Casing : 21 ft. Plain; 11 ft. Perfor. Static Water Level 15 ft. from top (gpm)(cfs) from 30 ft. Used for Irrigation on/at Past, E .. See. 2�i, Twp. 7 N, lige. 63 W (legal description of land or site) Water conveyed by Pipe , size 8 inch PUMP DATA Type Turh .ne Size 8 .ich Driven by 2 11.14. Mee. at 1760 RPM Well was first used , 19 25 cfs for Irri;ration using 150 gpm Well enlarged _ deepened , 19 to (gpm)(cfs)(ft) LOG SHOULD BE GIVEN ON REVERSE SIDE IF AVAILABLE NW 4 SE u, Section 25 W Rge. 63 W , 6 PM N 1 - I 1 I 1 - I I I I -_ -1- 1 I X I I I J. S E WELL TO BE LOCATED AS ACCUR- ATELY AS POSSIBLE WITHIN A SMALL SQUARE WHICH REPRESENTS 40 ACRES; OR IF IN A TOWN OR SUBDIVISION FILL IN THE FOLLOW- ING: Town or Subdivision Street address or Lot and Block The above well Mike (has not) been registered in the Office of the State Engineer prior to May 1, 1957. If Registered give Filing No. If NOT Registered prior to May 1, 1957, a $5.00 filing fee accompanies this form. The above statements are true and correct to the best of my knowledge and belief. Subscribed and Sworn before me this )8 day of R, r r� , 191+0 . My commission expire (SEAL) kid/1= yj . Notay Public �. WILLIAM MAY PY: FOR STATE ENGIVEER,S CountyUSE for IRRIGATION Located in / '" / district, wikk Registration No. /267 in (—/ on Y AI, dtz_ 144 ", eee.ie.e.0;„ .,eXc zeu.444 ,fre) , Form No. GWS-11 6/2003 STATE OF COLORADO OFFICE OF THE STATE ENGINEER 818 Centennial Bldg., 1313 Sherman St., Denver, CO 80203 (303) 866-3581 Fax (303) 866-3589 For Office Use Only RECEIVED SEP 2 7 2004 WATERRESOURCES ENGINEER COW. CHANGE IN OWNERSHIP/ADDRESS CORRECTION OF THE WELL LOCATION Insert the Well Permit Number 11579R Name, address and phone of the person claiming ownership of the well: NAME(S) Mailing Address City, St. Zip Phone ( Don Kehn 5900 S. County Rd. 5 Fort Collins, CO 80528 970 ), 226-.4111 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 WELD Owner's Well Designation (Address) NW 1/4 of the SE 1/4, Sec. 25 , Twp. (City ) (State) (Zip) 63 ❑ E. or ® W., 6th P.M. 7 N. or ill S., Range Distance from Section Lines 1715.5 Ft. 2146 Ft. From From a N. or ❑ S., ❑ E. or i' W. Line. Subdivision Name Lot , Block Filing/Unit The above listed owner(s) say(s) that he she amended for the following reasons: Change ❑ Correction of location for exempt wells May 17, 1965. Please see the reverse side (they) own the well described herein. The existing record is being Change in mailing address and non-exempt wells permitted before correction of the well location. in name of owner ❑ permitted prior to May 8, 1972 for further information regarding 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 Don Kehn Signature(s) of the new ner. i Date It is the responsibility of the new owner of this well to complete and sign the form. Signatures of agents are acceptable if an original letter of agency signed by the owner is attached to the form upon its receipt. For Office Use Only ACCEPTED AS A CHANGE IN OWNERSHIP AND/OR MAILING ADDRESS. t led ZI . State Engineer By Date Yield 150 (gpm)(cfs) from Used for Irri at ion Fore F5(I{e9. ) 7-57/5M Registrant William May P.O. Address Briggsdale Depth 314 WELL DATA ft. Diameter 2)a Casing 21_ ft. Plain; in, 13 ft. Perfor, Static Water Level_ 15 ft. from top ft, on/at 30 Part 1, Sege 25 Twp. 7 N h;e. 63 w (legal description of land or site) Water conveyed by Pipe , size 8 inch PUMP DATA Type Turbine Size L inch Driven by 2 H.P. glee. at 1760 RPM Well was first used September for _ irrigation using 150 7 19 51 cfs gpm Well enlarged , 19 to deepened (gpm)(cfs)(ft) LOG SHOULD BE GIVEN ON REVERSE SIDE IF AVAILABLE STATE OF COLORADO-.44)-61..i'e .-4'7 -"mom DIVISION OF WATER RESOURCES OFFICE OF THE STATE ENGINEER, GROUND WATER SEC �� rt 44'�� iiTrER SECT �Ilil i�f17� �l+�n REGISTRATION NOI. 9 OF WELL CJI.G: STATE ENNIN R April 12 19 60 Date , Colo. WELL LOCATION County Weld .(0, NW ;� ; Section 25. - . Twp. 7 N Rge. 63 1/1 , 6 PM w N I I 6- - T--- I 1 ---r r- I --.---_- I I I , -1 ... --- - -, -t - --- I I I I I I S E WELL TO BE LOCATED AS ACCUR- ATELY AS POSSIBLE WITHIN A SMALL SQUARE WHICH REPRESENTS 40 ACRES; OR IF IN A TOWN OR SUBDIVISION FILL IN THE FOLLOW- ING: Town ar Su ivision Street address or Lot and Block The above well MEN) (has not) been registered in the Office of the State Engineer prior to May 1, 1957. If Registered give Filing No. If NOT Registered prior to May 1, 1957, a $5.00 filing fee accompanies this form. 1'he-above. statements are true and correct to thebest of my knowledge and belief. Subscribed and Sworn before me this / --� F day of :My commission expires P{._ //, /9(r/ (SEAL) X11. Notary Public WILLIAM iIA I Registrant FOR STATE ENGINEER'S USE Located in / —1 district, W1i4 County for Registration No. /0. I , on IRRIGATION APR 14 1460. EGF'1 N° 1 M'" STATE OF COLORADO __�� OFFICE OF THE STATE ENGINEER Ill COMMilli Qkb.. 1313 Shannon IL, Denver, Coocmdo 40209 1303! 3521 _._ For Cfho. LW Ag8 2 7 'y 7 vt',' 13317"1 3.00 ._._ ...7TL 3.00 CHEQUE CHCy 0.@@ CL -1 1A724,2 PRIOR TO COMPLETING FORM, SEE INSTRUCTIONS ON REVERSE SIDE CHANGE IN OWNERSHIP / ADDRESS00-2B-90 WELL PERMR', LIVESTOCK TANK OR EROSION CONTROL DAM -r- 1. CURRENT OWNEB Harold L. Andrews and Wilma J. Andrews NAME(S) Mailing Address 37442 ccgoracti ItoE. 392, City, Sts Zip Bragged&] e r CO 80611 Phone ( 303) 2. THIS CHANGE IS,E9R ONE OF TIME FQJ..LOW1NG; - . g WELL PERMIT NUMBER 1-11580 -R ❑ LIVESTOCK WATER TANK NUMBER II ,r EROSION CONTROL DAM NUMBER 3, WELL LOCATION: COUNTY ! ;L'11 OWNER'S WELL DESIGNATION (Addends) (C+ i - 1/4 o11h. SE 1/4, Sec. 25 Twp..... 2 N. Of El S., Range L.3 .4444) 17445V) O E. or 111W. ( P,M. Distances from $ tiOftUagli Ft. from ❑ N. or ❑ S. Line, Ft. from O E. or ❑ W. Line. Subdivision Lot Block Filing (Unit) 4. LIVESTOCK TANK OR 11Q51QN CONTROL DAM LOCATION: COUNTY 1/4, Sec, Twp, ❑ N. or 11 S., Range O E. or ■ W. P.M. 5. The above listed owner(s) say(s) that he (they) own the structure described herein. The existing record is being amended for the following reason(s): ❑ Change In name of owner. O Change in mailing address. B. 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.) Name/Title (Please type or print) Harold' L. Andrews Wilma 3. Andrews Signature rte/ �rJ f�°` qq ��/�1��({ // ,t,- f1"vii, s, Date Aug1-ru1�r� 7 7 99 hu8t 23, 199( FOR OFFICE USE ONLY �igl.ni,� a _ BY 0 Du Court Case Na. _ Div. 7 Co. Id WD 1 Basin MD Use _ • TYPE OR PRINT IN, BLACK INK COPY OF ACCEPTED STATEMENT MAILED ON REQUEST. COLORADO DIVISION OF WATER RESOURCES 818 Centennial Bldg., 1313 Sherman St. Denver, Colorado 80203 STATE OF COLORADO COUNTY OF ._ WELD SS. RECEIVED '81 WATER RESOURCM AFIKEiSitkiitgA STATEMENT OF BENEFICIAL USE OF GROUND WATER X AMENDMENT OF EXISTING RECORD TO SHOW NEW OWNER - LATE REGISTRATION PERMIT NUMBER 1158O •^R LOCATION OF WELL MAY WELL NO. 1 THE AFFIANT(S) Harold W. Law and Betty J. Law Co.,„ty Weld _R whose mailing address is 1621 Elder Avenue .SW y, or tho SE Y4, Section 25 City Greeley Colorado 8O631 Twp. 7 N , Rng. 63 W 6th P.M in. nrcI IMO IN OR SI TL 'on rI being duly sworn upon oath, deposes and says that (theyjstiot(are) the owner(s) of the well described hereon; the well is NC means No Change from Original Data located as described above, at distances of NC feet from the NC section line and _ NC feet from the IN0P1.1 ar. nuur..) NC section line; water from this well was first applied to a beneficial use for the purpose(s) described herein on the NC tr,s• 5R Wrirt day of NC , 19NIS_; the maximum sustained pumping rate of the well is NC gallons per minute, the pumping rote claimed hereby is _ NC gallons per minute; the total depth of the well is NC feet; the average annual amount of water to be diverted is NC acre-feet; for which claim is hereby made for NC NC purpose(s); the legal description of the land on which the water from this well is used is NC of which NC 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;tbex (they)* (have) read the statements made hereon; knows the content thereof; and that the same are true of ftixp(their) knowledge. (COMPLETE REVERE SIDE OF THIS FORM) 12€04 549 Signature(s) Subscjibed and sworn to before me on th : s;" My Commission expire 15f ALI ,..i570&,/, rte. , 19cP1 arlcws ruetil ACCEPTED FOR FILING BY THE STATE ENGINEER OF COLORADO PURSUANT TO THE FOLLOWING CONDITIONS: ALA ECS1 MANGE DE MrERSHIR ONLY _11=0_1981_ ._1981._ D„E FOR OFFICE USE ONLY Court Case No. Prior Div. Mo, Day Sec. Well Ucs Dist. C) r Basin 'r. Mon. Din. STATE ENGINEER BY Well drilled by NC Lic. Na. NC Permanent Pump installed by NC Lic. No. NU Meter Serial No. NC Owner of land on which water is being used NC ❑ Flow Meter Date Installed NC THE LOCATION OF THE WELL MUST BE SHOWN AND FOR LARGE CAPACITY IRRIGATION WELLS THE AREA ON WHICH THE WATER IS USED MUST BE SHADED OR CROSS -HATCHED ON THE DIAGRAM BELOW. NORTH This diagram represents nine (9) sections. Use the CENTER SQUARE (one section) to indicate the location of the well, if possible. I + - I + .r.- 1 + - I + I -1- I + - + - + _.._ A- - NORTH SECTION LI + 1E 4.. Y. + - WEST SECT 4 - - + - ION LINE L. ---- - 11111 I - Y. .+ _ + SOUTti SECTION — + — L1NE + I + THE SCALE OF THE — + DIAGRAM IS — + --- —1 M TWO INCHES E + ilei DU ALS ONE -MILE + - f WATER EQUIVALENTS TABLE (Rounded Figures) An acre-foot covers 1 acre of land 1 foot deep. 1 cubic foot per second (efs) ... 449 gallons per minute (gpm). 1 acre-foot ... 43,560 cubic feet ... 325,900 gallons, 1,000 gpm pumped continuously for one day produces 4.42 acre-feet. 100 gpm pumped continuously for one year produces 160 acre-feet. (WHITE AND PINK COPY TO BE FILED WITH THE STATE ENGINEER PINK COPY WILL BE RETURNED TO OWNER) a UP F (Rev . ) r-. .... .. 7,- -57/5M -- STATE OF COLORADO L , , . __ `� S ji DIVISION OF WATER RESOURCES - - OFFICE OF THE STATE ENGINEER, GROUND WATER SECTIONAi3R 141960 1580 REGISTRATION NO. [?sf OF WELL 09 GROUND 0RAD0 WATER Registrant William May P.O. Address Bri;rgsdale , Colo. WELL DATA Depth 138 ft. Diameter 12 in. Casing : 60 ft. Plain; 16 ft. Perfor. Static Water Level 15 ft. from top Yield 200 (gpm)(cfs) from 90 ft. Used for Irri. pat to on/at Part EL Sec. 251 TWp, 7 is, jee,6p w (legal description of land or site) Water conveyed by Pine , size , 5 PUMP DATA Type Turbine Size 5 inch Driven by 5 H.P. lac. at 1760 RPM Well was first used March , 19_111 cfs for 1rri.jation using 20.0 _ gpm WELL TO BE LOCATED AS ACCUR- ATELY AS POSSIBLE WITHIN A Well enlarged , 19 to SMALL SQUARE WHICH REPRESENTS deepened 40 ACRES; OR IF IN A TOWN OR (gpm)(cfs)(ft) SUBDIVISION FILL IN THE FOLLOW- ING: l`L Date Apri.fi WELL LOCATION County Weld NW t, SE u, Section 25 Twp. 7 N, Rge. _--63 W , 6 s -PM W N I 1 1 E I 1 I. I I I I 1 I S E LOG SHOULD BE GIVEN ON REVERSE SIDE IF AVAILABLE Town or Subdivision Street address or Lot and Block The above well (hlia (has not) been registered in the Office of the State Engineer prior to May 1, 1957. If Registered give Filing No. If NOT Registered prior to May 1, 1957,, a $5.00 filing fee accompanies this form. The above statements are true and correct to the best of my knowledge and belief. Subscribed and Sworn before me th►is__day of , 19&L. My commission expires Ike e. f J� 1y&/. LfJ4t ` ►�. . Notary Pub is (SEAL) BY: wW]ILIAN MAY 7/I Registrant FOR STATE ENGINEER'S USE Located in if — / district, y° u2,b,1 County for Registration No. /-/>6.11-in / — / on IRRIGATION r,14 ,,0. F Fori4 iNon -' OFFICE OF THE STATE ENGINEER c-25 COLORADO DIVISION OF WATER RESOURCES 818 Centennial Bldg., 1313 Sherman St., Denver, Colorado 80203 (303)'8.68-3581 APPLiQ NT HAROLD L ANDREWS 37442 WCR 392 BRIGGSDALE, CO 80611- (970) 656-3400 PERMIT TO CONSTRUCT A WELL } _ LIC WELL PERMIT NUMBER 74c 6 I DIV. 1 WD 1 DES. BASIN MD J APPROVED WELL LOCATION WELD COUNTY NW 1/4 SE 1/4 Section 25 Township 1 N Range 63 W Sixth P.M. P1STAI4CES FRQM_S.ECTLON LINES 1920 Ft. from South 1840 Ft. from East Section Line Section Line 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 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 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 37-92-602(3)(c) for the relocation of an existing well, permit no. 78267. 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. 4) The use of ground water from this well is limited to fire protection, ordinary household purposes inside not more than two (2) single family dwellings, the watering of poultry, domestic animals and livestock on a farm or ranch and the irrigation of not more thanbne (1) acre of home gardens and lawns. 5) The maximum pumping rate of this well shall not exceed 15 GPM. 6) This well shall be constructed not more than 200 feet from the location specified on this permit. 7) This permit has been approved for the location specified above pursuant to an August 16, 2000, telephone conversation with 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.) APPROVED KL$ Jeceipt No. 0465265 State Engineer DATE ISSUED AUG 2 2 2000 13 EXPIRATION DATE AUG 2 2 2O Aug -17-00 02:12P P.02 r'} 1 e 7 � c OLORADO DIVISION OF WATER RFSOURCFS OE ARTM NT OF NATURAL RESOURCES 1313 81MRMILN ST., RM. 818, DENVER CO same phone - info: (303) 866-3587 main: (303) 866-3581 RESIDENTIAL * Plow You may Wrote. dee Wet to ePPM terine.aKe erar,rr) Water Well Permit Application Rttvlew trittrugdonis prior x4 exnnpfetirre form Musktts completed in hledc ink or typ 1. APPIuCANT INFORMATION 6. USE OF Wel (ctechappripew0e entry tx o'*iesY rrraear eMe..r Sri inrareedene fur detentes* tats(.) for wHch 11041 miry waft — C A. Ordinary howeeltold use N one smoke-lemay dwelling Ea neat* amyl mamma. ma. la a. Ortinary household use In 1 to 3 Bald a 'Iy dwe Angst Nurnber of drams Oki *OW 7. ace. e22,2,-.7c mow la Borne gonis ulawn Willem, not to t ceeed 1 es e: west irrigated, I AC Clan, cc 0 \.e ® w�ra Domestic animal ed is I 2. TYPE OF APPLICATION Iclaedt appliatble ba.des)) IS C. Livestock irbot f rd 0 Construct new well 51 Replace rodstirq,well Q Change.t acne) aquifer 0 other. O Use Gloating well ❑ Change / Increase Use • Reappfrcadont r eina mwas 7. WELL DATA 3. REFER TO Of appeiaableiO Winer court ems ee�,.wn ■ rlF t -rwe,awl-whham e 41 � �d 30 `t feet I I o X f i ecrwMat %WSW r lakmitemirip hob acbwwkirn.em f MH- Wei nom or I 4_ LOCATIOON O Cowry seat:., Tow' Jraerr�p rr pr S '1 Zr op t77srenee of wee horn sraeon liner ft. tom 0 N ❑ s w mrr+en eee,ent, it iA.rerll wine eptrre •ddriee fY +tholes Quarter/evertor CEA a a Quarter PeIrdiri I !L hum '.f 1atrloun ur♦ w ashy - ea1Mme ed dimefrl him e4 won to now 9. TYPE OF RESIDENTIAL S _ EWA E SYSTEM. IS Septic tank f absorption leach field 0 Central system District name: 0 Vault Locution ■ewe te be hauled tot _ 0 Other i.a.eh copy orene lraatino dtnipn) 9. PROPOSED WELL DRILLER t.ptlarri 10. SIGNATURE of applicants) or authodzed agent The making of false statements herein ottn,tu es perit.ry 0 E ❑ w in the second degree, whits is puree cable as a lass 1 Reis• demeanor pursuant to C.H.S. 24-4-104(13)(e). I have read the statements herein, know the Contents thereof end State that they . e true to my knowledge, feet direction 5. TRACT ON WHICH WELL WILL 8€ LOCATED A. You num check sure of the tralowing - eve instructions 0 Subdivision Name w,al.. .d.-... r?S Lot no, Block no. Fding/Unrt 0 Cotxrty exerrnOdon (crutch copy of county approval dl survey' Namelna. Tract no. 0 Mining claim much copy ei dced or survey) Herne/no. iir O h r ietliCh kpel Ornelitieln ro .pplaar.mAI rot frA AOri OfmONAL INFORMATION u906 ■„a ,vane I%M alert m. -1'1 f.wlmils WV. g . STATE PARCEL ID# l0000new C. a owes in beet 0. AI you the owner of We propeyrty7 M ES 0 NO lit no - sea instructions, E Will this be the only wad on this tract,? OYES I NO (ii other wells ere on this traer- bur inssnroti0nf) Office Use Only Invoice # 465265 d/1B/k19:. -- 9:52:3EC AM Cashier ID; #1 $ 28.88 Credit Card Purchase -- done DIV CO_ II WO I 40/6`10 a Wr4 EA USE MD 'Form GINS -U (11195) Hello