HomeMy WebLinkAbout20153458.tiff WATER SUPPLY INFORMATION SUMMARY
Section 30.28.1334d1. C.R.S. requires that the applicant submit to the County,Adequate 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 Drill Green
2. LAND USE ACTION Use By Special Review
3. NAME OF EXISTING PARCEL AS RECORDED Recorded Exemption No. 1211-33-4 RE-3693
SUBDIVISION FILING BLOCK LOT B
4. TOTAL ACREAGE 35 5. NUMBER OF LOTS PROPOSED 1 PLAT MAP ENCLOSED g YES
8. PARCEL HISTORY - Please attach copies of deeds, plats or other evidence or documentation.
A. Was parcel recorded with county prior to June 1, 1972? 0 YES IXI NO
B. Has the parcel ever been part of a division of land action since June 1, 1972? %] YES 0 NO
If yes, describe the previous action
7. LOCATION OF PARCEL - Include a map deliniating the project area and tie to a section comer.
NE 1/4 OF SE 1/4 SECTION 33 TOWNSHIP 3 KIN ❑ S RANGE 66 ❑ E 123 W
PRINCIPAL MERIDIAN: 6TH 0 h.M. 0 UTE ❑ COSTILLA
8. PLAT - Location of all wells on property must be plotted and permit numbers provided.
Surveyors plat ® Yes 0 No If not, scaled hand drawn sketch 0 Yes ❑ No
9. ESTIMATED WATER REQUIREMENTS - Gallon: par Oay or Acre Fist per yaw 10. WATER SUPPLY SOURCE Future Well
❑ EXISTING 0 DEVELOPED 0 NEW WELLS -
WELLS SPRING PROPOSED AQUIFERS (CHECK ONE)
HOUSEHOLD USE p of units GPO AF WELL PERMIT NUMBERS ❑ALLUVIA ❑VIPER ARAPAHOE
UPPER OAWSON ❑LONER ARAPAHOE
DAKOTA COMMERCIAL USE #20,000 of S.F. 75 GPD AF item ❑DAKOTR a WWII oAwsan ❑ FOX wus
❑
❑OTHER
IRRIGATION # of acres GPD AF
STOCK WATERING # of head GPD AF 0 MUNICIPAL
❑ ASSOCIATION WATER COURT DECREE CASE NO.'S
OTHER - GPD AF 0 COMPANY
❑ DISTRICT
TOTAL GPO AF NAME
LETTER OF COMMITMENT FOR
SERVICE 0 YES 0 NO
11. ENGINEER'S WATER SUPPLY REPORT 0 YES LX NO IF YES, PLEASE FORWARD WITH THIS FORM. (The may be required before our review is completed!
12. TYPE OF SEWAGE DISPOSAL SYSTEM
❑ SEPTIC TANK/LEACH FIELD 0 CENTRAL SYSTEM - DISTRICT NAME
❑ LAGOON 0 VAULT • LOCATION SEWAGE HAULED TO
O ENGINEERED SYSTEM (Attach a copy of engineering design) gl OTHER Future Individual Sewage Disposal System
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