HomeMy WebLinkAboutQb App-NOI Fire Pond 6-2009OFFICE OF THE STATE ENGINEER
DIVISION OF WATER RESOURCES
303-866-3581
FOR OFFICE USE ONLY
DAM NAME _________________________________ NO.____________ WATER DIV: ______ DIST:_______
NOTICE OF INTENT TO CONSTRUCT A NON-JURISDICTIONAL
WATER IMPOUNDMENT STRUCTURE1
This notice is required per Section 37-87-125, C.R.S. (1998).
This notice must be submitted to the Division Engineer’s Office a minimum of 45 days prior to construction.
(PLEASE PRINT OR TYPE NOTICE)
OWNER INFORMATION
Name: _________________________________________________________Telephone: (_________)______________
Address: _________________________________________________________________________________________
Street / P.O. Box/ Rural Route City State Zip Code
Responsible Person: _____________________________________________Telephone: (________)_______________
Address: _________________________________________________________________________________________
Street / P.O. Box/ Rural Route City State Zip Code
Contractor: ____________________________________________________ Telephone: (________)_______________
STRUCTURE INFORMATION
Name of Dam: _________________________________________ Water Division: __________ Water District:________
Location2:
● Option 1
¼ / ¼ Sect: ________ ¼ of the ________ ¼; Sect: _____, Township: _____, Range: _______, ___ P.M.
Distance of dam from Section lines ____________ft from
LOCATION SPECIFYING EXAMPLE
26 25 30
35 36 31
NE¼ of the SE¼
1,000 ft.
Dam Location 1,500 ft.
2 1 6
R67W R66W
NW
NE
SW
NW
SW SE
●
T1N
T2N
Section 36, Township 2 North, Range 67 West, 6th PM
(S36 T2N R67W)
Dam is located in the SE¼ of the SE¼ of Section 36
1,000 feet North of the South Section Line
1,500 feet West of the East Section Line