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HomeMy WebLinkAbout1.0 ApplicationGARFIELD COUNTY Building & Planning Department 108 8th Street, Suite 401 Glenwood Springs, Colorado 81601 Telephone: 970.945.8212 Facsimile: 970.384.3470 www.qarfield-county.com GENERAL ADMINISTRATIVE PERMIT GENERAL INFORMATION (Please not legibly) ➢ Name of Property Owner: Gary 4 Mt'wjare'�' Owker �y > Mailing Address: 43(5 Gr4ss MCsot J Telephone: t,70 )‘25-041 > City: Rf'f IC. State:CO. Zip Code: SIS Cell: ( ) > E-mail address: .bow ketezref ( 3YVWtiI,COM FAX: ( ) > Name of Owner's Representative, if any, (Attorney, Planner, Consultant, etc): > Mailing Address: Telephone: ( ) > City: State: Zip Code: Cell: ( ) > E-mail address: FAX: ( ) R; quested Use from Table 3-501 or 502: oare > Street Address / General Location of Property: > Legal Description: GrOSS MSA -Ranch IA- 9f > Assessor's Parcel NU bey 2 'f o3 - 0 3 2 - 0 0 - 0 > Existing Use: Fest rrici > Property Size (in acres) Lf 8.578 Zone District: Last Revised 12/29/08 --prean??(CCcr'Oh \int --4I �+ �j i54ta i n J.bmi- chs lic,t-ti011 -tiO J r I. GENERAL APPLICABILITY & SUBMITTAL REQUIREMENTS The following general application materials are required for all Administrative Review Applications in Garfield County. To determine if the use you request requires an Administrative Permit, refer to Table 3-501 and 3-502 of Article III. Application materials and review standards that are specific to an individual use (Accessory Dwelling Unit, Home Office, etc,) are detailed in Sections 3-301 of Article III and Section 7-801 of Article VII of the Unified Land Use Resolution (ULUR) of 2008. 1. Submit a completed and signed Application Form, an application fee, and a signed Agreement for Payment form. N.,2. Submit a narrative explaining the purpose of the application and supporting materials that address the standardsAnd criteriaound in Articles III and VII of the Unified Land Use Resolution of 2008. q re$oss-i�owbj qucc4141s 3. Submit a copy of the deed showing ownership. Additionally, submit a letter from the '�/ property owner(s) if the owner is being represented by another party other than the owner. If the property is owned by a corporate entity (such as an LLC, LLLP, etc.) Please submit a copy of recorded "Statement of Authority" demonstrating that the person signing the application has the authority to act in that capacity for the entity. 4. Submit a vicinity map: An 8 1/2 x 11 vicinity map locating the parcel in the County. The v vicinity map shall clearly show the boundaries of the subject property and all property within a 3-mile radius of the subject property. The map shall be at a minimum scale of 1"=2000' showing the general topographic and geographic relation of the proposed land use change to the surroundipg area for which a copy of U.S.G.S. quadrangle map Own-1y be used. y Mae / 5. Submit a Site Plan which is required in Section 4-502(C)(3) of Article IV which shall be scaled at 1 inch to 200 feet for properties exceeding 160 acres in size, or 1 inch to 100 feet for properties less than 160 acres in size The Director may require, or the applicant may choose to submit, a more detailed version of all or part of the site plan. The site plan shall include the following elements. \, a) Legal description of the property. b) Boundary lines, corner pins, and dimensions of the subject property, including land \., survey data to identify the parcel with section corners, distance and bearing to ,corners, quarter corners, township and range. Nc) Existing and proposed topographic contours at vertical intervals sufficient to show the topography affecting the development and storm drainage. d) Significant on-site features including: natural and artificial drainage ways, wetland areas, ditches, hydrologic features and aquatic habitat; geologic features and hazards including slopes, alluvial fans, areas of subsidence, rock outcrops and SD>4C4-Y Wo Survet� rockfall areas, radiological and seismic hazard areas, soil types and landslide areas; vegetative cover; dams, reservoirs, excavations, and mines; and any other off-site features of the same type that influence the development. \e) Existing and proposed parking areas, driveways, emergency turn-outs and emergency turnarounds, si k(ewalks and paths, shown by locationan imensi n\ ci s4-ng tv v way ciI I t t cnbre (Jt t i N. f) Existing and proposed toads, railroad tracks, irrigation ditches, fences and if ility lines on or adjacent tok the parcel, shown by location and dimension. N, g) Uses and grantees of all existing and proposed easements and rights-of-way on or adjacent to the parg9� shown by location and dimension. Ni.h) Area of the individual parcels, and the total square feet of existing buildings, driveways and parking area. i) Zone district in which the site is located. rvvai j) Location and dimension of all structures, existing and proposed, and distance of structures from property lines. k) Elevation drawings showing existing grade, finished grade, and height of the proposed structures above existing grade. I) Description of the proposed wastewater treatment system, including location and size of leach field, sewer service lines, and tre, tment facilities to serve the proposed use. �y _f w S'wer V61tt ` m) Description of the source and capacity of the water supply, including location and size of well(s) and/or water\ Bines to serve the proposed use. n) Location andize of signs for the p�lrpose of identification, advertising and traffic control. T/A o) Additional information that may be reasonably requested by the Director to enable an adequate evaluation of the proposal. 6. Submit a copy of the Pre-Application Conference form from the original Pre-Application Conference. , t, a.' s o tth s om !Nil '"�fi"op and„ �jT h` atir artiji`t??:tt al Ira ri lsrl " 7.E 3o the :q.ld o °)z nj ad`n n. ®'ep `rtet i Staff will request additional copies once the application has been deemed technically complete. 11. Administrative Review Process The following section outlines and describes the Administrative Review process for the variety of uses that are governed by the Board of County Commissioners by the Unified Land Use Resolution of 2008 (ULUR). Please refer to Section 4-401 of Article IV in the regulations themselves for a higher level of detail. [The following process is required for applications for land use changes that are subject to Administrative Review as defined in Table 3-501 or 3-502 in Article III.] A. Outline of Process. The Administrative Review process shall consist of the following procedures which are more fully described in Sections 4-401 and 4-104 of Article IV: 1. Pre -Application Conference (Section 4-103(A)) 2. Application (4-103 (B)) 3. Determination of Completeness (4-103 (C)) 4. Evaluation by the Director/Staff Review (4-103 (E)) 5. Decision by Director I have Seaa-t which is statements above and have provided the required attached information act 1yj .•.te to the best of my knowledge. (Signature of P operty Owner) I. 74- of Date GARFIELD COUNTY BUILDING AND PLANNING DEPARTMENT FEE SCHEDULE Garfield County, pursuant to Board of County Commissioners ('Board") Resolution No. 98-09, has established a fee structure ("Base Fee") for the processing of each type of subdivision and land use applications. The Base Fee is an estimate of the average number of hours of staff time devoted to an application, multiplied by an hourly rate for the personnel involved. The Board recognized that the subdivision and land use application processing time will vary and that an applicant should pay for the total cost of the review which may require additional billing. Hourly rates based on the hourly salary, and fringe benefits costs of the respective positions combined with an hourly overhead cost for the office will be used to establish the actual cost of County staff time devoted to the review of a particular project. Actual staff time spent will be charged against the Base Fee. After the Base Fee has been expended, the applicant will be billed based on actual staff hours accrued. Any billing shall be paid in full prior to final consideration of any land use permit, zoning amendment or subdivision plan. If an applicant has previously failed to pay application fees as required, no new or additional applications will be accepted for processing until the outstanding fees are paid. Checks, including the appropriate Base Fee set forth below, must be submitted with each land use application, and made payable to the Garfield County Treasurer. Applications will not be accepted without the required application fee. Base Fees are non-refundable in full, unless a written request for withdraw from the applicant is submitted prior the initial review of the application materials. Applications must include a Payment Agreement Form ("Agreement") set forth below. The Agreement establishes the applicant as being responsible for payment of all costs associated with processing the application. The Agreement must be signed by the party responsible for payment and submittedwith the application in order for it to be accepted. The following Base Fees shall be received by the County at the time of submittal of any procedural application to which such fees relate. Such Base Fees shall be in addition to and exclusive of any cost for publication or cost of consulting service determined necessary by the Board for the consideration of any application or additional County staff time or expense not covered by the Base Fee, which have not otherwise been paid by the applicant to the County prior to final action upon the application tendered to the County. GARFIED COUNTY BUILDING AND PLANNING DEPARTMENT BASE FEES TYPE OF LAND USE ACTION Vacating Public Roads & Rights -of -Way Sketch Plan Preliminary Plan / Conservation Subdivision Preliminary Plan Amendment Final Plat Final Plat Amendment / Correction Plat Combined Preliminary Plan and Final Plat Minor Exemption / Amendment Major Exemption / Amendment Rural Land Development Option Exemption / Amendmen G erel; oaf i' :`.a rf Floodp ain Development Permit Pipeline Development Plan / Amendment Small Temporary Employee Housing Minor Temporary Employee Housing Limited Impact Review / Amendment Major Impact Review / Amendment Rezoning: Text Amendment Rezoning: Zone District Amendment Planned Unit Development (PUD) / Amendment Comprehensive Plan Amendment Variance Interpretation Planning Staff Hourly Rate • Planning Director • Senior Planner ■ Planning Technician • Secretary County Surveyor Review Fee (includes review of Amended Plats, Final Plats, Exemption Plats) Mylar Recording Fee Page 2 BASE FEE $400 $325 $675 + application agency review fees and outside consultant review fees, as authorized pursuant to the Regulations, such as the Colorado Geologic Survey $325 $200 $100 $1,075 $300 / $300 $400/$300 $400 / $300 $400 $400 / $300 $50 $250 $400/$300 $525 / $400 $300 $450 $500 / $300 $450 $250 $250 $50.50 $40.50 $33.75 $30.00 Determined by Surveyor$ $11 — 1st page $10 each additional page The following guidelines shall be used for the administration of the fee structure set forth above: 1. All applications shall be submitted with a signed Agreement for Payment form set forth below. 2. County staff shall keep accurate record of actual time required for the processing of each land use application, zoning amendment, or subdivision application. Any additional billing will occur commensurate with the additional costs incurred by the County as a result of having to take more time that that covered by the base fee. 3. Any billings shall be paid prior to final consideration of any land use permit, zoning amendment, or subdivision plan. All additional costs shall be paid to the execution of the written resolution confirming action on the application. 4. Final Plats, Amended or Corrected Plats, Exemption Plats or Permits will not be recorded or issued until all fees have been paid. 5. In the event that the Board determines that special expertise is needed to assist them in the review of a land use permit, zoning amendment, or subdivision application, such costs will be borne by the applicant and paid prior to the final consideration of the application. All additional costs shall be paid prior to the execution of the written resolution confirming action on the application. 6. If an application involves multiple reviews, the Applicant shall be charged the highest Base Fee listed above. 7. Types of "Procedures not listed in the above chart will be charged at an hourly rate based on the pertinent planning staff rate listed above. 8. The Planning Director shall establish appropriate guidelines for the collection of Additional Billings as required. Page 3 GARFIELD COUNTY BUILDING AND PLANNING DEPARTMENT PAYMENT AGREEMENT FORM (Shall be submitted with application) ,J GARFIELD COUNTY (hereinafter COUNTY) and Galy 4 PIM rg4Ye wke Property Owner (hereinafter OWNER) agree as follows: 1. OWNER has submitted to COUNTY an application for � Itza4t" on Loi- S'i. (hereinafter, THE PROJECT). yvlkhth Grass Mesa G6�ivisloh 2. OWNER understands and agrees that Garfield County Resolution No. 98-09, as amended, establishes a fee schedule for each type of subdivision or land use review applications, and the guidelines for the administration of the fee structure. 3. OWNER and COUNTY agree that because of the size, nature or scope of the proposed project, it is not possible at this time to ascertain the full extent of the costs involved in processing the application. OWNER agrees to make payment of the Base Fee, established for the PROJECT, and to thereafter permit additional costs to be billed to OWNER. OWNER agrees to make additional payments upon notification by the COUNTY when they are necessary as costs are incurred. 4. The Base Fee shall be in addition to and exclusive of any cost for publication or cost of consulting service determined necessary by the Board of County Commissioners for the consideration of an application or additional COUNTY staff time or expense not covered by the Base Fee. If actual recorded costs exceed the initial Base Fee, OWNER shall pay additional billings to COUNTY to reimburse the COUNTY for the processing of the PROJECT mentioned above. OWNER acknowledges that all billing shall be paid prior to the final consideration by the COUNTY of any land use permit, zoning amendment, or subdivision plan. R (OR AUTHORIZED REPRESENTATIVE) 7-/1-b) SignatureDate Mq je---gbWker. Print Name Mailing Address: 315 Grass Me SA ei 1-ik1 Co. elloS0 Page 4 The purpose of this ADU is for my brother to live in. this ADU will be located within our properties boundaries and will be within the guide lines of all County set backs. Address is located 4315 Grass Mesa Road Rifle, Co. 81650 Garfield County • The ADU will use existing driveway and we will call the Road and Bridge Department to see if we need to pull permit to extend the driveway. • No other existing roads, railroad tracks, emergency turn -outs, sidewalks or paths are effect nor is any easements. (see maps regarding any roads) • See map of individual parcels • Zone Rural Residential • See site map • see topo map regarding grades • Water will be run to ADU from existing well attached to main house. Well have paper regarding how many houses the water well can accommodate. • Leach line sewer will be used for home and we will pull a permit to do this. It will not affect any other surrounding property. • Not signs needed except for additional address on ADU, which will be located off of Grass Mesa Road. • Applicant: Job Address: Subd- Lot/block: FINISHED LIVING SPACE: UNFINISHED ,BASEMENT: CRAWL SPACE: GARAGE: 20• z F' UNCOVERED PATIO/DECK COVERED PATIO/DECK MISC: MISC: FEE ESTIMATE FOR S/F STICK BUILT HOMES (ALL FEES ARE ESTIMATES UNTIL FINAL PLANS ARE REVIEWED) �nr# gYtr'x k€4,- /}�(� sf X 74.68= ///, 71i. Z$ sf X 41.00= sf X9.00= /349-4 (An S 7 sr X18.00= /ot 3,g.00 sf X 12.00= sf X 24.00= / 174 TOTAL VALUATION: THIS SECTION WILL BE DETERMEND BY GARFIELD COUNTY BUILDING & PLANNING PLAN REVIEW FEE: PERMIT FEE: TOTAL: SEPTIC= PERMIT: PERC: Account R247215 Year District 2009 024 N Apr Dist GREG St A Cancel STR Owner Name/Address BOWKER, GARY L JR & MARGARET 4315 GRASS MESA ROAD RIFLE CO 81650 Parcel Number 2403-032-00-049 Street No ([ 004315 Street Name GRASS MESA ?Location Zip 81650 BACode (Business Name Owner Id MH Space Seq Type RD INo# ( SECT,TWN,RNG:3-7-93 DESC: SEC 3 LOT 2, N1/3N1/2SW AKA ILOT 54 GRASS MESA RANCH. DESC: EXCEPT A TR OF LAND it 1CONT.212 AC PRE:R247185 AND/THRU:& TO:R247187 PRE:R247195 BK:0643 PG:0348 BK:1913 PG:0587 RECPT:721104 13K:1913 PG:0583 RECPT:721103 BK:1522 PG:832 RECPT:637310 BK:1413 PG:831 RECPT:615972 BK:13561 IPG.661 RECPT:603806 BK:1352 PG:962 RECPT:602916 BK:1195 IPG:355 RECPT:565706 BK:1173 PG:219 RECPT:559414 BK:0972 1 PG:0644 Acct Type Owner Location Map No Name Situs Mobile Tract Condo Block Tax Items Protes(I) CAM(A Pre/Suc M(o)bile Autin P(e)rmit Remarks [] Value ;.Li (P)ersonal Tax (S)ale Li State Asd Spc Asmt 4[ j Control kw ,r rr a an ,vrTn vw S M(t)nes ) ] History Sales Si(b)ling `[11 PPCert(L)t mise M (j Flags -[_ j Exemptioi Mail (F) 4[ i Tax (C)hr-. Mtq Trac(k) (6)15 Map (V)alue Sum TYPE RESIDENTIAL ACTUAL I ASSD ACRES 400,110 31,840 48.578 Oil and Gas% Recor(d)i Imaging W P(h)oto Y,11 Sketch TOTAL 400,1 0 Queries u.l 31,840 48.578 NAME Current Year Prior(Y)ear (N)ext Year Prior VersionQ Ne(x)t Version Characteristics Tax Trx Abatement Property Card Update GARFIELD COUNTY Building & Planning Department 108 8th Street, Suite 401 Glenwood Springs, Colorado 81601 Telephone: 970.945.8212 Facsimile: 970.384.3470 www.ciarfield-county.com PRE -APPLICATION CONFERENCE SUMMARY TAX PARCEL. NUMBER : 240303200049 APPLICANTS PLANNER: PROJECT: ADU OWNER: Margaret and Gary Bowker REPRESENTATIVE: PRACTICAL LOCATION: Grass Mesa 4315 Grass Mesa Road TYPE OF APPLICATION: Administrative permit - ADU DATE: June 12, 2009 GENERAL PROJECT DESCRIPTION Request a General Administrative Permit to allow an Accessory Dwelling Unit on a 48.5 acre parcel in the Rural Zone District II. REGULATORY PROVISIONS Accessory Dwelling Unit - Garfield County Unified Land Use Resolution of 2008 a. Article III, Section 3-304 - General requirements for an ADU b. Article IV, Section 4-501 - Submittal Requirements c. Article VII, Division 1 - General standard (water/sanitation/access) d. Article VII, Division 2 General Resource Protection (wildlife, hazards, etc - just write a statement regarding each item based upon that section in the code) e. Article Vii, Division 8, Section 801 - standards specific to ADU Submittal Requirements: e Application and fee • Written description of the request • Deed and Title Commitment s Names and mailing addresses of all property owners within zoo' of subject site, as well as names and addresses of any mineral interests in the subject site • Vicinity Map - locate your parcel of land within a three mile area of the County • Site Plan - 4-5o2C3 which requires the site plan to contain: o Legal description of the property. o Boundary lines, corner pins, and dimensions of the subject property, including land survey data to identify the parcel with section corners, distance and bearing to corners, quarter corners, township and range. (this means that the site (parcel) must be located within a section, township and range and clearly show the property boundary lines) o Existing and proposed topographic contours at vertical intervals sufficient to show the topography affecting the development and storm drainage. (various maps may be found at the County which would provide this information). o Significant on-site features including: natural and artificial drainage ways, wetland areas, ditches, hydrologic features and aquatic habitat; geologic features and hazards including slopes, alluvial fans, areas of subsidence, rock outcrops and rockfall areas, radiological and seismic hazard areas, soil types and landslide areas; vegetative cover, dams, reservoirs, excavations, and mines; and any other off-site features of the same type that influence the development (you can just identify the area of where these occur on the parcel and label as such). o Existing and proposed parking areas, driveways, emergency turn-outs and emergency turnarounds, sidewalks and paths, shown by location and dimension. (the existing driveway and home must be shown on the site plan, identify if the driveway will be shared with the main residence or where a new driveway would be located). o Existing and proposed roads, railroad tracks, irrigation ditches, fences and utility lines on or adjacent to the parcel, shown by location and dimension. o Uses and grantees of all existing and proposed easements and rights-of-way on or adjacent to the parcel, shown by location and dimension, (all of this information should be itemized in your title commitment or in the public records). o Area-of-the-individual-parcels; and the total square feet of existing buildings, driveways and parking area. (identify the square footage of the existing home, and approximate area for driveway and parking). o Zone district in which the site is located. o Location and dimension of all structures, existing and proposed, and distance of structures from property lines. o Elevation drawings showing existing grade, finished grade, and height of the proposed structures above existing grade. o Description of the proposed wastewater treatment system, including location and size of leach field, sewer service lines, and treatment facilities to serve the proposed use. o Description of the source and capacity of the water supply, including location and size of well(s) and/or water lines to serve the proposed use. o Location and size of signs for the purpose of identification, advertising and traffic control. (DOES'T APPLY) III. REVIEW PROCESS a. Pre -application Conference; b. Submittal of Application; c. Technical Completeness Review; d. Acceptance of Application — Director Decision date finalized, adjacent owner notice occurs, referral agency review requested (3o days); staff review and comment on the application occurs during this period; e. Director makes a determination of approval or denial (after applicant provides proof of mailing to adjacent property owners (APO) f. County provides notice to APO and BOCC (14 days) g. Permit is issued If no call-up is requested Public Hearing(s): None, unless requested by the BOCC Referral Agencies: Division of Water Resources, Environmental Health, Grass Mesa HOA, any other agency deemed necessary upon review of submittal. IV. APDL ICAT1QN REu.1.EW FE_E_$ Planning Review Fees: $25o.00 Referral Agency Fees: $ Total Deposit: $250.00 (additional hours are billed at hourly rate of $40.50 hr) General AppLicatiorl Processing Planner reviews case for completeness and sends to referral agencies for comments. Case planner contacts applicant and sets up a site visit. Staff reviews application to determine if it meets standards of review. Case planner makes a recommendation of approval, approval with conditions, or denial to the appropriate hearing body. Disclaimer The foregoing summary is advisory in nature only and is not binding on the County. The summary is based on current zoning, which is subject to change in the future, and upon factual representations that may or may not be accurate. This summary does not create a legal or vested right. •pre',p.plicptisztrLu .rnary.EL r.S y_ Kathy E. stley, ICP .r x j INDIVIDUAL SEWAGE DISPOSAL PERMIT GARFIELD COUNTY BUILDING AND SANITATION DEPARTMENT Permit N2 Assessor's Parcel No. 109 lith Street Suite 303 Glenwood Springs, Colorado 81601 Phone (303) 945-8212 tt PROPERTY • This does not constitute a building or use permit;: t ; A 3. Owner's Name Rock A ip `Tx( Present Address 5)` 35 64-0 Phone �Ago K t Cl/65o tick., ,� ,Lof 51-1GP'ass /11es2 cO- yr-%. CJ%so 11' System Location �'/ t Legal Description of Assessor's Parcel No. SYSTEM DESIGN fP })s 12 C-0 7 Septic Tank Gapaclty (gallon) Other Percolation Rate (minutes/Inch) Number of Bedrooms (or other) Cf 4)fTH bIsFos4L Required Absorption Area - See Attached Special Setback Requirements: -7_ 00 Date snidtafrt,b, S tb LEACH cti'Nm03 . 8 �EA-cI : imm Inspector FINAL SYSTEM INSPECTION AND APPROVAL (as Installed) Call for Inspection (24 hours notice) Before Covering Installation System Installer /4 -1A' Septic Tank Capacity ))<0 Septic Tank Manufacturer or Trade Name a1 Septic Tank Access within 8" of surface ! f .mwl r raM 31 tif1 } I(oot) as) sat 014EWAkrb goo Absorption Area gtb xTL Absorption Area Type and/or Manufacturer of Trade Name L Adequate compliance with County and State regulations/requirements Other Date 4-) $-oo fc r* +t- 7) 3+& RETAIN WITH RECEIPT RECORDS AT CONSTRUCTION SITE /0 *CONDITIONS: 1. All Installation must comply with all requirements of the Colorado State Board of Health Individual Sewage Disposal Systems Chapter i r .k 25, Article 10 C.R.S. 1973, Revised 1984. '. ' 2. This permit is valid only for connection to structures which have fully compiled with County zoning and building requirements. Con- t nection to or use with any dwelling or structures not approved by the Building and Zoning office shall automatically be a violation or a • t requirement of the permit and cause for both legal action and revocation of the permit. t 1' i 3. Any person who ponstrOcts, altere,o7 installs an Individual sewage disposal system in a manner which involves a knowing and material , variation from the terms or specifications con'tained In the application el permit commits a Class 1, Petty Offense (E500.001ine-8 months in )ail qr both). White- APPLICANT \Yellow- DEPARTMENT 4 L5 • t, �% , INDIVIDUAL SEWAGE DISPOSAL S}'STEM APPLICATION OWNER 4�-vv "`"d n[� ADDRESS 236- CI /C %7`e �PHONE ‘2,�</y$ Z CONTRACTOR. 0 G'/ra ADDRESS 51M-1; PHONE PERMIT REQUEST FOR (tEW INSTALLATION ( ) ALTERATION ( ) REPAIR Attach separate sheets or report showing entire area with respect to surrounding areas, topography of area, habitable building, location of potable water wells, soil percolation test holes, soil profiles in test holes (See page 4). LOCATION OF PROPOSED FACILITY: Near what City of Town I • Legal Description or Address WASTES TYPE: (r/j DWELLING ( ) COMMERCIAL OR INDUSTRIAL ( ) NON-DOMESTIC WASTES ( ) OTHER - DESCRIBE BUILDING OR SERVICE TYPE: y Size of Lot 60 f4-we5 6J/f.55 97eyPf` Ad Q i -c'k ( ) TRANSIENT USE Number of Bedrooms Number of Persons �~ (}/Garbage Grinder (vYAutomatic Sher (cshwasher SOURCE AND TYPE OF WATER SUPPLY ( WELL ( ) SPRING ( ) STREAM OR CREEK If supplied by Community Water, give name of supplier: / DISTANCE TO NEAREST COMMUNITY SEWER SYSTEM: 7m 44s d Was an effort made to connect to the Community System? A site plan is required to be submitted that indicates the following MINIMUM distances: Leach Field to Well: 100 feet Septic Tank to Well: 50 feet Leach Field to Irrigation Ditches, Stream or Water Course: 50 feet Septic System to Property Lines: 10 feet YOUR INDIVIDUAL SEWAGE DISPOSAL SYSTEM PERMIT WILL NOT BE ISSUED WITHOUT A SITE PLAN: GROUND CONDITIONS: Depth to first Ground Water Table Percent Ground Slope 2 OF INDIVIDUAL SEWAGE DISPOSAL SYSTEIVJROPOSED: SEPTIC TANK VAULT PRIVY PIT PRIVY CHEMICAL TOILET ISPOSAL BY: ABSORPTION TRENCH, BED OR PIT UNDERGROUND DISPERSAL ABOVE GROUND DISPERSAL AERATION PLANT ( ) COMPOSTING TOILET ( ) INCINERATION TOILET OTHER - DESCRIBE ( ) Y VAULT RECYCLING, POTABLE USE RECYCLING, OTHER USE ( ) EVAPOTRANSPIRATION ( ) SAND FILTER ( ) WASTEWATER POND ( ) OTHER - DESCRIBE WILL EFFLUENT BE DISCHARGED DIRECTLY INTO WATERS OF THE STATE? PERCOLATION TEST RESULTS: (To be completed by Registered Professional Engineer, if the Engineer does the Percolation Test) Minutes per inch in hole No. 1 Minutes per inch in hole NO. 3 Minutes per inch in hole No. 2 Minutes per inch in hole NO. _ Name, address and telephone of RPE who made soil absorption tests: we Name, address and telephone of RPE responsible for design of the system: Applicant acknowledges that the completeness of the application is conditional upon such further mandatory and additional tests and reports as may be required by the local health department to be made and furnished by the applicant or by the local health department for purposed of the evaluation of the application; and the issuance of the permit is subject to such terms and conditions as deemed necessary to insure compliance with rules and regulations made, information and reports submitted herewith and required to be submitted by the applicant are or will be represented to be true and correct to the best of my knowledge and belief and are designed to be relied on by the local department of health in evaluating the same for purposes of issuing the permit applied for herein. I further understand that any falsification or misrepresentation may result in the denial of the application or revocation of any permit granted based upon said application and in legal action for perjury as provided by law. S Datei PLEASE DRAW AN ACCURATE MAP TO YOUR PROPERTY!! 3 4/06254452 5tar Ge4 tc MTN STUCCO PAGE 01 gc x 3 9 —adz -9 6eASs /Ass/ 0 0 I ------ y95 <Pt G93 c WELL / 0 0 Thrm No. GWS-1l 8/2007 STATE OF COLORADO OFFICE OF THE STATE ENGINEER 818 Centennial Bldg., 1313 Sherman St., Denver, CO 80203 Phone — Info: (303) 866-3587 Maki: (303) 866-3581 Fax: (303) 866-3589 http://www.water.state.co.us For Office Use Only RECEIVED NOV. 5 2008 WATER RESOURCES STATE IN OWNERSHIP/ADDRESS CORRECTION OF THE WELL LOCATION Review instructions on the reverse side prior to completing the form. Name. address and phone of the person claiming ownership of the well: NAME(S): Mailing Address: City, St. Zip:--R1 Phone die l6R�1 '" Malt ax et 130cuk-� U14315 G /-a_S..S iiie<5a_ R©a_ a ... CO I &40 l28 )(2.5 -_6 !iv This form is filed by the named individual/entity claiming that they are the owner of the well permitted as referenced above. This filing is made pursuant to C,R.S. 37-90-143. WELL LOCATION: Well Permit Number: d-a7 1 09 Receipt Number: County C Ar f /r✓ic4 Well Name or # (optional) (Address) (City) (State) (Zip) 1/4 of the, 1/4, Sec. Twp. 0 N. or 0 S., Range _ 0 E. or 0 W., P.M. _ _ Distance from Section Lines: Ft. From 0 N. or 0 S., Ft. From 0 E. or 0 W. Line. Filing/Unit Subdivision Name Onea 55 n'1C 6&.Ra11CA Lot 51 , Block_ The above listed owner(s) say(s) that he, she (they) own the well described herein. The existing record is being amended for thefollowingreasons: g(Change in name of owner 0 Change in mailing address 0 Correction of location for exempt wells permitted prior to May 8,1972 and non-exempt wells permitted before May 17, 1965. Please see the reverse side for further information regarding correction of the well location. I (we) claim and say thatI (we) (are) the owne (s) of the well described above, know the contents of the statements made herein, and state that they are true to my (our_knowledge. Si ure(s) j% • • the ne own Pleaset the Signer me & Title 6-(11'' y wfrrtOWvYCr Marc`are[ Wker owner Date 11-i-07 II -I -og y It is thelsponsibility of the new owner of this well to cdmplete and sign the f m. Signatures of agents are acceptable if an original letter of agency signed by the owner is attached to the form upon its receipt. For Office Use Only pCCE RMAtI NG s3 R�SSO eSNtP pNDIO / lifrtnite e Engineer By Date GWS -31 tie / WELL CONSTRUCTION AND TEST REPORT STATE OF COLORADO, OFFICE OF THE STATE ENGINEER For gree u4 -e only 04,63 V l `' RECEIVED JUL 2 9 2000 WArFanc OU.4L SrAtE LtNnINEf.A 9.227/05 1. WELL i' ' 227/09 PERMIT NUMBER - u 2. OWNER Mailing C]ty, Phone NAME(S) p_i`n_r. -pvrJC Address 23 6 r ,ciA 51-, St. ZIP P.', {•"t t, C',.n , W 14-xiS (9,o) 4.73-- • «5�,2. 3. WELL LOCATION AS DRILLED: Saki 1 /4/1 1.41.421/4, Sec, CtRat c , Range -f ,7 a 6.v,•. Twp. S 7 DISTANCES FROM SEC. LINES: ft from line, and ft. from Sec, line. OR FILING(UNfT) SUBDIVISION: STREET viol tit or ouriSec, \ .; rc 5 5 Y� 54- (LOT$' noirowl of rSLOCK ADDRESS AT WELL LOCATION: 4 GROUND DATE SURFACE ELEVATION ft. DRIWN TOTAL DEP] ,,,METHOD A t r r'Co i J COMPLETED j -.5 - ori. ]i 500 ft DEPTH COMPLETED 00 0 k. 5. GEOLOGIC LOG: Depth Deecriptlon of M nal (type, Sim Color Water Location) 0 - ,s` f%$cJ * CL'rc•.r Ke„ elNr♦ 6. HOLE DIAM. (in.) From (ft) To (k) PO 4 a 0 7» " ro.2 3c) c• z1-- 2Hn ',11r, Iz --iit.•a .0'If7 - Alio (") CA .....1 r c se..... -- .. -.a 7. PLAIN CASING OD (in) Kind Wall Size From(k) To(ft) 4 4 -s)% l ire ,-->+1 3 - a4 0 - 3 O 0 f' /ci,,r` % er-/7 ,.-.-.' •T OJC yp it 30v PERF, CASING: Screen Slot r Ptuc tro Size: 4-e 5 /o t' - anc 600 8. FILTER PACK: Material 9. PACKER Type Depth PLACEMENT: Size Interval 10. GROUTING RECORD: Material Amount Density Interval Placement Cie tri •-2_5:0_.* / / -.f - &/2 .i -•i f'' REMARKS: 11. DISINFECTION: Type �ui• , ;, c. Amt Used / 9g/ • 12. d�---IIe4j WELL. TEST DATA: IJ,Check box if Test Data Is submitted on Form No. GWS 39 Supplemental Well Test. 0,0 7- gpf». TESTING Static Pumping Remarks METHOD 4 , r Level /,?4 ft. Date/Time measured s -s,o 0 iZAIM , Production Rate level ? k, Date/Ttme measured 5.5--0. 3 , Test length (hrs) 3 ,aa, /pr., 13. CONTRACTOR Mailing I have C.R.S., read the statement. made herein and know the content* thereof, and thn they are true to my knowledge. (Pursuant the making of false statements herein conatdutee perjury in the eeoond degree and ie punishable es a claaa .17% -t Phone (pa) 9f>r;/9ur 1 misdemeanor.] - to Section 24-4-104 (13)(4-) Lic. No. / . Address - Nameffltle (Please ettype or print) Signature �JJ/y- / Date Form No. GWS -25 x r� APPLICANT OFFICE OF THE STATE ENGINEER COLORADO DIVISION OF WATER RESOURCES 818 Centennial Bldg., 1313 Sherman St., Denver, Colorado 80203 (303) 868-3581 PETE ROCK 4315 GRASS MESA ROAD RIFLE, CO 81850- (970) 625-4452 PERMIT TO CONSTRUCT A WELL 1259 WELL PERMIT NUMBER 227109 DIV. 5 WD45 DES. BASIN MD Lou 54 Block Filing: Su iv: GRASS MESA RANCIi APPROVED WELL LOCATION GARFIELD COUNTY SW 1/4 NW 1/4 Section 3 Township 7 S Range 93 W Sixth P.M. DISTANCES FROM SECTION LINE$ 2850 Ft. from South Section Line 4700 Ft. from East Section Line ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT CONDITIONS OF APPROVAL 1) Thls well shall be used in such a way as to cause no material injury to existing water rights. The issuance of this permit does not assure the applicant that no injury will occur to another vested water right or preclude another owner of a vested water right from seeking relief in a civil court action. 2) The construction of this well shall be in compliance with the Water Well Construction Rules 2 CCR 402-2, unless approval of a variance has been granted by the State Board of Examiners of Water Well Construction and Pump Installation Contractors in accordance with Rule 18. 3) Approved pursuant to CRS 37-92-602(3)(b)(II)(A) as the only well on a tract of land of 48.8 acres described as government lot 2 and the N 1/3, N 1/2, SW 1/4, Sec. 3, Twp. 7 South, Rng, 93 West, 8th P.M., further identified as lot 54 Grass Mesa Ranch, Garfield County, more particularly described on the attached exhibit A. 4) The use of ground water from this well is limited to fire protection, ordinary household purposes inside not more than three (3) single family dwellings, the irrigation of not more than one (1) acre of home gardens and lawns, and the watering of domestic animals. 5) The maximum pumping rate of this well shall not exceed 15 GPM. 6) The return flow from the use of this well must be through an Individual waste water disposal system of the non -evaporative type where the water is returned to the same stream system in which the well is located. 7) This well shall be constructed not more than 200 feet from the location specified on thls permit 8) Monitoring hole notice MH -37896, was acknowledged for construction of a monitoring and observation hole for this applicant, in this 1/4, 1/4, on 02/042000. 9) This permit has been approved for the location noted above. Per phone conversation with the applicant, the original proposed location was for a different property and was in error, see attached deed for correct porperty. Additionally the original footage distances were from the property lines not the section lines and were also amended. You are hereby notified that you have the right to appeal the Issuance of this permit, by filing a written request with this office within sixty (60) days of the date of issuance, pursuant to the State Administrative Procedures Act. (See Section 24-4-104 through 106, C.R.S.) %"-- 1� NOTE: Expired permit 192817, was previously issued for this lot. NOTE: Parcel Identification Number (PIN): 23-2403-032-00-049 7,-----7632CIO 'd NOTE: Assessor Tax Schedule Number. 247215 NOTE: Section 3 is an irregular"SHORT section APPROVED DMW ,Receipt No.9500100 tate Engineer DATE ISSUE6 18 2000 ByEXPIRATION DATE.JtIt 18 2002, Permit Application Chanze Form To be used when issuing well permits based upon information other than as received. P��. ;4. final Permit Mcei t No. 2. 2 7 / d'7 Name of Applicant /R ©c k ,fie' RECEIVED JUL 21 2000 pri.744.414 CAO colo Summary of change(s): ©C414.F c—t.l� C4 s • et„ ,vvt -t o L L �' f Co, n c• (—' (d c . - - •D Z 6 S'o r-ctA ,fro.. t- SOefrlf CL�o� e.p700, ,Fe c fra.yY&IL4- Jwsr' jto#. — /,;its S N ivy St 3 r4.-,47 7 Sowt4/ R "y 9 3 t .s f / 6 '` !°. r� , TX • r t—er s ,oh one_ 7t -4c- 05.10/ t_ et et. dL t(c- ,p -4 -di ,t¢,rcof C.i'“b..- ) 6y tic a 44,67l.' c.a f Tit- Atal •7 /o � � � o `. r7rJI.c1 6y tit- ape, !ra s fig •G Pro,2,sect fa) /.1C� Pc k ce t` eke. 4of 2 I' -ass "cit. C O I`I`c— c— zt /r7// `376'9$ /1/12r /�7N" ^-3sr" 7V/. -63 Date 7// 200.0 Signed i+.. 9t.'' .4-o Print Name 41w -J 4 L A 4'Ct,i�c�t,n/t r COLORADO DIVISION OF WATER RESOURCES DEPARTMENT OF NATURAL RESOURCES 1313 SHERMAN ST., RM. 818, DENVER CO 80203 phone - info: (303) 886-3587 main: (303) 866-3581 NEW 35+ ACRE RESIDENTIAL RECEIVED RECEIVED aul 21 2000 a 5'Il0 tl sew 't RI R +Iter WeII Perfmtitt*Pj tion Must be compte£3df 4nk or typed r DV 1e1Y Nmw VV„Vuo p„v, ,v Wu, p,p...y .v.... 1. APPLICANT INFORMATION 6. USE OF WELL. (check appropriate entry or entries) e of applicant /. �C�l�. Ordinary household purposes in up to 3 'Asingle-family dwellings, the watering of animals, and the Irrigation of not more than one (1) acre of home gardens and (awns 0 B. Livestock watering (en famVranohnange/pasture) Mailing Addressdomestic c/3 /5 C,n��5 SA �P C�,I�j /C I FC. Slatei 0 6 o s /Jelephpneumbar (include area code)) `5%©%s— c/ (7/57 7. WELL DATA MAXIMUM PRODUCTION RATE OF THE WELL SHALL NOT EXCEED 15 GPM 2. TYPE OF APPLICATION CONSTRUCT A NEW WELL ON A TRACT OF LAND OF 35 ACRES OR MORE 8. TYPE OF RESIDENTIAL SEWAGE SYSTEM aseptic tank / absorption leach field 0 Central system Distad name: 3. REFER TO (If applicable): ma, - 3 76 e 7 ❑Vault Lnceuon sewage to be hewed o Monitoring Pole acknmwade tl SCL 3 OE/( MH- r-- 7Soat4 ,40 A"1 93 Wnn .■ Other (mach copy or engineednpdealon) 4. LOCATION OF WELL 5W N"/ County (� CjARF/CAL-d Quarter/quarter 1/4 Quarter 1/4 9. PROPOSED WELL DRILLER (optional) Name - On/ / ,•NC bCi 2-Z./MG License number / 75, Section Township N.ot 6 %72P. ----T ei 4 Range EorW 513 ❑ ® Principe' Odom 10. SIGNATURE of applicant(s) or authorized agent ' 2 er� Distance of wallirom aeclbn unci jr:3, 11. from I:! t76S n.!I The making of false statements herein constitutes perjury in the second degree, which is punishable as a class 1 mis- demeanor pursuant to C.R.S. 244.104(13)(a). I have read the statements herein, know the contents thereof and state that they are true to my knowledge. WeII location address, .Ifere }. Oilcan' addreea Of CPO .5. TRACT ON WHICH WELL WILL BE LOCATED Muelbe • foal eignalure A. ATTACH LEGAL DESCRIPTION FOR 35+ ARE TRACT 0 Development Name Tie pUjA C fC Data 7/540 oKjeiti�M ryfr Ae Az7ioq oCec4.>" tt 9COO# I" DWR Map No. `oce-X- -, ti ©�,o,/✓ IG / / , >424e -kg- ". t.. y j..� /e fir 7 ,0 a,/ /he ".•... e o nrset 14'o'. � �T''°' L,otuf'm'- :s Gc/ te- rV ,S"` DN Lot no. Unit # r�j ,t [.o>< -S -`le 6/Uri;/UV eztc k Z Other Ak COPY 0r LEGAL Z Sc i a Int it et: et M tirc.c,[- take MB PPI 8. STATE PARCEL ID# oolong! M Pf - 3 7 datilhote/thatf CO .z. m /Y"'- 95 34 � -C C. #ecrosIntract qg,K e p prwt 23 - R(ArtkWPuRh?j�e- etP1F7 WD T/ rayir; z(re 7zi o�,., D. THIS WILL BE THE ONLY WELL ON THIS TRACT Ft ''t ( BA H O 1"7ld. 4 ern,/ r,,', ,. `',7° f USE MD ”.0 �4tF* /9z8/7(E;" — ' P 01/17/2000 1030 97B5254452 j.1,iiiuiuiNmir m��p 1 e/ 2 R 5.00 D 0.00 owl= CagTT C0 d3VITC1AIM 0650 TEM fttq mods ma 23rd Wire Pater 3. Rock 6 Joy 14, Rock alM %Wore Carfl. id .naahha dyne Juno MTN STUCCO PAFE 61 RECEIVED 21 2000 1T 2000. rda,m ex%end Pater 3. Rock L'1 w f .hallagrderuwa 4315 Waco Meas Rd., Rifir, Cu, 61650 Of, C&,.trof Garfield KOPerortlbrleeeem0 WltNtea,tewekp.zIo,( Was4 ie, tn.hmliwonemmorTen D011ere a Other oalueplt Conelderetioua barn the sweated larcener afwhia a Metz Rbtiete ,h..e mart nbsd. fad wd tjNRlelMfta w,d by Oen pwerodotB ,MdardMMwe.MOVTTCLA7T4 onto aeWdeetl). heln.ae'sahleea"V"Rreer,tR OcOOd. ekjnerertcWm wd dcwdeMMlde nmv(a1Me Inudpdee Rel Dmoretedetwwwilmpme neea.tr..y, ,mew,Mynat hdo ['PAW Garfield eM0laeatblwade dew,jbtd u b lett Let 2 .nd the M 1/3 R 1/2 0H 2/4 of Section 3, Tu.nehip l Bouch, Hear 93 Vast of the 6th Principal Tlefldfane County of (Arnold, Rtato of Colorado fl": z g -.2340.2 - on- ©o - ©s4 9 ra -Y : z. $ 7 2 -d -s .M Aurae by alta sed eumbv w . rile nNteama pemasa: h TV HAVE AHDTOHOLDthe Hme,theaAer MIA mit uM a,aalw nevaatameto ewe pe eler Neese Mane%M la ',wean Hiatt* arpataMne and all the ate, dabs, One haute eM thea lesopomne,d ea pte•euh Maar in tew .e nutty. to e. roe promo. bereft and teed and create) Mtn And mean Ree{a. 04 WI1N093WHRRW0 Hhpa.w(0ke tamed eat eked oadadaeea tents/we aMtalovcOcee Get Cdnaya Garfield � .YaejppfJlpalenawauaatoackkked baae mt due 23td .'OTZy '.< el:/kDek & Joy M. Reck r r.,:,l aao..wr.'s+Took. do of Jun. WkNu as herd end Adams, N1 neeniSi.. "pine '7 -a -i• xacr /• .fl 2000 'iJ-),y U–, T—_ veva,lab Igo &pd, ,a.• IQ,re/r 431 ea SfIso Eli RF Gchrr.,f;. 'ATE Etc,M.rn C42,0 Narai IM.A.fe. mnynkocmwo embed Molar%. I,411kmI tiontrAVIM0i•-tlelXrtr.11m—sae 1• • 07/06/2000 14:33 9706254452 02-04-00 00:4SAM. ROW -DIVISION OF PATER RESOURCES MTN STUCCO 3CRSS*1213 PAGE 02 T -IU P.01/0I F -TPI dwe•n NOTICE Of INTENT TO CONSTRUCT MONITORING HOLI(Sf ECEIVED Preece type a Pr=R *IOW In black Ink JUL 21 2000 FEB ' %7tie 41117t Wan O*tier'e Name Landowner! Nome ed leaf DAM MOMS pep'ePet Cantsos CameMY Addrase City, State, DrlRer tld. No. Of 1001110 Ant No. 131F Fl RESGli1(.ES ,lAiE I, OUEEP, COLO Looatlenr SOUS, AAA, lNattan�, .. TownwiNpcL. County SubdivkAon Ieleltl to be connutted: Nimbst A letllnalsd paetjlh o G p.. A4 ' T s-1' A Panes of McNtedng WW1 1 Asccooirnete We Of Cane rube" ACKNOWLEDGENON( STATE ENGINEER'S OFFICE Pall Onset Utn ONLY PROPUND Pt MN• DAT! ACKNowil0110 GROUND MN ---- USG S MAR x Div, 5 CNTY — �-= t#A1 �• Mo�� CONDITIONS OP MONITORING HOLE ACKNOWLEDGEMENT A COR' OF TIE WRITTEN NOYltI 011 Acstgren,0102MINT MALL bot,tvw1ut AT TM 01162aN0 SMI. consnuedon of the WOW moot be sontined wnt in 10 doe et tM dale Wake wan two to the Ikea !n r*1V, Tndno .nd/W eurneUq eine Mt actedm wane wr . a tad of 200 hatow M appravel i etta d lam ttie tat► Pro'nesr. vim* swerved d ifl nods Mill 61L t Wee 1a b cvdte d ourcens TM ewn■r •1 tM heielel 1a ngensie* lit eMAlnlnt Dermato) ■nd erninvine with fe Moe end ree•,mlone DertIISndi a the diesMf e N MI6 preened eeRn1 tellnt, n. �e� .yam y����y �tyy j�p y��er�[syI{��� en 4102.7. MYlrmim eonnaUatbn mndatN .mot' be mer It +M 1n,n107rYR neM 1Nrn1R. NNI1R'II N�Ift flllfl1' IA1 MN a Mrls Nme en� eiinee must {N At A4 en eN v.I Perml1 mendenbd, vee ee itve') n eml ebdndanment repons. A minalrMM ha eon net be convened la a nvduaibn watet was Whet men a recovery vredl utwae chi Mie or well w■e moire eerlsauead W a Naehed wtl a oMbunSMr'ednvaotor. ride Acanov LWUW *4T OF Nona POA NOT MAT WELL Ptd vets) CAM 11 AP►IIOVMD. Adainei Ceedh)en■ cQLCMOO DIVISION OF WATT RESOD g• •1313 $KAMAN 10.410 221 03 303401.321 116•astt Form .: ` GWS-25 f r j APPLICANT Na OFFICE OF THE STATE COLORADO DIVISION 818 Centennial BIdg„ 1313 Sherman (303) 888.3581 • MICHAEL A & JACQUELINE $ DORITY 2501 GROVE LN CARY IL 60013- (847)639.3197 PERMIT TO CONSTRUCT A WELL ENGINEER RECEIVED OF WATER RESOURCES 2 1 2000 St, Denver, Colorado 80203 JUL WA IfNH SC)HCES LIC STATE Eui'LH C LCi WELL. PERMIT NUMBER 19281/ • DIV, 5 CNTY. 23 WD 45 DES. BASIN MD Lot: 54 Block: Filing: Subdly: GRASS MESA RANCH APPROVED WELL LOCATION GARFIELD COUNTY NW 1/4 SW 114 Section 3 Twp 7 S RANGE 93 W 8th P.M. DISTANCES FROM SECTION LINES 2600 Ft. from South Section Line 4100 Ft. from East Section Line ISSUANCE OF 1) This well shall be used in such a way permit does not assure the applicant owner of a vested water right from 2) The construction of this well shall approval of a variance has been granted Installation Contractors In accordance 3) Approved pursuant to CRS 37-92.602(3)(b)(li)(A) lot 54, Grass Mesa Ranch division 4) The use of ground water from this single family dwellings, the irrigation of domestic animals. 5) The maximum pumping rate shall 6) The mtum flow from the use of the non-evaporative type where the water 7) This well shall be constructed not THIS PERMIT DOES NOT CONFER A WATER RIGHT CONDITIONS OF APPROVAL as to cause no material injury to existing water rights. The Issuance of the that no injury will occur to another vested water right or preclude another seeking relief in a civil court action. be in compliance with the Water Well Construction Rules 2 CCR 402-2, unless by the State Board of Examiners of Water Well Construction and Pump with Rule 18. as the only well on a tract of land of 50.92 acres described as of land, Garfield County, well is limited to fire protection, ordinary household purposes inside three (3) of not more than one (1) acre of home gardens and lawns, and the watering not exceed 15 GPM. well must be through an individual waste water disposal system of the Is resumed to the same stream system in which the well is located more than 200 feet from the location specified on this permit, DIVISION Onr, iV APPROVED /� d T f��� r w .� Siete Nine,'Receipt No. 0395229 DATE ISSUED FEB 0 9 1996 EXPIRATION DATE FEB 0 9 1998 INSTRUCTIONS CONTINUED - RESIDENTIAL & LIVESTOCK APPLICATIONS (GWS -44) PAGE1 • COLORADO DIVISION OF WATER RESOURCES GWS-501NST (12/95) DEPARTMENT OF NATURAL RESOURCES NEW 35+ ACRE RESIDENTIAL - GENERAL INSTRUCTIONS There are a variety of uses for ground water In Colorado. This form (GWS -50) is to be used only when applying for a new well that will be used for household use in up to three single family residences, watering of up to one acre of home garden and lawn, and watering of the owners domestic animals (this is sometimes referred to as "domestic" use), and/or for the watering of livestock on a farm, ranch, range, or pasture. This form is to be used only if the well will be the only well on a tract of land of 35 acres or more. This fore should eat be used for the following situations: HOUSEHOLD USE ONLY - use RESIDENTIAL form GWS -49 REPLACEMENT of a residential or livestock well - use RESIDENTIAL form GWS -49 FEE This Application must be submitted with the required $60 non-refundable filing fee. Checks should be payable to the COLORADO DIVISION OF WATER RESOURCES. Applications are evaluated In chronological order. Please allow approximately six weeks for processing. APPLICATIONS must be completed dearly, and legibly in BLACK INK or typed. ALL ITEMS in the application must be completed. Incomplete applications rrey be returned to the applicant for more information. THE LOCATION of the well in item 4 must be correctly and accurately described. The county, quarter/quarter, section, township, range, principal meridian, and distance from section lines must be provided. NOTE: Distances are not necessarily the same distances as the distances from (your) property lines. Far additional assistance in describing the location of your well review the instruction sheet entitled 'How To Deterttlne A Well Location" which can be requested from any Colorado Division of Water Resources Office. A LEGAL DESCRIPTION, survey, or cdpy of a map showing your lot or parcel of land is required. This description m11,as be legible, and must Include a tie to a section line or comer. If you are unsure of what USE to request, the instruction sheet enetted 'Qualifying For A Well Pamit", may be of assistance in determining the maximum use for which you may qualify. This can be requested from any Colorado Division of Water Resources office. In Colorado the primary criteria for evaluation of availability of permits for residential and livestock water well use is based on injury to other water rights. There are specific exclusions to the injury determination that are based on the tract on which the well is to be located, For applications other than new construction the criteria for evaluatlon may be based on additional factors such as historic use, previously permitted use, or decreed use. An ORIGINAL signature must be on each application. The applicant's authorized agent may sign the application, if a letter signed by the aoolicant is submitted with the application authorizing the individual signing the application to act as agent for the purpose of obtaining a well permit. DETAILED INSTRUCTIONS ARE AVAILABLE UPON REQUEST IF YOU HAVE ANY QUESTIONS regarding any item on the application form, please call the Division of Water Resources Ground Water Information Desk (303-8663587), or the nearest Division of Water Resource Field Office located in Greeley (970.3524712), Pueblo (719-542.3368), Alarrlosa (119-689-6683), Montrose (970-249-6622), Glenwood Springs (970-945-5665), Steamboat Springs (970-879-0272), or Durango (970-247-1845). COLORADO DIVISION OF WATER RESOURCES, 1313 SHERMAN STREET, ROOM 821, DENVER, CO 80203 PHONE 303-866-3557 (Informatlen), 30348a-3581 (Male). 303-806.3447 (Well 8 Water Rights Recede), 303.663560 (Fax) Form No. GWS -25 APPLICANT OFFICE OF THE STATE ENGINEER COLORADO DIVISION OF WATER RESOURCES 818 Centennial Bldg., 1313 Sherman St., Denver, Colorado 80203 (303) 886.3581 PETE ROCK 4315 GRASS MESA ROAD RIFLE, CO 81650- (970) 625-4452 PERMIT TO CONSTRUCT A WELL 1259: WELL PERMIT NUMBER 227109 DIV. 5 WD45 DES. BASIN MD Lot: 54 Slack Filing: Subdiv: GRASS MESA RANCH APPROVED WELL LOCATION GARFIELD COUNTY SW 114 NW 1/4 Section 3 Township 7 S Range 93 W Sixth P.M. DISTANCES FROM SECTION LINES 2850 Ft. from South Section Line 4700 Ft. from East Section Line ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT CONDITIONS OF APPROVAL 1) This well shall be used in such a way as to cause no materiel injury to existing water rights. The issuance of this permit does not assure the applicant that no injury will occur to another vested water right or preclude another owner of a vested water right from seeking relief In a civil court action. 2) The construction of this well shall be in compliance with the Water Well Construction Rules 2 CCR 402-2, unless approval of a variance has been granted by the State Board of Examiners of Water Well Construction and Pump Installation Contractors in accordance with Rule 18. 3) Approved pursuant to CRS 37.92-602(3)(b)(II)(A) as the only well on a tract of land of 48.8 acres described as government lot 2 and the N 1/3, N 1/2, SW 114, Sec. 3, Twp. 7 South, Rng. 93 West, 6th P.M., further identified as lot 54 Grass Mesa Ranch, Garfield County, more particularly described on the attached exhibit A. 4) The use of ground water from this well is limited to fire protection, ordinary household purposes Inside not more than three (3) single family dwellings, the irrigation of not more than one (1) acre of home gardens and lawns, and the watering of domestic animals. 5) The maximum pumping rate of this well shall not exceed 15 GPM. 6) The return flow from the use of this well must be through an Individual waste water disposal system of the non -evaporative type where the water Is returned to the same stream system in which the well Is located. 7) This well shall be constructed not more than 200 feet from the location.,ppecified on this permit, 8) Monitoring hole notes MH -37690, was aoknowiedgod for Qonstruction 5f a monitoring and observation hole for this applicant, in this 1/4,1/4, On 02/04/2000. , 9) This permit has been approved for the location noted above. Per phone conversation with the applicant, the original proposed location was for a different property and was in error, see attached deed for correct property. Additionally the original footage distances were from the property lines not the section lines and were also amended, You are hereby notified that you have the right to appeal the issuance of this permit, by filing a written request with this office within sixty (60) days of the date of issuance, pursuant to the State Administrative Procedures Act. (See Section 24-4-104 through 106, C.R.S.) NOTE: Expired permit 192817, was previously issued for this lot a. - NOTE: Parcel Identification Number (PIN): 23-2403-032-00-049 %j/£iGr0 d NOTE: Assessor Tor Schedule Number. 247215 NOTE: Section 3 is an irregular "SHORT' section APPROVED DMW o State Engineer (1 L 1 p D060 JS ceipt No.9500100 DATE ISSUE 1 0 LUUI! A 2,, _ .2-- t` r ByEXPIRATiON DAT III i 8 �2 Account R247226 Year District 2009 024 Cancel STR Owner Name/Address ENCANA OIL & GAS (USA) INC. N C!0 K.E. ANDREWS & COMPANY 3615 S. HURON STREET, SUITE 200 ENGLEWOOD CO 80110 Apr Dist GREG Parcel Number 2177-334-00-380 St IA MH Space (SECT,TWN,RNG:33-6.93 DESC: SEC 33 SESE AKA LOT 45 GRASS MESA RANCH. PRE:R247185 ANDITHRU:& TO:R247187 I; PRE:R247195 BK:0643 PG:0348 BK:1522 PG:832 RECPT:637310' BK:1424 PG:622 RECPT:618225 BK:1352 PG:962 RECPT:602916 BK:1270 PG:517 RECPT:584794 BK:0973 PG:0769 (Business Name Acct Type #0 Name +ar Situs u Mobile k Tax Items pratesI) �1 CAM(Al Pre/Suc ❑ M(o)bile Autt❑ P(e)rmit ,{'re'1 Remrks N*s aValue 10 (P)ersonal 4a 41u;..t❑ n.._.�amms. ct ❑ Tax (S)ale State Asd {❑ Oil and Gael - Condoms Spc Asmt �Control Recor(d)ingti Biock 0 yM i net ji History y�,RC ❑ Sales Fi.0 PPCert(L)tr Misc (M)) - F.lags fl ExemPwcen_ptio Mail (F , ❑ Tax (C)h -1 Mtq Track) TYPE VACANT LAND fiq ;fs;aEPS NeYJVPto, 00908110Q ACTUAL { ASSD ACRES { SQ FT 170,000 49,300' 40.2001 Imaging W TOTA P(h)oto iD Sketch 70,0001 49,300; 40.2001 I El Queries ACCOUNT (G)IS Map (V)alue Sum Current Year Prior (Y)ear (N)ext Year Update Prior VersionQ Tax Trx Ne(x)t Version Characteristics Abatement Property Card , Clear Account R247201 Year District 2009 024 Apr Dist GREG ❑ Cancel STR Owner Name/Address nKELLY, GARY L & STOKVIS, BONNIE L 50% N HUTTON, WILLIAM E & JANET L 50% 4371 GRASS MESA RD RIFLE CO 81650 St A Parcel Number 2403-033-00-044 Street No 004361 MH Space Location City RIFLE BACode Owner Id Business Name Location Zip 81650 Seq No# Lag L p ❑ AFIC SECT,TWN,RNG:3-7-93 DESC: S213N2SW AKA LOT 55 GRASS MESA RANCH. AKA LOT 55 4071 GRASS MESA ROAD WILLIAM HUTTON ACCESSORY DWELLING UNIT PRE:R247110 BK:0634 PG:0348 BK:1522 PG:832 RECPT:637310 BK:1352 PG:962 RECPT:602916 BK:1196 PG:727 RECPT:899062 BK:1186, PG:391 RECPT:563187 BK:1124 PG:206 RECPT:543758 BK:0966 PG.0974 Owner Location Map No ❑ Tax Items Q Protes( j CAMJAj Pre/Suc ❑ M(o)bile Autt❑ P(e)rmit Mobile ❑' Remarks ❑ Value (P)ersonal }}❑ Tract a*.rv'�*:v�❑ Tax (S ale ❑ State Asd L - Oil and Ga . n;�s,.ra+�'t+:,�,tt= ...v:5��.ian.�amu. ACTUA RESIDENTIAL I ASSD j ACRES SQ 747,850} 59,520153.2501 '❑ Condo ))❑ SpcAsmt ❑ Control {❑ Recor(d)m ❑ Block L M(i)nes ❑ Histo Si(b)ling ❑ PPCert(L)tr Sales ❑ Misc (M)'J Flags s. eptioi 11 Mad fF) ❑ Tax (C)het ' Mtq Trac (G)IS Map (V)alue Sum I , I TOTAL 747,050 59,5201 53.250j Queries ACCOUNT Current Year Prior (Y)ear (N)ext Year Update Prior VersionQ Ne(x)t Version Characteristics Clear Abatement Property Card ❑ Cancel STR Owner Name/Address Account R247198 CHARTIER, ANDRE P. & CHERYL A. f=, District 2009 024 Apr Dist GREG 4300 GRASS MESA RD RIFLE CO 81650-8440 'SECT ,TWN,RNG:4-7-93 DESC: SEC 4: E2E2, LOT 1, E2E2SE lIAKA LOT 53 GRASS MESA RANCH. PRE:R247110 BK:0634 PG:0348 BK:1522 PG:832 RECPT:637310 BK:1352 PG:962 RECPT:602916 BK:1307 PG:668 RECPT:592762 BK:0962 PG:0816 Parcel Number 2403-041-00-041 Street No Dir 004300 Location City RIFLE BACode Street Name GRASS MESA 9 Location Zip —81650 Owner Id Business Name f� Name na Situs ❑Mobile ;II Tract 4❑ Condo Block Sales isc (M)� it (F) IMH Space ISeq Acct Type Tax Itemsl I Protes( a J CAM(9J PrelSuc 0 M(o)bile AutEL; P(e)rmit i ersona ACTUAL I ASSD ; ACRES SQ FT RESIDENT 364,420 29,0001 46.0801 Remarks Value ❑ (P) I ❑ State Astl❑ Oil and Ga Tax (S)ale v Spc Asmt ❑ Control R or(d)in es.+a,n�.,ucs-,.,--o-n ses -ty ^S .-`,••amzv:- wm. TOTAL Mines ❑ History` Si(b)ling ❑ PPCert(L)tr P(h)oto Lt C Tax(C)h( MtgTra 364,420] c(k Flags � 0 ExemptiokiLJ Sketch (G)IS Map (V)alue Sum 29,0001 46.080 Queries ACCOUNT Current Year Prior (Y)ear (N)ext Year Update Prior VersionQ Ne(x)t Version Characteristics Tax Trx Abatement Property Card Clear ❑ Cancel STR Owner Name/Address ARC Account KCS REVOCABLE LIVING TRUST DTD 10123106 R247233 N Year District 20091024 Apr Dist GREG A 919 SAMOY STREET LAS VEGAS NV 89110 Parcel Number 2177-343-00-387 MH Space ISeq Street No 003711 Dir Street Name GRASS MESA Type RD L LeYS o SECT,TWN,RNG:34-6-93 DESC: SEC 34SWSW AKA LOT44 (GRASS MESA RANCH. DESC: ALSO A TR OF LAND CONT .212 QAC PER BLA PRE:R247185 ANDJTHRU:B TO:R247187 PRE:R247195 BK:0643 PG:0348 RECPT:767511 RECPT:734671 BK:1913 PG:0587 RECPT:721104 BK:1913 PG:0583 RECPT:721103 RECPT:717668 RECPT:717668 BK:1886 PG:648 RECPT:715706 BK:1877 PG:0214 RECPT:713769 BK:1736 PG:159 RECPT:684435 BK:1732 PG:608 RECPT:683589 BK:1732. PG:607 RECPT•683588 BK:1729 PG:249 RECPT:682946 BK:1729 No#PG:247 RECPT:682945 BK:1718 PG:748 RECPT:680625 BK:1522 IPG:832 RECPT:637310 BK:1356 PG:664 RECPT:603807 BK:1352 PQ -4R9 RFCPT•R0741R RK•1175 Pr -1•A13 RFCPT•SRn17d RK•1165 Location City RIFLE BACode 9 Location Zip 81650 Owner Id (Owner Location Acct Type Map No Lag Business Name Name Situs Tax Items Protes(I'Sx CAM�A� Pre/Suc ❑ M(o)bile AuttE P(e)rmit 11 obi Remarks ❑ Value -moi❑ (P)ersonal s Iract s❑ Tax (S)alee 0 State Asd L Oil and Gas le ❑ Condo Asmt ❑ Control ❑ Recor(d)ing TOTAL ❑ Block1 nes L j History si�.©magmg zooaraog4E , TYPE VACANT LAND Pi (!� ACTUAL ASSD NACRES I 170,000; 49,3001 40.5021 Yersim 09081 D01 SQ FT Sales Misc ❑ Flags Tax (C)hc." (G)IS Map (V)alue Sum PPCert(L)tr t❑ P(h)oto I" Queries �; Sketch `^," (ACCOUNT Exemptiox Mt4 'Rac(k) 170,0001 49,300 40.5021 Current Year Prior VersionQ Prior (Y)ear Ne(x)t Version (N)ext Year Characteristics Tax Trx Abatement Property Card .10 Update Clear Exit Account R247221 Cancel STR Owner Name/Address HOLZER, HANS ULRICH ❑ AFIG District 024 PO BOX 11928 ASPEN CO 81612-9388 Apr Dist GREG SECT,TWN,RNG:34-6-93 DESC: SEC 34 S1/2SESW, S1/2SWSE 1 AKA LOT 43 GRASS MESA RANCH. PRE:R247185 g AND/THRU:8. TO:R247187 PRE:R247195 BK:0643 PG:0348 BK:1522 PG:832 RECPT:637310 BK:1352 PG:962 RECPT:602916j BK:0982 PG:0959 Parcel Number 2177.343.00475 Location City RIFLE BACode 9 Location Zip 81650 Owner Id Business Name ❑ Tax Items ❑ Protes(I t❑j CAM{A). Situs PE Pre/Suc ❑ M(o)bile AutD P(e)rmit ❑_Mobile ❑ Remarks ❑ Value i❑ (P)ersonai; ❑ Iract 0 eTax (S)ale ❑ State Asd 1LJ Oil and Gash �r❑ Condo i Spc Asmt ❑ Control ❑ Recor(d)ing? Imaging W ❑ P(hoto A, ❑ Sketch ACTUAL I ASSD ion Block ❑ Sales Misc (M) Ji Mail IF rars�v.�,.nah�xi Ones nes Si(b)Im9t❑ PPCert(L)tr lags <.Y4a1❑ Exemptio Tax (C)huhLMt4,Tra (k, (G)IS Map (V)alue Sum VACANT LAND 190,000 ACRES SQ FT 55,1001 40.3301 TOTAL 90,000 55,1001 40.330 ACCOUNT Current Year Prior VersionQ Prior (Y)ear Ne(x)t Version (N)ext Year Characteristics Update Clear Tax Trx Abatemen Property Card Li Cancel STR 46'4." "101mill Owner Name/Address Account BENZEL LAND LLLP R247156 980 E SADDLEHORN ROAD Year 1 District SEDONA AZ 86351 2009 024 512000 [li AFIC eacri 1`.;: SECT,TWN,RNG:36-6-93 DESC: SEC 25 W2, SEC 26 S2NE, SE, SEC 35 E2, SEC 36 ALL DESC: 7-93 SEC 1 LOTS 1 (24AC), LOT 2 (24AC), 82. DESC: SEC 2 LOT 1 (23.65AC), E2SE. SEVERED MINERALS: 8024-307-07-000, 8024-310-07-000, 8024-308-07-000, 8024-306-07-000 PRE:R024516 AND/THRU:& TO:R024517 BK:0765 PG:0314 RECPT:739040 RECPT:739039 RECPT:739038 RECPT:738626 RECPT:738625 RECPT:738624 RECPT:730699 BK:1877 PG:222 RECPT:713773 BK:1791 PG:777 RECPT:696378 BK:1769 PG:982 RECPT:691798 BK:1736 PG:205 RECPT:684451 BK:1666 PG:195 RECPT:669342 BK:1661 PG:356 RECPT:668311 BK:1658 PG:470 RECPT:667609 BK:1651 PG:729 RECPT:666072 RK.1 A51 P61-777 RFC.PT.RAM71 RK•16t1R PG -Ma RFCPT•RMRS7 Owner Location Map No 1 yerelo Business Name Saar .:,29,4,19aLLIMtilliCaNt..„1 situs @El Pre/Suc M(o)bile Au0E1 P(e)rmit Mobile 1111 Remarks LI1 Value (P)ersonal :41 Tract pri Tax (S)ale Ej State Asd 1091]and Gas, Condo Spc Amt Control Recor(d)ingQ; 20 90 00,:v>' TYPE AGRICULTURAL L At AO ACTUAL 22,490 lock History to - gr] Sales4E1 Si(b)Iing [1 PPCertiLtr P1 misc(i)LIFIags Li Exemptiot [1 Mail („Fil- 1 TaxiC)hiv, Mtq TraclkILTrAT Imaging W tatTAMPE epearkow< Sagt-P4V Sketch $ ACCOUNT ASSD 6,520 versipte 90, ACRES SQFT 1,991.650 22,4901 I1N* Queries (G)IS Map (V)alue Sum 6,520J 1,991.650 Current Year Prior (Y)ear Prior VersionQ Ne(x)t Version Abatement (N)ext Year Characteristics Property Card Clear Exit