HomeMy WebLinkAbout20180844.tiffWATER SUPPLY INFORMATION SUMMARY '
Section 3028.133,(d), C.R.S. requires that the applicant submit to the CountyAdequate evidence that a water supply that
is sufficient in terms of quantity, quality and dependability will be available to ensure an adequate supply of water,
1. NAME OF DEVELOPMENT AS PROPOSED N. 5 e a V e� O i l Te�01r '1a(
2. LAND USE ACTION Cr--ur,e O, (r S ' r yr ,I e
3. NAME OF EXISTING PARCEL AS RECORDED C )" 525 -Yo N A 6,-0 67`14 1° pt'I
SUBDIVISION 4 /Jr FILING N/4 BLOCK N/4 LOT N/A
4. TOTAL ACREAGE 5030iii5.
NUMBER OF LOTS PROPOSED f FLAT MAP ENCLOSED ® YES
8. PARCEL HISTORY - Please attach copies of deeds. plats or other evidence or documentation.
A. Was parcel recorded with county prier to June 1, 1972? ❑ YES ❑ ND
B. Has the parcel aver been part of a division of land action since June 1, 1912? 0 YES 0 NO
If yes, describe the previous action
7. LOCATION OF PARCEL - Include a map derniatinp the project area and tie to a section corner,
C 114 OF 114 SECTION 7 Si- TOWNSHIP O3 LE4N ❑ S RANGE . 0 E .® w
PRINCIPAL MERIDIAN: Eq. 6TH ❑ h.M. 0 UTE 0 COSTILLA
8. PLAT - Location of all wells on property must be plotted and permit numbers provided.
Surveyors plat 0 Yes ® No If not, scaled hand drawn sketch 0 Yes 0 No
9. ESTIMATED WATER REQUIREMENTS
HOUSEHOLD USE # of units
COMMERCIAL USE q of S.F.
- Gallons per Day or Acre Feet per Year
GPO Al
10. WATER SUPPLY SOURCE
0 EXISTING 0 DEVELOPED 0 NEW WELLS
WELLS SPRING I PROPOSED MUMS •fCHECK ar4
WELL PERMIT NUMBERS ❑ ROAM ❑ UPPER ARAPANOE
0 M ER OAWSON 0 LOWER ARAPAHOE
0 LowrR DAwSOH 17LARAAOE PH Hue
GPO AF
—
` a oenm ❑ DAIWA
IRRIGATION If of acres
STOCK WATERING N of head
GPO Al
Q OTHER
❑ MUNICIPAL
GPO AF
OTHER - GPO AF
0 ASSOCIATION ': WATER COURT DECREE CASE NO.'S
0 COMPANY
-
TOTAL
GPO AF
0 DISTRICT
NAME
LETTER OF COMMITMENT FOR
SERVICE 0 YES 0 NO
11. ENGINEER'S WATER SUPPLY REPORT 0 YES 151 NO IF YES, PLEASE FORWARD WITH THIS FORM. (This mey be required before our review q complaied)
12. TYPE OF SEWAGE DISPOSAL SYSTEM
❑ SEPTIC TANKILEACH FIELD
0 LAGOON
0 ENGINEERED SYSTEM Islnch a copy
0 CENTRAL SYSTEM
0 VAULT • LOCATION
of engineering design) 8 OTHER (61I
• DISTRICT NAME
SEWAGE HAULED TO
—II-^ a - to 11('5
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