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HomeMy WebLinkAbout20151289.tiff WATER SUPPLY INFORMATION SUMMARY Section 30.28.133,(d), 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 (/ /54e (Anskt �n,� Ll C. Lr9 it # o r-F ee/ c 4S .,i/0-1 2. LAND l/SE ACTION / 3. NAME OF EXISTING PARCEL AS RECORDED 1,o1 fig fr-coidecl Exep¢ AAA- it/ 9_ 0/-4//�- p� 9 SUBDIVISION FILING BLOCK LOT 4. TOTAL ACREAGE 5 D S. NUMBER OF LOTS PROPOSED / PLAT MAP ENCLOSED YES 6. PARCEL HISTORY - Please attach copies of deeds, plats or other evidence or documentation. A. Was parcel recorded with county prior to June 1, 1972? O YES IN NO B. Has the parcel ever been part of a division of land action since June 1, 1972? YES O NO If yes, describe the previous action 7. LOCATION OF PARCEL - Include a map deliniating the project area and tie to a section corner. 5ff 114 OF 1/4 SECTION _ I TOWNSHIP I f$r N ❑ S RANGE 6 7 ❑ E ( (Vy PRINCIPAL MERIDIAN: X 6TH 0 k.M. O UTE 0 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 O No 9- ESTIMATED WATER REQUIREMENTS - Gallons per Day or Acre Feat par Year 10, WATER SUPPLY SOURCE EXISTING O DEVELOPED WELLS SPRING 0 NEW WELLS - HOUSEHOLD USE # of units GPO PROPOSED/mints-(CHECK ONO AF WELL-PEERMIT NUMBERS AueyUL O OFFER ARAPAHOE ©O Q 2 ! f -UPPER DAYISON O LOWER ARAPEHOE COMMERCIAL USE # of S.F. Zl 7 GPD O ,���AF 112�l/ j L DAWSON LARAMIE Fox HILLS _ O DAKOFA IRRIGATION # of acres `OTHER GPD AF STOCK WATERING # of head GPO AF O MUNICIPAL OTHER 0 ASSOCIATION WATER COURT DECREE CASE NO.'S GPO AF 0 COMPANY TOTAL 0 DISTRICT GPO AF NAME LETTER OF COMMITMENT FOR r SERVICE 0 YES 0 NO 11. ENGINEER'S WATER SUPPLY REPORT 0 YES NO IF YES, PLEASE FORWARD WITH THIS FORM. (This may be required before our review s completed.) 12. TYPE OF SEWAGE DISPOSAL SYSTEM lil SEPTIC TANK/LEACH FIELD 0 CENTRAL SYSTEM - DISTRICT NAME O LAGOON O VAULT • LOCATION SEWAGE HAULED TO 0 ENGINEERED SYSTEM (Attach a copy of engineering design) O OTHER 07/03/28137 13:41 3a38570b37 Form No. OFFICE OF THE STATE ENGINEER wA�Cr< sl ���ICE I GWS 2S COLORADO DIVISION OF `ter (3r8 Centennial 8 3. 9393�'hemranS►.,Denver,CoA,WA3 TER RESOURCES WEE-PERMIT NUMBER _. EXsr APPUCANT DIV. 7 �2 74246 - 2--- - - DES.BASIN M t Lot A Bloch. F-ing: Subdsv:COUNTY EXEMPTION tdC).i[69-0i-4 RE45E39 APPftCJVF�WELL LOCATION WELD COUNTY WRIGHT INVESTMENT GROUP INC T NE 114 SE 114 C/O DONALL1Township 1 N Ran Sin T WRIGHTV4fRiGHT Range&7 W Sixth P.M. [3iS BOX 73 T'ANCE�F FORT LUPTON.CO 80621- —013 �� ROiVI pA!LINES 2420 Ft from South Section tine pp)65B-6523 10 Ft. from East Section Line � R �[?S , WELLFy UM Q,NAlES MeterZone:13 NAD83 ISSUANCE of THIS PERMIT DOES NOT Easting Northing CONFER q WATER RIGHT ��. shalt used C II QI AP_�v?r'pVAL 1) aafss,� �s�a does not ensure diet no way as to cause no material injury ba existing water nights. The issuance The ing relief a civil court acticai to another sled rat or preclude it 7; construction of this wellowner uf a vested right from seekof a vattr shad in ncaof Examiners of Water WO Cons rRulesuctio 2 leiCCRP•!02_ a1 t,asn granted by the State Board aPProvtors in accordance 2 amass � Approved�the use of an existing well Construction a�Pump Installation C4) Approved warn to CRS 37-��a �"��>>9rsn�� 23Rs5t3 water m y to the South Platte River sym and the parley of the State ngiraeEr dated aka for a Andtlean reground 5) The use of ground*reset from !+h a commercial of er f w this well is d to clOniting and sanitary fac ies as described in CRS 37--tom for outside the bust s Water fry lawn or landscape structure. weA Meg not used for S02(7)(s) �P®litigation or for orb'other sr+rt;)cse B) Production from this well is►est+icted to the South Platte Aliuviurra_ 8 The pumping rate of this watt shall not tamed 15 CPI The anrtatat amount of ground water 9m 8) Approved o-rs mo t gw o n a rater of be diverted by this welt shag not land of 5.61 atxe(s)described, 113 a l(1013,600 1 gallons). Weld Courtly.refonmoe attached exhibit A" Lot County i� The re on no_14�99�144 turn flow free,rite yOf this ust be tyr,ugj RE-1569. 0DrtJt!$1 posit of se type when?:it to 6metemed,At7 lam sixeaindividual sywastem water Willett ett pSit� tis;system off Iv 7 A g and water than not end to ;r7 Whieh the weft is tDtehttsrg taw mfr must be installedi>£+'L9snL � - T�maximum dtVet'�ons r be maintained on this+ and maintained in good working order. Perm request. by the well owner(rte at least annually)and submitted records gall v� This wed shalt be f�to the Division Engineer upon constructed nut more brio 200 feet trorn the location spacirma on this d l t C APPROVED _403;4/id ri -11 ;'x i t No. 1 - i stare Eng)reesr TE isa�lEo tlYt Eli ��( ' tt6-29-208 r1i taxi TftaN r ATE Hello