Ground Water Commission State of Colorado. Final Permit No 2567 FP KIOWA BIJOU DESIGNATED GROUND WATER BASIN. 600 acre feet gallons per minute

Transcription

1 Gound Wae Commsson Sae of Coloado Fnal Pem No 2567 FP KOWA BOU DESGNATED GROUND WATER BASN Poy Dae Mach Use s RRGATON Name of Claman DANEL A SHELLY K FRHAUF Pemed Well SE 4 of he NW 4 a a pon 2660 fee fom he Souh Secon Lne and 3640 fee fom he Locaon Eas Secon Lne of Secon 23 Townshp Souh Range 60 Wes of he Sxh Pncpal Medan Maxmum annual volume of appopaon 600 ace fee Maxmum pumpng ae Numbe of aces whch may be gaed Toalzng Flow Mee Descpon of aces gaed 24 o place of use 000 gallons pe mnue 240 aces Mee may be equed aces n he N 2 of Secon 23 Townshp Souh Range 60 Wes Aqufe s QUATERNARY ALLUVUM COMMNGLED ACRES AUTHORZATON Ohe wells commngled Commngled annual appopaon 5954 R 635 ace fee Subjec o ndvdual well pem lms Numbe of commngled aces 254 aces Descpon of commngled aceage 254 aces n he N 2 of Secon 23 Townshp Souh Range 60 Wes Done hs Z 74 day of 20 Z 7 y 40 By Dck Wolfe Sae Engnee Keh Vande Hos P E Desgnaed Basns Team Leade Sae of Coloado Recep No

2 UNOFFCAL Pem nfomaon Shee Recep Basn KOWA BOU Pem Numbe 2567 F Owne FRHAUF DANEL A SHELLY K Addess 580 MMOSA ROAD BYERS CO 8003 Phone h Poy dae Use Deph 29 Aqufe s RRGATON QUATERNARY ALLUVUM Mee Requed No DB 2 w Expanded Aces Nod Gp 3 Commngle APD Yes ml WELL LOCATON SE 4 NW 4 Secon 23 Townshp S Range 60 W PM S 2660 fee fom he S secon lne 3640 fee fom he E secon lne UTM Coodnaes Easng Nohng Laud OP Ol 0ak de Longude Dv 8 Co j WD CO C MD 7 PERMT STATSTCS Descpon of Aces gaed X86 Ace fee yea 000 G P M aces 24 aces n he N2 of Secon 23 Townshp Souh Range 60 Wes Dae Compleed Dae ssued Benefcal Use expaon dae 7973 Fs Use Dae Assocaed pems and noes nals Dae EXPANDED ACRES Poy Dae The poy s dae of Applcaon Fs Use Ohe 0 Ace fee yea Addonal Aces Descpon of Addonal Aces Toal Aces nals Dae COMMNGLNG Pems 5954 R 3 Ace fee yea Aces 254 aces n he N2 ofsecon 23 Townshp Souh 2d Descpon of aces noe 60 Wes nals Dae FnSBUPERMT EVALUATON CHECKLST 4 d eceved Evaluaed nalsf Dae b Clafed nals Dae bae Eneed nals Dae

3 w GM FORM NO lwl 08 STAlE OF COLORADO OFFCE OF THE STATE ENGNEER Coolonno eoooa 303l Nay PROR TO COMPLETlNG FORM SEE NSTl UCTlONS ON REVERSE 5OE WA FjuHGf S STAll fcf GNb H CHANGE N OWNERSHP ADDRESS WELL PERMn UVESTOCK TANK OR EROSON CONT lol DAM CURRENT OWNER NAME 5 DNV A fv DAA Malng Addess S Rnx 7A Cy 5 Zp 2 f 0S P one 303 ll j El9 f f 35 0 U 5U j eu 33 O GU ST G TTL CHC T CL Gf 7 U UnC U U 2 THS CHANGE S FOR ONE OF THE FOLLOWNG 8l WELL PERMn NUMBER 2 c 7 F o LVESTOCK WATER TANK NUMBER o EROSON CONTROL DAM NUMBER 3 WELL LOCATON COUNTY OWNER S WELL DESGNATON v 3 h Sf Cl SoOo Zp 4 N 4 See 3 TwpL 0 N Of 5 Range 0 E Dl Of W C M Dsances fom Secon Lnes 2D F fom 0 N Of l2 8ubdvso U f e wan Nw S Lne 0 Lo Block 4 UVESTOCK TANK OR EROSON CONTROL DAM LOCATON COUNTY Fmng Fl fom Zl E Of0 W Lne Un 4 Sec Twp o N Of 0 5 Range DE Of0W P M 5 The above lsed owne s say s ha he hey own he suc ue descbed heen The exsng ecod s beng amended fo he followng eason s Z Change n name of owne 0 Change n malng addess 6 we have ead he salemel lls made heen know heconel lls heeof Qld sae ha hey ae ue o my ou knowledge pusuam o Sec on a C R S he makng of fal esaemens heen conslules pejuy n he second degee Qld s as a class msdemeqllo punsheble Name Tle please ype o Dale pm S7j O FOR OFFCE USE ONLY fl Cou Case No Dv Co n ff By WD Basn 2 lloo MD Use

4 Clev s8 S l STATE OF COLORADO APPLCATON FOR USE OF GROUND WATER C fle gnnff l Use ndelble Pencl o we W SU Applcan P O Addess Quany appue Couny S 4U l Sec W9 CT L Used fo A q 7 Puposes on a s egal descpon of land se Toal aceage gaed and ohe s ESTMATED DATA OF WELL Hole sze 3Lln o l 9f n o f Casng Pef Plaln L4 ln n fom foln o f n ao f fom o l7 f n fom o f PUMP Oule DATA Type AL HPdSlze LL Use naon dae 9 Use Supplemenal pages fo addonal daa THS APP CATON NO 7 F PPROVED DATE MAY W Rge of u 6 P M See Addess o Lo L OR Block No Town o Subdvson N S fee equed commeca Applcan Agen o Dlle E fo ndusal gaonl uses Locae well n 40 ace small squae as nea as possble p Addess NOTE SATSFACTORY COMPLETON REQURED FOR APPROVAL 0 APPLCATON

5 n n F l 5l4 c d Typed Owne 3 Sl C v j Addess ST 8os COPYAvalable OF COLORADO DVSoN OF WATER RESOURCES OFFCE OF THE STATE ENGNEER ROUND WATER SECTON AND HSTORY OF WELL 4 PERMT NO C 7 Le No fl WELL LOCATON l 0 lemgdw v MAR 2296 GROUND WATER SECT ST Gj R Couny W 3 S of fw of Sec L Tenan Used on o by fo YMA L Al 7 descpo lof se o land Dae Saed 26 9 D Dae Compleed 9kO Dae Tesed 9 o Yeld gpm f cfs Pump ype Oule Sze L2 Dven by 3 V HP@ RPM 7 n Deph o Wae SF Daw Deph o nle nf Bowl Sze and Knd of Casng down 5 F 3 F Fom 6 o 7 l Typ Wd Fom o Type W Twp k Rge f PM LOCATE WELL ACCURATELY N THE SMALL SQUARES REP PRESENTNG 40 ACRES W f he above s no applcable fll n N S Town o Subdvson E Fom o Type W See Addess o Lo Block Pelfoaons FomZa o Sze and Type TYPe s Sze f Gound elevaon f known Fom o Type Sze How Dlled Fom o Well descpon fom Hole fom Dlam fom Type Toal Deph o 9 o o Sze v 2 7 F 2 n n n REMARKS Cemenng Packng Type of Shu off Deph o Shu off ec PUT LOG OF WELL ON RE VERSE SDE TO BE MADE OUT N QUADRUPLCATE Ollool Blue and Duplcae Geen o Sae Engnee s Offce Whe copy o Owne and Yellow copy o Dlle

6 C Bes Copy Avalable j LOG 6F WEL ADD SPACES AS NEEDED Fom f o f o 3 f f f o f f o f f o f

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11 Poy Dae Apl Use s Gound Wae Commsson Sae of Coloado Fnal Pem No 5954 RFP KOWA BOU DESGNATED GROUND WATER BASN RRGATON Name of Claman DANEL A SHELLEY K FRHAUF Pemed Well NE 4 of he SW 4 a a pon 2544 fee fom he Souh Secon Lne and 2554 fee fom he Locaon Wes Secon Lne of Secon 23 Townshp Souh Range 60 Wes of he Sxh Pncpal Medan Maxmum annual volume of appopaon 635 ace fee Maxmum pumpng ae Numbe of aces whch may be gaed Toalzng Flow Mee 500 gallons pe mnue 254 aces Mee Requed Descpon of aces gaed 254 aces n he N 2 of Secon 23 Townshp Souh Range 60 Wes o place of use Aqufe s QUATERNARY ALLUVUM COMMNGLED ACRES AUTHORZATON Ohe wells commngled Commngled annual appopaon 2567 F 635 ace fee Subjec o ndvdual well pem lms Numbe of commngled aces 254 aces Descpon of commngled aceage 254 aces n he N 2 of Secon 23 Townshp Souh Range 60 Wes Done hs day of A4a 4AA 20 z 7T U 4 B Dck Wolfe Keh Vande Hos P E Sae Engnee Desgnaed Basns Team Leade Sae Of Coloado Recep No

12 n Hn 02 o STATE OF COLORADO OFFCE OF THE STATE ENGNEER R CE V uoo g 33 FOR NSTRUCTONS SEE REVERSE SlOE STATEMENT OF BENEFCAL USE wf 0 WELL PERMT NUMBER R 5954 RF WELL OWNER NAME S Dan Fhauf Malng Addess Sa Roue Box 7 A Cy S Zp Buyes CO Phone 2 WELL LOCATlON COUNTY Adams OWNER S WELL DESGNATlON Cy Zp SE 4 NW 4 sec 23 Twp l G N Es Ra le 60 E E lll W P M sances fom S 0 n 2684 F fom 0 N S Une The well s beng used fo he followng pupose gaon s of F fom 0 E fam cops U W Une 4 Wae fom he well was s used benefcally fo he above pupose s on Apl The pumpng le cl8lmed s gallons pe mnue 6 The aveage annual amoun of wae dvened s 635 ace fee 7 The land 8e gllad waeed by descbed as N Sec 23 TS oas wle fom hs well s R6OW loaollooool Subdlvlslon Lol s 254 Numboo Block lk Aces o 0 Squae fell Flllng Un B Well dllled by Canfeld Dllng Co Uc No 765 Pump nsalled by Canfeld Dllng Co Uc No Mme Mfg by Selal No Dae nselled we have eed he saemans made heen know ha comens heeof and sae ha hey ae ue o my ou knowledge Pusuan o Secon a C R he S makng of false saemens heen consues peju n he second d ee and s punshable as a Class mlsdemeeno 0 Namefnle y O gna e Dae Dan Fhauf Land well owne Eng Cou Case No Dv By Dole Co WD Basn MD Use

13 Vn THS FORM MUST BE SUBMTTED WTHN 60 DAYS OF COMPLETON OF THE WOR DESCRBED HERE W l QP RECE VED COLORADO DVSON OF WATER RESOURCES 33 Semon See Room 88 c2 2 f Q D 0 90 Denve Coloado ON TYPE OR PRNT N BLAC N WELL COMPLETON AND PUMP NSTALLATON REPORT PERMT R5954 RF NUMBER XO W u 0O T TE ENGN WELL OWNER Pl Fhauf SE 4 of he NW 4 of Sec 23 ADDRESS S R Box l Byes T S R 60 w 6 P M DATE COMPLETED Dec 2 9 HOLE DAMETER WELL LOG Wae Fom To Type and Colo of Maeal Loc 34 n fom o f n fom o f 0 2 loam 2 n cay 3 56 clay sand sand same gavel coase gavel sand an 97 gavel gavel sand clay gavel sand 05 3 coase gavel 3 7 coase gavel ace of clay 7 20 coase gavel 20 l22 gavel coase sand coase gavel few bouldes shale blosscm blue shale n fom o f DR LlNG METHOO C c CASNG RECORD P n Casng Sze ll knd plan fom o f Sze knd fom o f Sze knd fom d f Pefoaed Casng Sze knddoe fom o 05 f Sze knd HS Sceen fom 05 o 25 f Sze knd oe fom 25 o 29 f GROUTNG RECORD Maeal Nea cemen nevals o 20 Placemen Mehod spll ube GRAVEL PACK Sze 3 4 pea bucksho mx neval 20 o 29 TEST DATA Dae Tesed Dec Sac Wae Level Po o Tes 73 f Type of Tes Pump Lengh of Tes Tubne 24 hs TOTAL DEPTH 29 Use addonal pages necessay o complee log Susaned Yeld Meeed Fnal Pumpng Wae Level 700 gll 27

14 u j l l m PUMP NSTALLATON REPORT Pump Make Type Poweed by Wohngon Tubne Elecc HP 30 l h Pump Seal No T Pump nake Deph Remaks 5 4 W WA TER W w w w a w S z Z WELL TEST DATA WTH PERMANENT PUMP 0 f Dae Tesed an ll 29Q l 0 O E OF Sac Wae Level Po o Tes 73 0 ll DEPRESSON Lengh of Tes 2 Hous Susaned yeld Meeedl GPM Pumpng Wae Level 27 Remaks CONTRACTORS STATEMENT The undesgned beng duly swon upon oah deposes and says ha he s he conaco of he well o pump nsallaon descbed heeon ha he has ead h saemen made heeon knows he conen heeo and ha amej ue of n k n o lleed Sgnaue 7 Lcense No 765 Sae of Coloado l Couny o Subscbed and swon o beoe me hslz day of My Commsson expes SS 9 f Noay Publc FO M TO 8E MACE OUT N QUADRUPLCATE WHTE FORM mu bl an ognal copy un h sdes and g ed WHe AND GREEN eop 5 ml be fled wh hes Envn8s PNK Copy f fo he OWne and VEL OW COPy 5 fo he Olle

15 l j W5 R 76 COLORADO DVS ON OF WATER RESOURCES Applcaon nll be u flpde lvhl applcable Type o pn n BLACK N K No ov s kes o easues naled unless 88 Cenennal FOR 33 Shoman S Denve Coloado Bldg PERMT APPLCATON FORM X A PERMT TO USE GROUND WATER X A PERMT TO CONSTRUCT A WELL X A PERMT TO NSTALL A PUMP X REPLACEMENT FOR NO 5954 OTHER WATER COURT CASE NO 2 l 89 q f jhlyhw FflDl T 6LlOD T 6 0 RECEVED OEe 89 WATEf f ources STATE ENGNEER COLa APPLCANT malng addess FOR OFFCE USE ONLY lfnot WRT j fjs olum NAME Dan Fhauf Sa Roue STREET Box 7A Recep No 9 7 Basn 2 f f f n yy L D 7 CTY Byes CO S alh 8003 Zp CONDTQ ls Qf APPROV AL TELEPHONE NO LOCATON OF PROPOSED WELL Couny Twp SE y of he Adams NW S 60 W Rng N Sl E W 3 WATER USE AND WELL DATA y Secon Poposed maxmum pumpng ae gpm 500 Aveage annual amoun of gound wae o be appopaed ace feel E Numbe of aces o be j gaed Poposed oal doph fee Aqufe gound wae s o be obaned fom Bou Owne s well desgnaon GROUND WATER TO BE USED FOR P M HOUSEHOLD USE ONLY no gaon 0 DOMESTC NDUSTRAL 5 LVESTOCK 2 XX RRGATON 6 COMMERCAL 4 MUNCPAL 8 OTHER 9 DETAL THE USE ON BACK N 4 DR LLER Name See Canfeld Dllng Co P O Box 59 Wes See Ths well shall be used n such a way as o causa Tha no maeal njuy o exsng wae ghs ssuance of he pem does no assue he applcan ha no njuy wll occu o anohe vesed wae gh o peclude anohe owne of a vesed wae gh fom seekng elef n a cvl cou acon APPROVED PURSUANT TO SEWON l e G U AS A REPLACEMENT OF THE EXSTNG WEll WTH PERMT NO R THE WEll WHCH S REPLACED MUST BE PLUGGED AND ABANDONED ACGORDNG TO THE WATER WEll CONSTRUCTON AND PUMP NSfAllATWN RULES THE E ClOSED AFFDAVT FDRH MUST BE SUBMTTED WTHN 60 DAYS AFTER THE CDNSTRUCTlON OF HE NEW WEll AFlRMN fhal HF EXSTN WELL WAS PlUllED AND ABANDONED 3 CONSTRUCTON OF THS WEll WAS AUTHORZED ON DECEMBER BY VFRBM AUTHORZATON NO 89VEh05 THS VERBAL MHORZATlON WAS GVE TO DWGHT CA FElD lce SE O 76S AND AUTHORZED THE REPLACEMENT WElL TO BE DRllED WTHN 45 FEET N A NORTH fasterl DRECTON OF THf ORG Al WELl 4 PRODUCTON FROM THS WEll S lhlted TO THE AllUVUM OF BOU CREEK OR TS TRBUTARES THE TOTAL DfPTH OF THS WEll SHAll NOT EXCfFD Lo FEET OR THE DEPTH AT WHCH SANDSTONE OR SHALE FRST ENCOU TERED 5 THE MAXMUM PUMPNG RATE OF THS WEll SHALL NOT EXCEED 50D U M 6 APPROVAL OF THS REPLACEMENT PERMT SHAll NOT RESDL N EXPANDED USE 0 ROUND WATER THE SEOF THClELL S HTfl RY THE PERMT TO THE RRGATON OF 254 ACRES located N THE 2 OF SECTON 23 TOW SHP SOUTH RANGE 60 WEST 7 A OAllZlHG ELOW HE ER MDST BF NSTALLED ON THf WELl ANNUAL DVERSON RECORDS SHALL SE MANTANED BY THE WEll OWNES AND SURMTlED TO THE DVSO OF WATER RESOURCES UPON REOf YUEST V d Sc P5W 4 5 Sl T6 PERMT NUMBER A 53 5 R DATE SSUED DECZ L EXPRATON DATE MAR Cy Fo Mogan CO 8070 Slae Zp Tolephone N Lc No 765 D 0 COUNTY 0 f

16 l 5 THE LOCATON OF THE PROPOSED WELL and he aea on whch he wae wll be used mus be ndcaed on he dlegem below Use he CENTER SECTON secon 640 aces fo he well locaon NORTH c MlE 5280 FEET NORTH E TON lne w 0 Z w The scale of he dagam s 2 nches mle Each small squae epesens 40 aces WATEF l QUVALENTS TABLE O ol lnded Fgues A n ace foo Gove9 f ace of land foo dl lllp cubc foo pa second ch 449 gallon pe mnue gpml A famly of 5 wll eqlje appoxmaely ace foo of wae pfl yea acfl foo cubc fee glqn 000 gp n pumped connuously fo Onday poduces 4 42 fll Z 6 THE WELL MUST BE LOCAHD BELOW by dsances fom secon lnes 2684 f fom souh see lne 2594 f fom wes noh o souh a5 owes LOT BLOCK FLNG SUBDVSON sec lne 7 TRACT ON WHCH WELL WLL BE LOCATED Dan Fhauf Owne No of aces 254 Wll hs be he only well on hs ac No B PROPOSED CASNG PROGRAM Plan Casng n fom 7 f o RO f Pefoaed cas ng n fom f o f 6 n fom 80 f o 29 f n fom f o 9 FOR REPLACEMENT WELLSgve dsance and decon fom old well and plans fo pluggng New well wll be 40 noh 40 eas of old well Old well wll be abandoned as pe Sae Regulaons 0 LAND ON WHCH GROUND WATER WLL BE USED Owne s n n Fn lf No of aces 254 Lega descpon N 7 T R OW DETALED DESCRPTON of he use of gound wae Household use and domesc well mus ndcae ype of dlsposa sysem o be used gaon of fam cops 2 OTHER WATER RGHTS used on hs land ncludng well Gve Regsaon and Wae Cou Case Numbes Type o gh 2567 F Used fo pupose gaon Descpon of land on whch used N Sec 23 TS R60W 3 THE APPLlCANT S STATE S THAT THE NFORMATON SET FORTH HEREON S T E TO THE BEST OF HS KNOWLEDGE SNA TURE OF APPLCANTS Use addonal shees of pape f moe space s equed

17 l l RECEVE e l be Appll ao ll le vn applcable Type o p H n BLACK NK No oveskes o easues d led lmlesl FOR PERMT APPLCATON FORV X A PERMTTO USE GROUND WATER X A PERMT TO CONSTRUCT A WEll X A PERMT TO NSTAll A PUMP X REPLACEMENT FOR NO 5954 OTHER WlT l SAl n R 7 0 WATER COURT CASE NO APPLCANT malng addess FOR OFFCE USE ONLY DO NOT WRTE N THS COLUMN NAME STREET Dan Fhauf Sa Roue Box 7A Recep No l Basn 2 Ds 7 CTY Byes CO 8003 TELEPHONE NO S llh locaton OF PROPOSED WELL Couny Twp SE of he Adams NW Z Secon 23 S 60 W 6 Rng N S E W 3 WATER USE AND WELL DATA Poposed maxmum pumpng ae gpm 500 Aveage annual amoun of gound wae o be appopaed ac foo Numbe of aces o be gaed Poposod oal doph fool Aqufe gound wae s o be obaned fom Bou Owne s well desgnaon BQUND WATER TO BE USED FOR P M f HOUSEHOLD USE ONLY no gaon 0 DOMESTC NDUSTRAL 5 LVESTOCK 2 X RRGATON 6 COMMERCAL 4 j MUNCPAL 8 OTHER 9 DETAL THE USE ON BACK N 4 DRLLER Nam See Canfeld Dllng Co P O Box 59 Wes See Cy Fo an Mol CO 070 S ll Telephone N Le No 765 Zp CONDTONS OF APPROVAL Ths well shall be used n such a way as o cause no maeal njuy o exsng wae ghs The ssuance of he pem does no assue he applcan ha no njuy wll occu o anohe vesed wae gh o peclude anohe owne of a vesed wae gh fom seekng elef n a cvl cou acon APPROVED PlR UAN TD SEGTlON c U REPLACEMENT OP THE EXS NG WELl mh PERM NO YN 2 THE WELL WHCH S RfPLM E NUST BE fllg fd AlW ABMWOllfl ACCQRDNG TO THP WATPR WELl COHSTR CTOH AND PlNP NSALLAl N RULES THE ENCLOSED AfFDAVT PORN NUST BE SUBNlTTPD WlTHN O DAYS AFTER THE CONSTRUCTON OP HE NEW WW AfFlRNNG THAT TH EXSTNG WELL WAS PLUGGED AND ABANDONED 3 CONSTRUCTON OF THS WELL WAS AUTHORZED ON DECENBER 4 Bj BY VERBAL AUTHORZmON 0 89VE THS VmAL AUTHORZATON WAS GVEN TO DWGHT GANFEL LCENSE NO 7b5 AND AUlWRl O HF RfPl CENENT WELL TO BE DRLLE WlTHN 45 FEET N N HH E STERlY DRECTON OF THE ORGNAL WELL 4 PR DUCTlON FROM THS WELL S LMlTED TO THE lllvum mou CRm OR TS TRBUTARES THE TOm DEPTH OF H WELL SHALL NlT EXmO 30 FEET OR TH DFPTH M WHCH SANDSTONE OR SHALE S ENCOUNTERED 5 HE MAXMUM PUMPNG RATE OF THS WfL HALL Nl mu G P 6 APPROVAL OF THS REPLACEHENT wm SAL T mull j OPANDED US OF ROUND WATER THE USE O THL WELL S WHG H THE PERMT TO THE RRGATON OF 254 ACRES LOeAflO N HE M OF SECTON 23 TOWNSHP SOllTH RANGE 60 WEST 7 A TOTALZNG FLOW METER HO Sf NSTALLED OM THE WELL ANH L DVERSWN RECOR S SHALL BE MAH ANE BY THE WfLL OWlER AND SlHMTTE fo THE VSO OF WATER RESlllRCfS UPN Rl d N PERMT NUMBER pffwp B 5 S Rf DATE SSUED DEe 2 L 989 EXPRATON DATE MAR 2990 BY S ENGlN COUNTYQ s lls 6 f

18 FORM NO QW Qe STATE OF COLORADO OFFCE OF THE STATE ENGNEER 303 Bldg 3 80COOMo PROR TO COMPLEllNG FORM SEE NSTlUCT0NS ON REVERSE SDE CHANGE N OWNERSHP ADDRESS WELL PERMT UVESTOCK TANK OR EROSON CONTROL DAM NAME S Malng Addess Cy S Zp Phone 30 F NOV WATE SCljf GES STATE ffclneer COLO 20 9 j e 2 j 33 3 uu D ou S f 7000 TTl CL u 00 G j UQ TN U l D Cl LU D 2 THS CHANGE S FOR ONE OF THE FOLLOWNG o WELL PERMT NUMBER S4Qj R o UVESTOCK WATER TANK NUMBER o EROSON CONTROL DAM NUMBER 3 OWNER S WELL DESGNAl0N C Zp Range GO lzs 0 E CElw b P M F fom g N 0 S Une On S 0 F fom E W Lne Twp 0 N Lo Block Flng Un 4 UVESTOCK TANK OR EROSON CONTROL DAM LOCATlON COUNTY 4 o Sec N 0 S Range OE Dw P M Twp 5 The above lsed owne s say s ha he hey own he sucue descbed heen The exsng ecod s beng amended fo he followng SaSOn s lz Change n name of owne 0 Change n malng addess 6 we have ead he saemens mede heen know he comens heeof and sae ha hey ae ue o my ou knowledge pusuam o Secon e C R he S makng of false saemens heen conslles pejuy n he second degee and s punshable as a class msdemeano Name Tlla Pleese ype o pn 7U FOR OFFCE USE ONLY Dae f 0 8 q By Do Coun Case No Dv Co WO Basn MD Use

19 m n FCflM O GWS 9 7W STATE OF COLORADO OFFCE OF THE STATE ENGNEER 88 comonnl 303 8llll 3S8 33 Shennon S Dol l8 Coloado S0203 eldo Fo Ofc UM only RECEVED YPE OR PRNT N BLACK NK WELL ABANDONMENT REPORT ABANDONED WEll NUMBER F REGSTERED 5954 ffb H cs jlae NC l f CO j NDVDUALCOMPANY RESPONSBLE FOR PLUGGNG NAME S Dan Fhauf Malng Addess Sa Roue Box 7 A Cy Sl Zp Byes CO 8003 Phone ACTUAL WELL LOCATlON COUNTY Adams PROPERTY ADDRESS C Slole Zp SE 4 NW 4 Sec 23 Twp ON S Range 60 0 E E W 2P M Dsances fom Secon Lnes 2544 F fom 0 N G S Une 2554 F fom 0 E o W Lne 3 we epo ha an exsng well was plugged and abandoned fo he followng eeson s X The well was plugged and abandoned as equed unde he condllons of appoval of Well Pennl No R q 4 RF o The well wad no n use and was abandoned o Ohe please explan 4 The well was plugged and abandoned accodng o he Wle Well Consucon and Pump nsallaon Rules on Dec The well was plugged wh he followng maeals placed lhe ndlclled melvals AMOUNT AND TYPE OF MATERAL Rve sand METHOD OF PLACEMENT Backhoe NTERVAL fom ee o fee ne maeal fom Z2 ee o fee len Ce Shovel fom fee o2 fee Suface maeal Backhoe fom fee o ee NTERVALS OF CASNG REMOVED RPPED N FEET fom fee o fee fom fee o fee 6 we have fead he saemems made heen and know he comens heeof end ha hey ae ue o my ou knowledge pusuam o Secon a C R S he makng of false saemens heen conslues pejuy n he second degee and s punshable as a class msdemeano Name Tlle Dan Fhauf j please ype o pn Sf AA Land welljowne NFORMA0N s he esponsbly of he well owne o have he well popely plu9q ed and abandoned The well consucon comaco s esponsble fo nofyng hewell owne of he pluggng and ebandonmen equemen Ths fom may be epoduced by phoocopy o wod pocessng means Dae

20 m U WR fll ln COLORADO DVSON OF WATER RESOURCES 0 Columbne Bldg 845 Sheman S Denve Coloado STATEMENT Of BENEfCAL USE Of GROUND WATER X MENDMENT Of EXSTNG RECORD PERMT NUMBEl s sy RECEll Nq 9 2 l AE SO lqo c o V STATE OF COLORADO COUNY OF ad SS THE AFFANT S whose addess s CZuv M beng duly swam upon oah deposes and says ha he hey s ae he owne s Of he well descbed heeon he well s locaed n hp F of he sw v of Seccn Townshp LA ln S fp P M a dsances of Sd fee fom he 4 secon lne Range v VV E o w Noh o SQul and co fee fom lhp z secon lne he oal deph of he well s fee wa e E 5 O Wes was fs appled o a benefcal use fo he pupose s descbed heen on he C2 day of Dh fom hs well 9 2 he maxmum susaned pumpng ae of he well sls gallons pe mnue he pumpng ae clamed heeby sls gallons pe mnue he aveage annual amoun of wae o be dveed s A Lace fee fo whch clam s heeby made foat pupose s he legal descpon of he land on whch he wae fom hs well s o be used s 7 LL n 6 W p whch oals f aces and whch s llusaed on he map on he evese sde of hs fom ha hs well was compleed n complance wh he pem appoved heefo hs saemen of benefcal use of gound wae s fled n complance wh law he hey has have ead he saemens made heeon knows he conen heeof and ha he same ae me of hs he knowledsf e jkd Subscbed and swon o befoe me on hs 7 Slsnaue s 7n M y C ommlsslon exples s My xp oaap l p fa l NQ y Pubh d o E ACCEPTED FOR FLNG N THE OFFCE OF THE STATE ENGNEER OF day of FOR OFFC ls ONLY Po Dae 9 Well Use T 4 la Sec R P M COLORADO ON THS h Y eld W D 9 9 DAY OF U Co SlATE ENGNEER OA OlvlSON Of WATER RESOURCES PNK COPY FOR WE L OWN R nde

21 THE LOCATON OF THE WELL MUST BE SHOWN AND THE AREA ON WHCH THE WATER S ul o v MUST BE SHADED OR CROSS HATCHED ON THE DAGRAM BELOW Ths dagam epesens nne 9 secons Use he CENTER SQUARE one secon o ndcae he locaon of he well f possble Mla NORTH SEe ON LNE NORTH N 3 z H SOUTH SECT ON LOO THE SCALE OF THE OAGRAM S TWO NCHES EOUALS ONE MllE Mee Seal No Owne of land on whch wae s beng used o Flow Mee 0 Elecc Mee 0 Fuel Mee WATER EQUVALENTS TABLE Rounded Fgues An ace foo coves ace of land foo deep cubc foo pe second cfs 449 gallons pe mnue gpm ace foo cubc fee gallons 000 gpm pumped connuously fo One day poduces 4 42 ace fee 00 gpm pumped connuously fo one yea poduces 60 ace feel

22 f Regsan me 0 4 STATE OF COLORADO DVSON OF WATER RESOURCES OFFCE OF THE STATE ENGNEER Ted Mae Dll P O Addess llyel l Cloado Deph lz7 f Casng 7 Sac Wae Level WELL DATA Damee Plan REGSTRATON NO S l f n Pefo 32 f fom op GROUND WATER OF WELL 7 wv v V 7 Hf olo WELL LOCA TfN Couny Ad Twp f8 00 Om OWg ll UL SECTON GROUND WATER SECT Dae ul 2 f Secon Rge 6OW COLORADO SWE E NEE 23 6h 9 5 PM Yeld 500 gpm cfs fom 80 f N Used fo llne on a l e Sell 23 T2S 60W legal descpon of land o se Wae conveyed bydoh PUMP DATA sze Type w b Sze 8 Dven by 40 HP Elec c a 760 Well was fs used Apl 6 fo n Well enlaged deepened usng HflO RPM 96 cfs gpm 9 o gpm cfs f LOG SHOULD BE GVEN ON REVERSE SDE F AVALABLE W S WELL TO BE LOCATED AS ACCUR ATELY AS POSSBLE WTHN A SMALL SQUARE WHCH REPRESEN 40 ACRES OR F N A TOWN OR SUBDVSON FLL N THE FOLLOW NG Town o Subdvson E See addess o Lo and Block The above well has no been egseed n he Offce of he Sae Engnee po o May 957 f Regseed gve Flng No l NOT Regseed po o May 957 a 5 00 flng fee accompanes hs fom The above saemens ae ue and coec o he bes of my knowledge and belef Subscbed and S 0 befoe me 2 ffj dl y of D l 9 B Lkc Regsan c on exp Pel 7 h EA 900o f L Noay Publc FOR STfX E ENGNEER S USE Locaecn dsc Uca Couny fo YA ffd7 Regsaon No 72 n on 9

23 f 4 LOG 0 UlDERGlUllD FOllMATO T p ln3 Clay 335 Sucl aay8l Ue 4650 Clay 5 52 Sul Su4 cla y 6Q 73 n g llvol d 7386 Gl atel GaTol 9398 cq 98 l0l QaTol od lol 8 aanl U827 Shal 27 j w

24 lel 3 s Bes Copy Avalable STATE OF COLORADO ff m@ O h ull DVSON OF WATER RESOURCES UL OF THE STATE ENGNEER GROUND WATER SECTON GROUND WATER SECT COLORADO REGSTRATON NO S 5 OF WELL SlAE ENGUcEEl Te4 Mae Dlll Regsan j L p O Addess BYes Coloado WELL DATA 27 f Damee 8 n Deph Casng 47 f Plan 0 f Pefo Sac Wae Level 32 f fom op Dae lf Colo WELL LOCATpN Adua8 Couny Twp H fu 7 Secon Rge 6oW 23 6h PM Yeld 00 gpm cfs fom 80 N f Used fo n on a N o Soo 23 T2S 60W legal descpon of land o se Wae conveyed bydoh sze PUMP DATA Type TubD Sze 8 Dven by 40 HP n co a 760 RPM w E Well was fs used Apl 6 fo Well enlaged deepened nl usng oo 96 cfs gpm 9 o gpm cfs f LOG SHOULD BE GVEN ON REVERSE SDE F AVALABLE S WELL TO BE LOCATED AS ACCUR ATELY AS POSSBLE WTHN A SMALL SQUARE WHCH REPRESEN S 40 ACRES OR F N A TOWN OR SUBDVSON FLL N THE FOLLOW NG Town o Subdvson The above well N has no been See addesso Lo and Block egseed n he Offce of he Sae Engnee po o May 957 f Regseed gve Flng No NOT Regseed po o May 957 a 5 00 flng fee accompanes hs fom The above saemens ae ue and coec o he bes of my knowledge and belef Subscbed and S 0 befoe me hs c day l of 9 B f My commsam exp PU Regsan SEAL N Y FOR ST ENGNEER S USE Locaed n dsc Couny fo 9 oof 2 A A Regsaon No 572 n on 9

25 l MNUTES OF MEEHG f le BA D OF D RECTORS Of T le NORTH nowa BOU GROUND WATER MANAGEMEN l DSTRCT A e9ulb meeng of le Boad of Df s coof he Noh Kowa B O G ound Waa Managemen DU was hald on Oecembe he hou of 0 00 a m he offces of Eppe on McClay Zon McClaY 37 E nssln S ee o Mogln Coloado wh he follow ng decos peeen Donald Aldch Ronald Kamma ell f W Kekl3el Robe Loo Loyd Mus9ave Rchad f ce Eufaco Romeo pasem Don ld F MCClay Aoney fo he O c was al The mnues of he meeng of he Boad held on N vembe wee 9G9 ead and lppoved Thl feleng was c led o ode by h Pesden ld he follownq blls fo ho monh of Novembe 989 wel3 submed o l l Soad and appoved Check No n86 on Elon ns Check No 2387 D T lddch Check No 88 P W Kekaek Check No 389 E Romeo ChecK No 90 R pce Ga oo Che k No n9 R Kl mmezell 5 OO Check No 239 L MUSSl V Check No 2393 T Couoy Tbune 2 67 Check No 394 Waywa4 Wnd 6 43 Check No 2395 noeson Ooy Company 0 00 The Pe den hen bougn o he aco on of he Bo he follown maes a WAYNE and LOS SOUCEnWell Pem No 764R NWSE of Secon 24 Twp Nohl Range 60 Wes of he 6h P M Ronald Kammezell bou9h o he aen on of he mee n9 ha ne had nspeced h ype of mee ns lled by he 50uees on ha subjec well and fo no ha an ap oved mcomee mee has been n Blled w fuhe epoed ha M Souce has epoed o he 80ad hs fs eadng beng uly aqe ee and NovembQ 9a ace fea l T Nw of Secon 3 p 9o Range of he 6h P M The applcan M Fhau was pe en n peson and pesened he abov applcaon fo a epl c men well o b locaed 45 fee No h and 40 fe as of he e sng wall M f n uf also 0pOed and pesened o he Boao he appoval exocued by Clffod D Causey appov ng he poposed new loclol M Ca H S well s he onl y well whn mle of he subjec loc on who s qued o bo 9 ven noce unde he ules and cqulalons of h D sc W 9 noed h e ecodngly al C wh he accep e of he appoval n w llgly M Causey no uch nocq w s equed c efoa a hqang upon sad applcaon was h d M Ph l epoed ha he pesen Locaon of he well a upon he ll lnd of M Cl lu3ey and hs deed equel 5 hs lny eplacemen fo sa d well be placed ousde of h C usey pop y whch s he eason fo he move egu ed a d ance 9e le lao SO fee was fuhe To d ha he eplacemen applcao s fo he gaon of he s me lands same ae of ow and same annual ace of fee n accodance wh he ognal applcaon was fuhe no d ha h well s used n conjuncon wh Well No 2567F ll fo gaon of he N of Seon 23 Townshp Souh Range 60 Wes of 6h P M Upon moon uly made se onded and unanmously ca ed he followng e oluon w s adoped RESOLVED fhe above n led applcaon eplac3man well a a dsanc of 40 fee Noh and 40 fee as of ho e slng well locaon be appoved upon he ollqwlng condons A Tha ho ognal well locaon be abandoned and plugged n accodance wh he egulaon of he Sae Commsson nd he Dsc loc a he ow n 0 a leas annually he lle e eadng l Ol 3 well a he new u nhh o he Ds c numb C l ha he Blbjc eplacemen well s lmed o he same of 9 llonb pe mnue and ace fee pe ye ocml well and la nds as em he well wll b a e used only o 9ae he same

26 l MNUTES o ME TNG OF THE SOARD o DlE CTORS OF TlE NORTH KOWA luou GROUND WATE MANAGEM NT OSTRCT G Q l o W a A egula meen9 of he Bood of O eeos of ho Noh Wl 8j QU Goun d w e MAn men Dsc WlS hold on DeCQ b 989 a he hou of 0 00 a m a he ofce of Eppeson Clay Zon MeCl y 37 ns gn S e Fo Mo9 n Colo do h he ollown9 d eos p esen Ron8l Oonal Al lch F w Kekuek Kamme ell en Robe Loog e LOycl Muagav lchad Pce EuCac o Donald F MCClay ney fo h Dsc was also Romeo The mnues of he mqeng of he SO d hal on Novembe 989 ee ead and eppoybd The meeng was called o ode by hw Pegden nd he follown9 bll fo he monh of Ngve 9a9 wee submed o he Boad and appovo Check No 2366 ohnson ns Check No 238 D l ldch Check NO 2388 F W Kek 5ek jo OO Chlck NO 2389 E Romeo 4 00 Che k No 2390 R ce Check No 239 R Kamme cll ChllC k No 2392 L MU9ave CM ek NO 2393 TuCouny T bune 2 6 Check No 2394 WaywoCd Wnd 36 4 Check No 239 Andelon Doy Company The pes len he follown9 n B hen o ough o he aenon of he Boad WAYNE and ALLOS SOUC Wgll Pem No 64R NWS of Seaon 24 TWp 3 Nohl aang8 60 was of hq 6 p M Ron ld Kamme zell bough o he enon of he m ng ha he had nspaced he ype of m e nsalled by h Souces on he Bubjwc well and found ha an appove mcomee mqe has been n lled was fuh epo d ha M Souce has epoed o he Boad he fs eadngs beng uly ace 9 and Novembe 9a ace fee DAN FRlHAUF W ll em No 5954 Nw of Secon 23 Twp Souh Range 60 Wes of e 6h P M T e applc n M Fh uf was pesen n peson and pe5cn d ha a ove w appleoon fo eplac8men ll o be loc ed 4S fee Noh nd 40 foe Eas o he ax8ng well M fhau l o epoed nd p s ned o oe oad e appoval exacu d by Clfod D Cau ey appovng hq poposad new lqe on M Causey s ell s oe only well whn mle of he subjec locaon who s equed o bq qven no e unde he ule and e ulaon of he Ds c was noed h accodhgly and h he accepance o he app oval n wn by M Caus y no such noce was equed h e oe a he n9 upon sad was pplcaon had M Fhau epoed ha he pose locaon of he well upon he lands of M Causey and hs deed eque ha any epl cemen fo 9ad well be l ced ousde of ne Cau y popey whch he ea bon fo he equed ove a dsance q ea han o fee was f he no d ha he eplacemen applcaon s fo he qaon of he s ne lands ame Ae of flow od same annual ace of fe8 n ac od nce wh he o gnal applcaon was fllche noed ha h wall s used n conjuncon wh Well No 2S67F all fo gaon of he N of Secon 2 Townshp Souh Range 60 Was of ne 6h P M upon moon duly made seconded and unan mously caed he follown9 e 3oluon wag doped RESOLVED T e abov nll d plcaon eplacemen w ll a dsance of 40 fee Noh and 40 fee as of he e sn well locaon be appoved upon he follown9 o d QP A Tha he ognal well locaon be aban one n4 lu9ged n ac odance wh he 9ulalQn of e SAe COmm on nd he Dsc Th a lo M e b ll d on ho woll he ne local on and ha he owne of sad well funsh o he Dsc a leas annually he mee eadng C ha oe subjec eplac len well h lled o he slomo numba of gallons pe mnu e and ace fee pe yea as he oq al well and he well wll be used only o 9ae ho same lan a pemed n h 09nll ppleaon

27 3 j Fmcl f F 9c wu No frlho owne 7 ug 5csLj wej RECEVED lv j 89 WAEl FeMhCES STATE ENGNEER COlO 03fOl b ff a v 2 Y 5l

28 B Copy AvaUabl YU o Owne f vmf 567 F CVL CLd 63 Q RECEVU C 89 b lg s Ml m f 5S cj 0n d f Aol cu v 8

29 GWS 24 Rev 8 89 VERBAL EMERGENCY REQUEST NFORMATON V CC cql e Offce of he sae En9nee Dvson of Wae Resou ces G ound Wae Secon Fle C A 0 o CTY 0 Basn 2 MD 7 TAKEN BY nl NAME OF CALLER am 7 DATE Z 7 fl APPLCANT f CONTRACTOR e ADDRESS f dl c f f LC 7A PHONE 5 LO EXSTNG PERMT S ffz PHONE f2 5Z o H 0 CASE USE bvlf azz APPLCATON RECEPT DATE CTY DST LOCATON E 4 5fA 4 SEC 2 3 TWP RNG b CO PM b 30 DST FROM SEC LNES 2 f S 2 7 W REQ LOT BLOCK FLNG SUBDVSON DST DREC FROM OLD WELL f FOR DB Kd Kc DEPTH OF OLD WELL PROPOSED DEPTH 2 7 CASNG PLAN PERF AQUFER REASON FOR EMERGENCY ku E e L COMMENTS x n 4wA A FELD NSP REQ Y DONE Y BY NOTE ATTACH COPY OF WRTTEN REPORT OR VERBAL REPORT A DATE REC DWR STAFF RECOMMENDATONS 5 j Al c P wh f M AAv Loo qf EW 4 z A A4 T en ML f 2Ah k BY VERBAL APPROVED BY e c DATE 6 CONDTONS L v VERBAL GVEN TO jp V l AD 4 A7D VE Dwjkf G leld BYllR DATE j S ej A

30 GWS 24A 8 89 OFFCE OF THE STATE ENGNEER VERBAL FELD NSPECTON REPORT APPLCANT RPT TAKEN BY DATE APPL RECEPT NO f known NSPECTED BY DATE DST REPORTED BY WELL LOCATON 4 4 SEC TWP RNG DST S UNREGSTERED EXEMPT WELLS USE OF EXSTNG WELL OF SNGLE FAMLY DWELLNGS WATERNG DOMESTC ANMALS AND POULTRY WATERNG LVESTOCK ON A FARM OR RANCH OF HEAD RRGATON OF SQUARE FEET OF HOME GARDENS AND LAWNS FRE PROTECTON DRNKNG AND SANTARY N COMMERCAL BUSNESS DETALS OF BUSNESS DATE WELL CONSTRUCTED EST PUMPNG RATE DATE FRST USE FOR ABOVE PURPOSES DEPTH OF WELL TYPE OF WELL DRLLED HAND DUG DEVELOPED SPRNG NO OF ACRES N TRACT ANY OTHER WELLS ON PARCEL USED FOR S NONEXEMPT WELLS OLD WELL PERMT NO 95Ye ACRES RRGATED zf Z LEGAL z5 AUGMENTATON PLAN NAME OR CASE 4 USES OTHER THAN RRGATON ARE THERE OTHER WELLS WTHN 600 FEET CLOSER TO WEELS WTHN 600 FEET THAN BEFORE MOVE MORE THAN 200 FT WHY WLL THE REPLACEMENT BE S THE REPL BENG OTHER WELLS USED FOR THE SAME PURPOSE PERMT S SURFACE WATER RGHTS USED N CONUCTON WTH THS WELL COMMENTS NOTE A WRTTEN REPORT MUST BE SUBMTTED

31 C o j dl B M Sehool U 00 c D U C V Y n C mm 9B enn j c 2 o j l EC ccmc k F w c cv Vnd 89 L 25 l b 8S Well A Wellll g Well Y Beacon o s U Cb 34 p e j m 35 ms l f f

32 l l j f N l 6 TYPE OR PRNT N BLAC K NK COPy OF ACC EPTED STAT ON RE QUEH MNT MALED THE AFFANT S whose mal ng ddos s s COLORADO DVSON OF WATER RESOURCES STATE OF COLORADO COUNTY OF 88 Cenennlol Bldg 33 She mon S Denve Coloado Mogan W Q4 RECEVED A jlu lu NHXDf LO 0 LUA STATEMENT OF BENEFCAL USE OF GROUND WfR 6LUU XX AMENDMENT OF EXSTNG RECORD TTl 6 00 LATE REGSTRATON PERMT NUMBER 5954 Dan Fhauf Couny Adam SS CHG O CO LOCAT FlOF WRL LL l UM 89 Wj dh v L ES A TE ENGNEER COlO Sa R Box 7A NE y of he ll Secon uuc C y y s CO 8003 L Twp L R Rng Ol s FO R 6 P M E beng duly swon upon oah deposes ond soys ha he hey s ae he owe s of he well de5 dbed heeon he well Oloed as descbed obove a dsances of 2544 fee fom he ROlh secon lne and 6 Cl T 0 D lt fee fom he wes secon le wae fon hs well was fs appled o a benefcal use fo he plpos e s d@ scb d heen On he 6 T D Wl doy of Ap 9 46 he nloxmum s usaned pumpng oe of h well s nngollons pe mnue he pumpng ae cl med heeby s 509 gallons pe mnue he ool deph of he well s 7 fee he aveage annual amoun of woe o be dveed s 635 Ql fe fe e fo whch clam S heeby made fo T g nn nf f m npl pupose s he legal deslpon of h land on whch he wae fom hs well s us ed N Sec 23 TS R60W of wh oh 254 aces ae gaed and w c s llusaed on he map On he evese 5de of hs fom ha hs well was Lompleed n complance wh he pem appoved heefo hs saemen of benefcal use of gound wae s fled n omplanc e wh law he hey h05 hovl eed he saemens made heeon knows he COnen heeof and ha he sam e ae ue of h he knowledge COMPLETE RE VERSE SDE OF THS FORM gnaufe s Subscbed and won f 9P o befoe me on hs d day of Ou o No FOR OFFCE USONLY My Comm son L pes Pfo Dv v T ffl v e fsl P T ACCEPTED FOR FlNG BY THE STA ENGNEER OF COLORADO PURSUANT TO THE FOllOWNG CONDTONS C Yo W l Ds l05n Mo Ds DA T E ST A T F f N E E R BY

33 l v Woll d j d by Le No PemClnen Pump n lolled by No Mee Seal No o Flaw Meee Doe nsoll d Owne 0 lond an Le whjoh wqef beng used Dan Fhauf THE LOCATON OF THE WELL MUST BE SHOWN AND FOR LARGE CAPACTY RRGATON WELLS THE AREA ON WHCH THE WATER S USED MUST BE SHADED OR CROSSHATCHED ON THE DAGRAM BELOW Ths dagam epesens nne 9 secons Use he CENTER SQUARE one secon o ndkoe he lalaon of le w ll f po 5ble NORH SE NORTH m vo vo m n o z z m w CD SOU T E SCALE OF T E DAGRAM S TWO NCHES E UALS ONE E M le WATER EQUVALENTS TABLE Rounded Fgu s An ace foo Qve o e of land foo deep ube foo p second ds 449 gallon po mnue gpm oco OO ub fee gallons 000 gpm pl lmped connuously fo one day podul e 4 42 o e fe6 00 gpm pumped c onnuously fo one yecl poduces 60 ace fee WHTE AND PNK COpy TO BE FLED WTH THE STATE ENGNEER PNK COpy WLL BE RETURNED TO OWNER

34 j l fl f5 TYPE OR PRNT N 6 AC COF y OF AceE NK TED HA TeMEH M6ll ED ON REQUBT COLORADO DVSON OF WATER RESOURCES STATE OF COLORADO 88 Cenennol Bldg 33 Sheman S Denve CQloodo COUNTY OF Mogan SS 2 W lll4 llj lull N XD8 PlD4 STATEMENT OF BENEFCAL USE OF GROUND W fr 60 XX AMENDMENT OF EXSHNGRECORD TTL 600 RECEVEL Bes Copy Avalable LATE REGSTRATON CHEQUE CHG O Ol THE AFFANT S who odde55 emal ng Dan Fhauf PERMT NUMBER 5954 Counly Adams LOCATlWOF WRL GVl U lllb DEe 89 WATER AESOURf 5 STATE HlGlNEER COlO Sa R Box 7A NE y of sw Secon l Cy Byes CO 8003 TATE ZPl Twp l l fn N P E w M beng du y woupon oah dopo e and says ha he hey oe he owne 0 he well descbed heeon he well locae a ducbed obave Of d once of 2544 fee fom he n h secon lne and lj lll 0 5oUT NQT f fe fom fh wes T ll T secon lnej woel fom hwel was fs appled o a benefc ol use fo he pupos e 5 de cb@d heen on he6 doy 0 Apl 96 he maxmum Usofled umpjn9 ae of he well 5 Ollgallons pe mnue he pumpng oe amed heeby 500 gallons pe mnue he oal deph 0 he well 7 fee he aveage annual amoun 0 wo 0 be dveed s 635 Qce fee fo whch clam s heeby made fo T g n F Fa op pupo 5e s he legal decpon of he land o whch he wae fom hs well s used 5 N Sec 23 TS R60W 0 wh ch 254 aces oe gaed and whch s llusaed on he map on he evese sde of h5 fom ha hs well woos comple ed n complance wh he pem appoved heefo hs saemen ofbenefcal use of sound woe s fled n complance wh law he h y has hovel eod he saemens mode heeon kn w he onlenl h l and ha he some oe fue 0 hs he knowledge COMPLETE REVERSE SDE OF THS FORM Sgnoue s FOR OFF CE USE ONL Y 5ub clbed and swon 9 p o befoe me on h dqy of Coull Cou Nc My Commsson expes n a L ACCEPTED FOR FLNG BY THE STA ENGNEER OF COLORADO PURSUANT TO THE FOLLOWNG CONDTONS PdC Dv 5ec v T NVEf f T fsul y Wl lll De L BSln Man D s l O E STATE ENCNEER BY

35 Fom No GWS 25 OFFCE OF THE STATE ENGNEER COLORADO DVSON OF WATER RESOURCES 88 Cenennal Bldg 33 Sheman S Denve Coloado W WELL PERMT NUMBER V S APPLCANT DV 8 CNTY WD DES BASN 2 MD 7 Lo Block Flng SublN APPROVED WELL LOCATON ADAMS COUNTY DANEL A FRHAUF 580 MMOSA RD BYERS CO PERMT TO CONSTRUCT A WELL NE 4 NE 4 Secon 23 Twp S RANGE 60 W 6h P M DSTANCES FROM SECTON LNES 50 F fom Noh Secon Lne 50 F fom Eas Secon Lne CONDTONS OF APPROVAL Ths well shall be used n such a way as o cause no maeal njuy o exsng wae ghs The ssuance of he pem does no assue he applcan ha no njuy wll occu o anohe vesed wae gh o peclude anohe owne of a vesed wae gh fom seekng elef n a cvl cou acon 2 The consucon of hs well shall be n complance wh he Wae Well Consucon Rules 2 CCR unless appoval of a vaance has been ganed by he Sae Boad of Examnes of Wae Well Consucon and Pump nsallaon Conacos n accodance wh Rule 8 3 Appoved pusuan o CRS fo he eplacemen of an exsng well pem no 7V a fa The old well mus be plugged accodng o he Wae Well Consucon Rules The enclosed Well Abandonmen Repo fom mus be compleed whn sxy 60 days of consucon of he new well affmng ha he old well was plugged 4 Wae fom hs well may be used fo domesc puposes nsde one sngle famly dwellng 5 The maxmum pumpng ae shall no exceed 5 GPM 6 The gaed aea shall no exceed A ace squae fee of lawn and gaden 7 Wae fom hs well may be used fo he waeng of lvesock on ange and pasue 8 Poducon s lmed o he Laame Fox Hlls aqufe Plan casng mus be nsalled and goued fom gound suface o a mnmum deph of 00 fee o peven dveson of wae fom ohe zones The deph of he well shall no exceed 340 fee whch s he esmaed base of he Laame Fox Hlls aqufe 9 Ths well mus be consuced whn 300 fee of he locaon specfed on hs pem NOTE The ably of hs well o whdaw s auhozed amoun of wae fom hs non enewable aqufe may be less han he 00 yeas upon whch he amoun of wae n he aqufe s allocaed due o ancpaed wae level declnes 20 7 s g APPROVED SG el Recep No DATE SSUED UL 0 96 E 7AM BY

36 RECEVED T WR S Rev 76 COLORADO DVSON OF WATER RESOURCES 88 Cenennal Bldg 33 Sheman S Denve Colo NOV WATER RESUUH S la STATEENGNEER PERMT APPLCATON FORMUN Applcaon mus COLO be complee whee k A PERMT TO USE GROUND WATETEa E eq applcable Type o w X E pn n BLACK FOR L A PERMT TO NSTALL A PUMP NK No oveskes o easues unless OO REPLACEMENT FOR NO A P g47m 7 naled OTHER WATER COURT CASE N0 a kglx A 0 APPLCANT malng addess NAME jl QA AFFH R STREET 5 0 ns5 CTY RY RS e 4n Sae ZP FOR OFFCE USE ONLYCLQQ Recep No Basn Ds 4 CONDTONS OF APPROVAL THS COLUMN TELEPHONE NO CO3 4Z s 203 Ths well shall be used n such a way as o cause no maeal njuy o exsng wae ghs The 2 LOCATON OF PROPOSED WELL ssuance of he pem does no assue he applcan ha no njuy wll occu o anohe vesed wae gh o peclude anohe owne of a vesed wae Couny R DF7NlfS gh fom seekng elef n a cvl cou acon of he G Secon 2 3 Twp Rng O c N S E W LL Cn A PM k a3 3 WATER USE AND WELL DATA C sn lof ed Sc flan Poposed maxmum pumpng ae gpm C D E kl Aveage annual amoun of gound wae o be appopaed ace fee F l Numbe of aces o be gaed Poposed oal deph fee 2o Aqufe gound wae s o be obaned fom Bes Copy Avalable Owne s well desgnaon GROUND WATER TO BE USED FOR HOUSEHOLD USE ONLY DOMESTC no gaon 0 NDUSTRAL 5 LVESTOCK 2 RRGATON 6 COMMERCAL 4 MUNCPAL 8 A 4 6Lw L4 Sd OTHER 9 APPLCATON APPROVED DETAL THE USE ON BACK N 0 4 DRLLER Name 7 PERMT NUMBER DATE SSUED EXPRATON DATE See T Cy sae ZP 765 STATE ENGNEER T Telephone No 22 22M Lce No BY G D Q COUNTY D

37 5 THE LOCATON OF THE PROPOSED WELL and he aea on whch he wae wll be used mus be ndcaed on he dagam below Use he CENTER SECTON secon 640 aces fo he well locaon 4 4 MLE 5280 FEET VA03R 6 THE WELL MUST BE LOCATED BELOW by dsances fom secon lnes W f fom 4z 6RY 4 sec lne Af o sou hf 6 0 f fom FA5 sec lne ess o wes LOT BLOCK FLNG NORTH SECTON LNE SUBDVSON NORTHf T 2 zo m N Hem T A T ON WHCH WELL WLL BE LOCATED 0 ne fn fe No of aces Wll hs be he only well on hs ac UWN y Oz Z B PROPOSED CASNG PROGRAM Plan Casng SOUTH SECTON LNE 40 n fom 4 f o f Z n fom f o Lf Pefoaed casng n fom Fe f o 2 n f n fom f o f 9 FOR REPLACEMENT WELLS gvedsance and decon fom old well and plans fo pluggng The scale of he dagam s 2 nches mle Each small squae epesens 40 aces WATER EQUVALENTS TABLE Rounded Fgues An ace foo coves ace of lend foo deep cubc foo pe second gallons pe mnue lgpm A famly of 5 wll eque appoxmaely ace foo of wae pe yea ace foo cubc fee gallons 000 gpm Dumped connuously fo one day poduces 4 42 ace fee 2 o o nd Lx c L P 5s p e cg L4 0A S 0 LAND OW N WH Owne s f lel A No of aces 4 D RPTON of he use of gound wae Household use and domesc wells mus ndcae ype of dsposal sysem o be used d n A C 2EEp f a 7 a N S YSTEX 2 OTHER WATER RGHTS used on hs land ncludng wells Gve Regsaon and Wae Cou Case Numbes Type o gh Used fo pupose Descpon of land on whch used x03 THE APPLCANTS STATE S THAT THE NFORMATON SET FORTH HEREON S TR 0 THE OF S K GWEDE BE7 SGNATURE OF APPL Use addonal shees of pape f moe space s equed

38 EXEMPT WELL DATA SHEET DENVER BASN COLORADO APPLCANT FRHAUF RECEPT NO LOCATON NE 4 OF NE 4 OF SEC 23 T S R 60W 50 MSL 50 ESL LOCATON S WTHN THE KOUA BOU DESGNATED GROUND WATER BASN PROPOSED AQUFER SURFACE ELEVATON 480 NUMBER OF ACRES N TRACT 40 S PROPERTY WTHN SERVCE BOUNDARES OF MUNCPALTY S 8 5 CONSENT MAPS NO YES F SUBDVSON S UNDER AUGMENTATON PLAN CASE NO S DV F SUBDVSON WAS RECOMMENDED FOR APPROVAL BY THE WATER MANAGEMENT BRANCH DATE OF LETTER S NFORMATON ON SUBDVSON OR TRACT OF LAND SPECAL RESTRCTONS evaluaed by SG on UNE ELEVATON DEPTH TO ANNUAL NET APPROP STATUS AQUFER BOT TOP SAND BOY TOP A F UPPER DAWSON LOWER DAWSON DENVER UPPER ARAPAHOE LOWER ARAUUM cx7 ARAME FOX HLLS NNT noe E ndcaes locaon s a aqufe bounday and values my be moe appox ane ndcaes he poposed aqufe All values ae nepolaed fom he S B 5 daa base assembled n Novembe of 986