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Home My WebLink About20221503.tiff'COLORADO Division of Water Resources Department of NQtttra! Resource's WELL PERMIT NUMBER 31OO37- RECEiPT NUMBER 368685O ORIGINAL PERMIT APPLICANT(S) PREMIER COMMUNITY DEVELOPMENTS LTD PERMIT TO CONSTRUCT A NEW WELL APPROVED WELL LOCATION Water Division; 1 Water District: 2 Designated Basil'- N/A Management District: N/A County: WELD Parcel Name: ARISTOCRAT RANCHETTE (FILING: 3) Lot: 3 Block: 77 Filing: 3 Physical Address: N/A NW 1/4 SW 1/4 Section 26 Township 2.0 N Range 66.0 W Sixth P.M. UTM COORDINATES Neters, Zone:13, NAD831 Easting: 521347.0 Northing: 4439650.0 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 ensure that no injury wilt 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 shalt be in compliance with the Water Welt Construction Rules 2 CCR 4O2-2, 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)(II)(A) as the only well on a residential site of 1 acre described as lot 3, block 77, filing 3, Aristocrat Ranchettes Subdivision, Weld County. 4) The use of ground water from this well is limited to ordinary household purposes inside one single family dwelling. The ground water shall not be used for irrigation or other purposes. 5) The total depth of the welt shalt not exceed 250 feet, which corresponds to the base of the Lower Arapahoe aquifer. At minimum, plain casing shall be installed and grouted through all unconsolidated materials and shall extend a minimum of ten feet into the bedrock formation to prevent production from other zones. 6) The pumping rate of this well shalt not exceed 15 GPM. 7) The return flow from the use of this well roust be through an individual waste water disposal system of the norrevaporative type where the water is returned to the same stream system in which the well is located. 8) This well shall be constructed not mare than 2O0 feet from the Location specified on this permit. NOTE: To ensure a maximum productive life of this well, perforated casing should be set through the entire producing interval of the approved zone or aquifer indicated above. NOTE: This permit will expire on the expiration date unless the well is constructed by that date. A Well Construction and Yield Estimate Report (GWS-31) must be submitted to the Division of Water Resources to verify the well has been constructed. An extension of the expiration date may be available. Contact the DWR for additional information or refer to the extension request form (GWS-64) avaitable at: http://www.water.state.co.us Issued By DEBRA GONZALES Date Issued: 7/1O/2O18 Expiration Date: 7/1O/202O Printed 07-10-2018 For questions about this permit call 303.866.3561 or go to www.water.state.co.us Page 1 of 1 Form No. GWS-31 9/2016 WELL CONSTRUCTION AND YIELD ESTIMATE REPORT State of Colorado, Office of the State Engineer 1313 Sherman St., Room 821, Denver, CO 80203 343.866.3581 www.water.stale.co.us and dwroermitsonline@state_co.us For Office Use Only 1. Well Permit Number: 310037 Receipt Number: 3686850 2. Owner's Well Designation: 3. Well Owner Name: Premier Community Domes LTD 4. Well Location Street Address: 16240 Casler 5. GP5 Well Location: ©Zone 12 aone 13 Easting: 521340.0 Northing: 4439669 County: Weld 6. Legal Well Location: NW 1/4, SW 1/4, Sec., 26 Twp. 2 n N or S IN, Range 66 In E or W =i, 6th P.M. Distances from Section Lines: ft. from in N or S r-i section tine, and ft, from NI E or W ME section line Subdivision: Aristocrat Ranchettes , Lot 3 , Block 77 , Filing (Unit) 3 7. Ground Surface Elevation: feet Date Completed: 10/02/2018 Drilling Method: Air Rotary 8. Completed Aquifer Name : Lower Arapahoe Total Depth: 250 feet Depth Completed: 250 feet 9. Advance Notification: Was Notification Required Prior to Construction? III Yes ® No, Date Notification Given: 10, Aquifer Type: (Check one) ■Type [Type I (One Confining Layer) QType I (Multiple Confining Layers) OLaramie-Fox II (Not overlain by Type III) 0fype II (Overlain by Type III) QType III (alluvial/colluvial) Hills 11. Geologic Log: 12. Hole Diameter (in.) From 9" 0 (ft) To (ft) 41 Depth Type Grain Size Color Water Loc. 6 1/8" 41 250 0-1 Topsoil 8 Sand, Clay 45 Clay, Shale 13. Plain Casing OD (in) Kind Wall Size (in) 6 5/8" Steel .188 From (ft) To (ft) +1 41 68 Clay, Sandrock 105 Clay, Shale 4 1/2" PVC Sch 40 15 40 122 Clay, Sandrock 177 Clay, Shale 189 Clay, Sandrock Perforated Casing OD (in) Kind Wall Size (in) 4 1/2" PVC Sch 40 From (ft) To (ft) 40 250 250 Clay, Shale 14. Filter Pack: Material Gravel 15. Packer Type Placement: Rubber Depth 80 Size 1/4'. Interval 30-80 16. Grouting Record Material Amount Density Cement 6 Sacks 36 Gal Interval Placement 6-41 Poured Remarks: 17, Disinfection: Type HTH Amt. Used 6 Oz 18, Well Yield Estimate Data: laheck box if Test Data is submitted on Form Number GWS-39, Well Yield Estimate Method: Bailed Well Yield Test Report Static Level: 49 Estimated Production Rate 3 gpm. Estimate Length (hrs.) 4 Date/Time measured: 10/02/2018 Remarks: 19. I have read the statements made herein and know the contents thereof, and they are true to my knowledge. This document is signed filing online) and certified in accordance with Rule 17.4 of the Water Well Construction Rules, 2 CCR 402 2. The filing of a document that statements is a violation of section 37 91 108(1)(e), C.R.S., and is punishable by fines up to 51,000 and/or revocation of the contracting the State Engineer considers the entry of the licensed contractor's name to be compliance with Rule 17.4. (or name entered if contains false license. If filing online Company Name: Kunau Drilling LLC Email: kunaudritling@aol.com Phone w/area code: (719) 683-3720 License Number: 1148 Mailing Address: 23945 Lucky Lane Cathan, CO 80808 Sign (or enter name if filing online) Tim Kunau Print Name and Title Tim Kunau/ Manager Date: 10/10/2018 Application Number: Owner Name: Site Address: WELD COUNTY DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT 1555 North 17th Avenue, Greeley, CO 80631 \AAAN.weldheolth-org Septic Permit New SP -1800249 PREMIER COMMt1NITY HOMES, LTD 16240 CASLER AVE FORT LUPTON, CO 8062'1 App Type: Healt₹ lResidentiallNew OWTS1Septic Parcel Number: Legal Desc: Work Description: EHS SEPTIC GENERAL: Number of Bedrooms 4 Number of Persons 4 Parcel Acres 0.96 Private Water Supply Well Private Water Supply Permit Reference 3686850 Public Water Supply No SEPTIC SIZING INFORMATION: From the application information supplied and the on -site soil percolation data the following minimum installation specifications are required: Septic Tank Size (GAL): 1250 Bed Absorption Area for Rock & ripe(Sgft.) 1260 Trench Absorption Area for Rock & Pipe (Sgft-) 1050 Bed Absorption Area for Chambers (Sgft.) Trench Absorption Area for Chambers Sgft.) Application Status: Final Pending Applied Date: 07/09/2018 Intake Person: iVAZQUEZ Permit Expiration Date: Hoc' ,4dmSrrisi'o1 an Vlial 4a. arcis -Ms.6 a Y 0 Fax, 930-.'C'4-6.ti2 1635 3 LAYTON DR ENGLEWOOD, CO 80113 130926308003-R3444305 3AR L3 BLK 77 ARISTOCRAT RANCHETfES 3 FG IRC MODULAR HOME Pubk tioolth L EMrscal Smrvlcar feiFl: 926-304,54211 -'a,; 97[-304-5416 882 735 Envy rimorikal Hzoilb Sen lams Ten: V0-304-6415 Casnrrwr,9ccin n. Edvicei3or L Piannlrtg Tate: 97C-30444AI FC�1 9'f}301-64i'E Fax: 276-304:6,452 Erroorgency hoparstfneu i AvogroosAt frie:'�?6-3ga-6470 . ❑x. S'0 -.'3(A- 4.52 Page 1 of 3 PnbliCHealat Hello