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HomeMy WebLinkAbout1.12 WaterWEST DMDE WATER CONSERVANCY DISTRICT 818 Taughenbaugh Blvd., Suite 101 P.O. Box 1478 Rifle, Colorado 81650-1478 Tel: (970) 625-5461 Web: w ..wdwcd.org Email: water@wdwcd.org November 30, 2015 Jeffrey W. Sabo 5889 County Road 109 Carbondale, CO 81623 Dear Jeff: Enclosed is approved amended contract #990113BHW#A(c), amending the contract to include commercial use. You should now contact the Colorado Division of Water Resources in Glenwood Springs to update permit #051463-F. Sincerely yours, WEST DIVIDE WATER CONSERVANCY DISTRICT 'Janet Maddock Enclosure cc Division No. 5 Water Resources w/enclosure Wilson Water Group w/enclosure Directors: Samuel B. Potter Kelly Couey Robert J. Zanella Bruce E. Wampler Dan R. Harrison APPLICATION TOAME.AD WATER LEASE ct C� Ct 1 j Q N W Arlt I� Cci WEST DIVIDE WATER CONSERVANCY DISTRICT 818 Taughenbaugh Blvd. #101, P. O. Box 1478. Rifle, Colorado 81650 I. APPI Name: Mailing Email: 2. COURT CASE its: Decree Case No. Augmentation Plan Case No. 3. USE OF WATER RESIDENTIAL Number of main residences: Z No. ADU's Subdivision: No. constructed units: No. vacant lots._ Home garden/lawn irrigation of 17-i COC total sq. ft. Method of irrigation: flood_ sprinkler ✓ other_ Non-commercial animal watering of animals Fire Protection ,- Evaporation: Evaporation: Maximum water surface to be exposed: Description of any use, other than evaporation, and method of diversion, rate of diversion, and annual amount of diversion of any water withdrawn from the pond: ff'ell Slearing Agreearen! for multiple owner wells uurst be submined If greater than trvo owners, application roust be nuide ander a how"witers association. COMMERCIAL Number of units: Total sq. ft. of commercial units:1, Description of use: 0 -Hied, 1--ge'4rl —:iO= -;I"" r r INDUSTRIAL Description of use: Evaporation: Maximum water surface to be exposed: Description of any use, other than evaporation, and method of diversion, rate of diversion, and annual amount of diversion of any water withdrawn from the pond: DIRECT PUMPING Tributary: Location: 4. SOURCE OF WATER Structure: w6N Structure Name: 4srn1c�.� uv'1 1 t�L(I to Source: surface_ storage_ ground water Current Permit# (b S lale'3 -F (attach copy) Contract #990113BHW#A(c) Map #302 Date Activated 1/28/99 Date Amended 11/19/2015 Distance of well from section lines QDQ JIr torn S -- -_ In 5 Elevation: Well location address: Srskrl C_�lUa' (Attach additimml pages (or multiple slnrcMrs) 6. LAND ON WHICH WATER WILL BE USED (Legal description may be `provided as an atiaclunent.) J P e CZ'F VC Number of acres in tract: 9- , 12 Inclusion into the District, at Applicant's expense, may be required.. 7. TYPE OF SEWAGE SYSTEM Septic tank/absorption leach field ✓ Central System_ Other_ District name: 8. VOLUME OF LEASED WATER NEEDED IN ACRE FEET: Amended from ,)- of to _�:l of (minimum of I acre foot except augmentation from Alsbury Reservoir where a lesser amount is allowed) P menet Cd-kQ;, Provide engineering data to suppose volume of water requester, Commercial. municipal, and industrial users must provide diversion and Consumptive Attar on it monthly basis. A totalizing jlom meter with remote readout is required to be installed and usage reported to (Fest Divide. Applicant erpr•essly achnoudedges it has had the opportunity ro review the Distriel'sJorm Water Allotment Contract aunt agrees this application is mode pnrsuuut mal srsbject t the leans and Conditions Contained 1herX'r. i AppApp ci�l' o/a/ t Si ata Applicant Signature Application Date: 1 1 I Q I 1 5 DATE APPROVED: I/ Z `l % WEST DIVIDE W.A FER CONSERi ANCY9MTRIC Panted portions or this torn, except ditteremnated adadmns or deletions, have been approved and adopted by the West Divide Water clmwepyby District. Form: WDWCD 2009 AMEND APPLICATION � m � o m 0 — m � 2. c 3 � N o° m ^. e � 3c 0 o c o w J J (p C J O o 0 O� O j e y o N =a 000 00 O j O Oc Oc G O O j u 3 a 3 a n o 0000000000000 ym2 Ba < < v m v 3 W N v C o a + m - O O 0 N i N O O O (O N000 0 0 0 0 0 0 0 0 0 T C C m m e3 3m F. m n 0 01000000000o000D IV 00000000000 W c a w n G =42 m vs gao m°m corm H m 3 0 3 0 N N a N P C 3 N � n Dc'>3 — m 7 ? n N N O � N W = N N P. 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W O W A N N W O � N � ACAO m ^. tAO W UAi OMp ONi 0 o c J J (p C J mU WCC: <i CWItNNN N O N W M A 0 p E J O� 0000000000000 ym2 O N J ID 010 o O O O O o 0 0 0 0 0 Dc7_ N000 0 0 0 0 0 0 0 0 0 T C C ------------- 0 01000000000o000D IV 00000000000 cc3 T N O n J 0 0000000000000 0100000000o000Tc W o 0 0 0 0 0 0 0 0 0 0 0 Dc'>3 — m m v 0000000000000 ^y �m J J 0000 O 0000 O 000 ^D (7 tp 0n 0 0 0 0— 0 0 0 0 0 T C .O+ N O O N V O W N M 0 0 0 — J O r 000000000000o T��+ �^ J (7 �F v --000000000000,-.< MO V OO�MNUtAOOOMO Ty J � -� 0000000000000.-. �0000--�-�-•00000 D o MM(T AtnA�� W MMAm" 000000000000 o, -,Do 40000 ---- 0000 mo C) 0 _ K A m5 z O D MO�mo mo�vm D T>>r mm'- O m D D Z CO ��O 00z cn 0 T T O N M � O 0 (1 n m O O T D mpg D �M ;0 < c 0 M m z X N m to i < M 3 im { < N v n to 1 r'0 4m State of Colorado Water Resources - View Well Details: Receipt 0442748C WMdo Depahrrert of Natural Resxrtss Colorado's Well Permit Search Well Constructed Receipt: 04427480 Division: 5 Permit 0: 51463-F- Water District: 38 Well Name / #: County: GARFIELD Designated Basin: Management District: Case Number. 10/07/1999 WDID: 3808041 - BEULAH WILSON WELL A Help Last Refresh: 10171201512:01:2 SAM [-] Appilrant/Owners History Date Range Applicant/Owner Name Address City/State/tp Unknown - Present SAGO JEFFREY W & W1Ra 1 612 SURREY 0.D CARaONDALE, CO 81623 [-] Location Information Approved Well Location: Q40 Q160 Section Township Range PM Footage from Section LI es SW SW 28 7.OS B8.0W Sixth 2005 650W Northing (UTM y): 4364809.5 Basting (UTM x): 307557.7 Location Accuracy: Spotted from section lines Physical Address Subdivision Name WILSON FAMILY TRUST EXEMPTION City/State/Zip Filing Block Lot Parcel ID: 23-2393-283.00-397 Acres in Tract: 2 [-] Permit Details Date Issued: 03/12/1999 Date Expires: 03/12/2001 Use(s): DOMESTIC Aquifer ALL UNNAMED AQUIFERS Special Use: AUGMENTED (s): Area which may be irrigated: 12000 SQ. Fr. Maximum annual volume of appropriation: Statute: Permit Requirements: Totalizing Flow Meter Yes Geophysical Log Abandonment Report No No Cross Reference Permit Number Receipt Description Permit(s): 06/14/2005 Comments:Pump installed - Well not put to beneficial use - AOT, Tax #RO05782. Phy address: 12/06/1999 5889 CR 109, Carbondale, CO 81623. WDWCD #990113-BHW#A. Umlt use to 2 SFD, 10/07/1999 12,000 sq R lawn/garden Ing & water domestic animals. dmw 02/06/15 10/07/1999 [-] Construction/ Usage Cetalls 03/12/1999 Well Construction Date: 10/07/1999 Pump Installation Date: 10/07/1999 02/17/1999 Well Plugged: 1st Beneficial Use: Elevation Depth Perforated Casing (Top) Perforated Casing (Bottom) Static Water Level Pump Rate 28 23 28 IS 15 Lic # Name Address Phone Number Driller 1259 COLLINS, FRANKW. 45755 HWY 6324 GLENWOOD SPR1fIG5, CO 81601.9052 970-945-1014 [-] Application/Permit History Late Notice Sent 06/14/2005 Well Construction Report Recelved 12/06/1999 Pump installed 10/07/1999 Well Constructed 10/07/1999 Permit Issued 03/12/1999 Application Received 02/17/1999 [-] Imaged Documents Document Name Date Imaged Annotated Page I of Colaxeo.9w I C axt us hnp:7/wwwAwrstate,co.Us/WellPermitSearch/View.wpx?receipt=0442748C 10/72015 00 m \1 O N O CD O t r 00 a U) 0 O m } v � i N L fa M "OUU En fa 0 N a! U Vl Co M t N U1 U U_ D Q °n IL in i J i p ul O 00 0 Y Y O—Awo) N i+ 00— O V O C 7 U 0 S T IL U (o Form No. OFFICE OF THE STATE ENGINEER GWS -25 COLORADO DIVISION OF WATER RESOURCES 818 Centennial Bldg., 1313 Sherman St., Denver, Colorado 80203 fAnq) RRA-g5A1 APPLICANT EXST WELL PERMIT NUMBER 79714 -F _ DIV. 5 WD 38 DES. BASIN MD Lot: A Block: Filing: Subdiv: WILSON FAMILY TRUST EXEMPTION APPROVED WELL LOCATION GARFIELD COUNTY SW 1/4 SW 1/4 Section 28 JEFFREY SABO Township 7 S Range 88 W Sixth P.M. 5889 COUNTY ROAD 109 DISTANCES FROM SECTION LINES CARBONDALE, CO 81623- 200 Ft. from South Section Line 650 Ft. from West Section Line (970) 618-6096 UTM COORDINATES (MeterS,ZOne:13.NAD83) CHANGE/EXPANSION OF USE OF AN EXISTING WELL Easting: Northing: 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 material injury to existing water rights. The issuance of this permit does not ensure 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 37-90-137(2), on the condition that this well is operated in accordance with the West Divide Water Conservancy District Augmentation Plan approved by the Division 5 Water Courtin case no. 02CW0123. If this well is not operated in accordance with the terms of said decree, it will be subject to administration including orders to cease diverting water. WDWCD contract #990113BHW#A (Amended). 4) Approved for a change in use of, an existing well, constructed on October 7, 1999, to a depth of 35 feet, and with a pump being installed on October 7, 1999, all under Permit no. 51463-F (Canceled). Issuance of this permit hereby cancels permit no. 51463-F. 5) The use of ground water from this well is limited to fire protection, drinking and sanitary facilities for a commercial business (contractor storage yard), ordinary household purposes inside one (1) single family dwelling and one (1) accessory dwelling unit, the irrigation of not more than 12,000 square feet of home gardens and lawns, and the watering of three (3) domestic animals. This well is known as Beulah Wilson Well A. 6) The pumping rate of this well shall not exceed 15 GPM. 7) The annual withdrawal of ground water from this well shall not exceed 1.69 acre-foot. 8) 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. 9) The owner shall mark the well in a conspicuous place with well permit number(s), name of the aquifer, and court case number(s) as appropriate. The owner shall take necessary means and precautions to preserve these markings. 10) This well shall be located not more than 200 feet from the location specified on this permit and not more than 200 feet from the location decreed for Beulah Wilson Well A in case no. 02CW0281 (decreed location is 200 feet from the South section line and 650 feet from the West section line). 11) This well shall be located at least 600 feet from any existing well, completed in the same aquifer, that is not owned by the applicant, excluding well permit no(s). 39050-A, 233529, 233530, 51464-F & 54892-F (spacing waivers submitted by the well owners). 12) A totalizing flow meter must be installed on this well and maintained in good working order. Permanent records of all diversions must be maintained by the well owner (recorded at least annually) and submitted to the Division Engineer upon request. NOTE: This well was decreed as Beulah Wilson Well A, in Division 5 Water Court case no. 02CW0281. This well was decreed as an alternate point of diversion for the Avalanche Canal and Siphon. At the date of the entry of this decree with the court on September 30, 2010, the well owner was: Jeffrey W. & Laural J. Sabo. NOTE: This well is to be located on a residential site of 2.12 acre(s) described as lot A, Wilson Family Trust (aka Beulah Wilson) Exemption, Garfield County. Further identified as 5889 County Road 109, Carbondale, CO 81623. NOTE: Parcel Identification Number (PIN): 23-2393-283-00-397 NOTE: Assessor Tax Schedule Number: R005782 APPROVED x DMW � Poi-Gby "'9 ij;hL_ State � Engineer By Receipt No. 9504043 DATE ISSUED 03-07-2016 EXPIRATION DATE N/A Form No. OFFICE OF THE STATE ENGINEER GWS -25 COLORADO DIVISION OF WATER RESOURCES 818 Centennial Bldg., 1313 Sherman St., Denver, Colorado 80203 (303) 866-3581 APPLICANT JEFFREY SABO 5889 COUNTY ROAD 109 CARBONDALE, CO 81623- (970)618-6096 EXST WELL PERMIT NUMBER 79714 -F _ DIV. 5 WD 38 DES. BASIN MD Let- A Block- Filinn• Ruhdiv- Will -RnM PAI,AII V TO[ ICT cv Cn/nTlnk1 APPROVED WELL LOCATION GARFIELD COUNTY SW 1/4 SW 1/4 Section 28 Township 7 S Range 88 W Sixth P.M. DISTANCES FROM SECTION LINES 200 Ft. from South Section Line 650 Ft. from West Section Line UTM COORDINATES (Meters Zone:13.NAD83) CHANGE/EXPANSION OF USE OF AN EXISTING WELL tasting: Northing: 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 material injury to existing water rights. The issuance of this permit does not ensure 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 Slate Board of Examiners of Water Well Construction and Pump Installation Contractors in accordance with Rule 18. 3) Approved pursuant to CRS 37-90.137(2), on the condition that this well is operated in accordance with the West Divide Water Conservancy District Augmentation Plan approved by the Division 5 Water Court in case no. 02CW0123. If this well is not operated in accordance with the terms of said decree, it will be subject to administration including orders to cease diverting water. WDWCD contract #990113BHW#A (Amended). 4) Approved for a change in use of, an existing well, constructed on October 7, 1999, to a depth of 35 feet, and with a pump being Installed on October 7, 1999, all under Permit no. 51463-F (Canceled). Issuance of this permit hereby cancels permit no. 51463-F. 5) The use of ground water from this well is limited to fire protection, drinking and sanitary facilities for a commercial business (contractor storage yard), ordinary household purposes inside one (1) single family dwelling and one (1) accessory dwelling unit, the Irrigation of not more than 12,000 square feet of home gardens and lawns, and the watering of three (3) domestic animals. This well is known as Beulah Wilson Well A. 6) The pumping rate of this well shall not exceed 15 GPM. 7) The annual withdrawal of ground water from this well shall not exceed 1.69 acre-foot. 8) 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. 9) The owner shall mark the well in a conspicuous place with well permit number(&), name of the aquifer, and court case number(&) as appropriate. The owner shall take necessary means and precautions to preserve these markings. 10) This well shall be located not more than 200 feet from the location specified on this permit and not more than 200 feet from the location decreed for Beulah Wilson Well A in case no. 02CWD281 (decreed location is 200 feet from the South section line and 650 feet from the West section line). 11) This well shall be located at least 600 feet from any existing well, completed in the same aquifer, that is not owned by the applicant, excluding well permit no(s). 39050-A, 233529, 233530. 51464-F & 54892-F (spacing waivers submitted by the well owners). 12) A totalizing flow meter must be Installed on this well and maintained in good working order. Permanent records of all diversions must be maintained by the well owner (recorded at least annually) and submitted to the Division Engineer upon request. NOTE: This well was decreed as Beulah Wilson Well A. in Division 5 Water Court case no. 02CW0281. This well was decreed as an alternate point of diversion for the Avalanche Canal and Siphon. At the date of the entry of this decree with the court on September 30, 2010, the well owner was: Jeffrey W. & Laura[ J. Sabo. NOTE: This well is to be located on a residential site of 2,12 acre(s) described as lot A, Wilson Family Trust (aka Beulah Wilson) Exemption, Garfield County. Further identified as 5889 County Road 109, Carbondale, CO 81623. NOTE: Parcel Identification Number (PIN): 23-2393-283-00-397 NOTE: Assessor Tax Schedule Number: R005782 APPROVED qw/ b� / DMW v(�tn� YY ` S'�- __ _ _ State Engineer By 9'504043 "-7 7 7i� •—�— ry urvislon or water Resources, 1313 Sherman SL, RM $18, Denver, CO 50203 7 kl CZ F PLEASE COMPLETE THIS FORM IN BLACK INK 9s -!V eea �e3 r PERMIT NO: § 7 RECEIPT N0: �m�U4�+'�144 �'P DIV: S WD:� V Existing Well Location: '/. of the 1r0 y,, Sec. Zhu . Twp 75 , Rng 00 0 % .M. 200 feet from Nesec. line, &50 feet from the E/ iPY sec. line; County _t9AZF1 Existing well owner: Name: —SESEK OEI�(? ,�„ A !- Mailing Address: W tuzr, 0 City/State/Zip CO OjGZTelephone: 9L 70) gay - o5yz Description of parcel (subdivision, lot, blk, fig) Noy E 4a sm%tp10,5(c" Size Z_I Z. ac Existing well location and visual conditions: If stating no, please explain 14yr A, Type of Existing Well: rule' , Hand Dug, spring Well, Gallery Well, Gravel Pit, Other Distance to nearest septic tank/sewer line (approximate) 300 feet Distance to nearest leach field (approximate) feet Is the well in a clean and sanitary location? f Is the well maintained in a clean and sanitary condition? Ei Is the ground at the surface sloped away from the well for proper drainage? 46-5 Is the surface surrounding the well firm and stable? YES Is the well situated i a well house or vault? At t)o If so, is the well house or vault in good repair and condition?_ Existing well construction and materials: If stating no, please explain Is the well equipped with a sanitary well seal/cap? Oal> Is the well constructed with steel casing at the surface? (s Does the casing extend at least one (1) foot above the surra e7 fi Casing size (o ` in; Estimated well depth feet Who constructed well? _ 1jR� 0 L«S�z ; Who installed pump? :5 -kV -f-F18ri Current uses of existing well: Were the existing uses initiated prior to May 8,1972? PO _Household use in _ single-family dwellings _Watering of poultry and/or domestic animals _Watering of livestock on farm or ranch; approximately how many head? _ Is this a feedlot? ; How many head? _Lawn and/or garden square feet Crop Irrigation acres _Fire Protection _Commercial exempt for _Other: o -r 1A5� — (Cz.M ,� rtip aR < 71 e Lisa Estimated date well constructed 'D 7 Y ;Estimated date pump installed /O y Estimated date of first use=10(,. ; Estimated flow r to LCI Igpm How many other wells rya�re located o this parcel? O ; Uses: P/A Permit/Case Nos.: N1f1 Existing Well Owner Signature: For Office Use Only Has information above been verified? If not, please note accordingly, List any problems you have identified: (if none, please state so) E Date of inspection: Phone Number Inspected by (print): (signed): Attach photo(s) if available or needed for further evaluation. Additional comments or information on back. Gvr,31 Teva ONSTRUCTION AND TEST REPORT [;ATXL: ORADO, OFFICE OF THE STATE ENGINEER Far Orr � � "` DEC. 0 61999 srA�TIEe' w' iE i4 COLO. 1. WELL PERMIT NUMBER _ — 7? 71�4 OWNER NAME(S) Mailing Address ti� ��yq City, St. Zip 2 Phone ( gyp) 9 WELL. LOCATION AS DRILLED: 5 40 1/4 5 e,✓ 1/4, Sec.,j?'9 Twp..�� Range DISTANCES FROM SEC. LINES: �_ ft from u Sec. line. and ft from_L*kjwsr Sec. line. OR SUSDIVISION: {-rJslSurrref / ! tir� �"xe ,& LO7 BLOCK FIIJNG(UNIT) STREET ADDRESS AT WELT LOCATION: 4. GROUND SURFACE ELEVATION ft. DRILLING METHOD DATE COMPLETED /0 TOTAL DEPTH S h DEPTH COMPLETED 3 5 ft 5. GEOLOGIC LOG: Depth Description of Material (Type, Size Color, Water Location) M HOLE DIAM. (n.) From (ft) TO (ft) /0 •, q 7. PLAIN CASING OD (in) Kind Wall Size From(ft) Teft `PERF. CASING: Screen SlatSize:.,& t�;a 8 FILTER PACK: Material Size Interval SL PACKER PLACEMENT: Type Depth 10. GROUTING RECORD: t4laterial Amount Density Interval Placement REMARKS: 1 DISINFECTION: Two Amt. Used 12 WELL TEST DATA: ❑ Check box d Test Data is submitted on Form No. GWS 3g Supplemental Well Test TESTING METHOD d ' ?,— Static Level ` ' ft. Date/Trtle measured /O - 7 _/,?,4v-, Production Rate__C22 O fi' gpm. Pumping level e' ft. Date/Time measured n - Z a _, o a Test length (hrs.) Remarks 3. 1 have read the dedemerrrA made herein and knew the comente thereof, end that they are true to my knowledge. [Pursuant to Section 244104 (1;�)(a) QRS., the making of false slatements herein eonstituteis perjury in the second degree and is punishable as a class 1 misdemeanor.] CONTRACTOR 5'c�r'�/. s Phone Lie. No M 'ti Name/Trtie (Please type or prim) Signature pate DEPARTMENT OF NATURAL RESOURCES 1313 SHERMAN ST, RM 821, DENVER, CO 80203 Maln: (303) 866-3581 Fax: (303) 666-2223 dwmermitsonliner5stale co u= GENERALPURPOSE Water Well Permit Application Review Instructions on reverse side prior to completing form. The form must he computer generated, typed or In black or blue Ink. 1. Applicant Information ✓� `' 1UV rice Use Only I Form GWS -45 (07/2013) CIVE DEC 0 8 115 1,omll-r7 A-797/ef _ Attach a detailed description of uses applied for. SSG Gttk%>G �fLy__ 6o_ ....... .. .,_..... -_ ❑ Industrial ❑ Dewatering System Wail atltlress io9 Municipal l Geothermal (production or reinjection_—Saie_IrrigatiCiton _code _ ❑ Commercial Other (describe): ..._ .__. L Construct new well © Use existing well ❑ Replace existing well f O Change or Increase use ❑ Change source (aquifer) ❑ Reapplication (expired permit) ❑ COGCC Well F1 Other: Well permila (Water Court casae Oesignaled Basin Delerminalionll - I Wellmomora .__-_�•)a��tZ�(I I SUf 1f4oflhe 5\kf 1/4 _...... Section Tawashlp Nor s Range Eor ww I Principal ferldlan c`-1,0 i r'i �sianc¢ofwell fmm seGlign lines(seciJan Ines are typically not property lines) - - 2- 60 Fl. from['NII _.-....- Farreplacementwellsanly-distonce and &ediw (ram old well to new well feel direction _-.. _ ... _ .. Wall location eddres (Include- Cily, $late, Zlp) Check ifwell atltlrass is same asin item 7. Optional; GPS well location Information in UTN1 format You must check GPS unit For required settings as tallows: t Formal must be ln'b1 . I Zone 12 mu Zone 13 Basting Units must be Matms Datum must be NAD113 Northing Unit must be set to true north Was GPS unit checked for atimeT ❑ YES �' Remember to set Datum to NAD83 5. Parcel On Which Well Will Be Located (PLEASE ATTACH A CURRENT DEED FOR THE SUBJECT PARCEL) A. Legal Description(maybaprwidedosanauachmenq: \Cast:, Sc(-- marl,_" , 7. Well Data (proposed_) If s`Gi hladmum pumping rata Mnuala 20 opm T-- Talaldepth - --- I Aquifer 2� feet 1fl 8. Land On Which Ground Water u ryuvn m 4aI N Imay 0e pmwded as an att2Chmenm)t Saw Cts 5 L e w Are e Z acre-feet I ­ ? r (If used (orcrop Irrigation, attach a scaled map that shows Irrigated area.) A aAcres -. .. ... .. I B. owns,. C. List any other wetls or wafer rights usetl an His laid: I 10. Sign or Entered Name Of Applicant(s) Or Authorized Agent The making of false statements herein constitutes perjury In the second degree, which Is punishable as a class 1 misdemeanor pursuant to C.R.S. 24-4-104 (13)(a). I have read the statements herein, know the contents thereof and state that they ar true to my knowledge._ Si rent (s)al person(s)s IWg appprapan pate(m,NddlyyW) ti Iz/8�5 Irde__ a nln me and _ . _ .___ .... .._.. ....-. ---- - --" Office Use Only _GSGS ma nam ....._._ _ ......�._ _. GQJ � Qc,! ^ ^ C�✓©ry QI(JRpup no 'surface elev. /fp� d"1Rzcept area only, Ant 1L. nf'L 6 tt �ra"°•ir fl' _ .. B. aolacres In parcel C. owne AQUAMAFi� .. .. WE WR D. Will this be Ilia coy hell an Nis parcel? 1�1 YEsj] NO (ifno list other wells) C'NCB TOPO E, slate Parcel IDA (optional): _ MYIAR y/%l SBE DIV �WD 3" BA_ MD 00090MMEEW June 28, 2005 State of Colorado Office of the State Engineer 1313 Sherman Street, Room 818 Denver, CO 80203 Re: Well GWS -68 form Attn: Alex Teitz, Administrative Assistant Dear Alex, RECEIVED JUL I - 2005 WArgR srnrz ! R`SOUR GNC! S f, 1 have attached form GWS -68 as you requested with the $30.00 filing fee. I have also enclosed photos of the existing well on my property for your reference. I was able to contact the installer of the well, but the company that he worked for at the time is currently out of business, and the paperwork for this well is not available to me to forward to you. I was able to contact Bill Collins (the manager and installer at the time) and he explained to me that Saracuse Well Drilling went out of business shortly after the installation of the well on my property back in 1999. Please contact me and let me know that no other information is required of me. l want to make certain that you have everything that you need. It is frustrating to me that this wasn't taken care of by the previous owner when the well was installed. I just want to make sure that I have everything in place for when I build my house and activate the pump. Sin<\ 4- %.- Jeffrey W. Sabo Legacy Homes of Aspen, Inc. 612 Surrey Road, Carbondale, CO 81623 (970) 704-1950,(970)704-1952 fax 9504043 Jeffrey Sabo 5889 County Road 109 Carbondale, CO 81623 Commercial use added to current usage. Current usage is: 2 Main Residences 12,000 feet of irrigation Watering for 3 animals Fire Protection Add commercial designation for office restroom for contractor storage yard. RECEIVED DEC 08'15 WATER RESOURGES STATE ENGINEER GLENWOOD 9504043 LEGAL DESCRIPTION Exhibit "A" PNC# 0004977459 TAX ID# R005782 Loan P:I:mhcn 330621351 Rue' DECE)•IEER 13, 2606 PIDPcrly:lddlM LOT A, EEULAA ':)L' SOC; SUBDIVISICN - COUNTY ROAr 109, CAp.EOND:.LE, COLORADO 81623 EXHIBIT "A" r:.EIVED OEC 0 8 '15 WATER RESOURGRS STATE EtJGiNEM GLENYdGGO' A '=FACT 0? I.Atm EI•:UAiTED Z`! LC 23 R].'f7"; 11 NSA 2•1 OF SLCTiON 2G, TGiiNSti_TP 7 SOOTiI, P9 VEST OP Tis DTII PRINCIP:IL K?RID1Tv1, GP.^FIELD Co01.'TY, COLOpNrro, )?IM REINC MOFc2 PARTICULARLY DvSCRTCEO A5 "r OLLDf S. 9EOI11:i21IG AT A POIt!? oil TUE !(O R1711'.PSY II07HDAP.y L27•iE JP SAID LOT 1.1, RSO OEnIC AN rtLONslI'L:4 C0.P 24AlU,aD L.S. 13333 FD?fD IM PLACL•' POR THE SOUT_EZA.ST CCPSi<R DF LOT 13 Ii'* 3A -M SSCTION 18, WMICE A P.Ee.v AdID CAP i.LgRKED L -S. 7734 FOU -M Til PLACE FOR TlIE sou ImvE5T Cor"mit OF EAID £ECTSUIT 28 IIEARS SOOTIi 55 DEC_t.^:ES p3 ISI.WTEs 02 SECONDS WEST, G9S.2.1 11 -Mr, TAEE.CR MORTH 03 DEC -'IF= 11 ,U2,UTL9 ]? SEC0IUS EAST. :!a -SZ P.ET ;U,10240 THE K_STcRt'f DOUt{CT�.Y LIhE OF 5?L^ LOT 11 TO A POIGR ON TJ1E SOUTFNE.S. p ;; ASC:IT 0� WAY L.I_2E OF GAoFIELD COOISTy RGAD 109 AS BUILT ?SIT. IN PLACE, T)ISNCE AIl.714C SAID SOUTINErTEL" -y RIGHT OP WAY L1ME ON TFT: FOLL041i:G POUR (4) C07P=,ES, SOUTH 56 DEGREES 25 M_!(OTE3 14 SECONDS ;.'AST, 96.17 FEr—, TNENCE 182.•7; FEET ALOl1C Trl_ AAA' O: A i`. U. 00 RADSUE CCR'JF TO TKK I• -r, 171E GsJRD O7 K7:iIC11 HEl_RS SOUTR 34 D: rtO EES 45 I1I11PTES 34 SECOibO ZA,57, !32.2.7 FLET, T IlCF -0 .1 33 DEGRELS D4 NThi:TS i'. SECO)7D5 4%;ST. 91..25 `_"22T, TFicNCS SCO'1^_ 3E OPGRt�s 1G laiL:TL•'S 2p SECONDS P.XS^_, :30.15 P2ET; TILIIC' W4Si 202.31 FEE- TO Tl -',E i,ES7ERL7 BOUNDARY L1N5 OF 1'NE PARC'L OF LTJ.. DrSCRTSIM Ill DOOM 198 AT PAGE 3GO OF SAID ti4FiYIELD t.DUM=y R,-COR:)Cl THIDICL•' NORTI 33 DEGRF.F.S 31 14INUTES 00 LECOIMZ; 4JEST, ;15.50 FLET 'PO A POINT C_J T:IE 14ORTHLPLY EOI-PM C LIZ.? C? SAID LIT 14, =3E1G^-y SOUT:t 03 DEC?ZF3 00 MSWU'lS'S 37 53CCUDS E.A.ST, 177. 5o PELT AL SAID tIOR.T.MMY BOMEDARY L::,r4 TO TIM POII.T OF BL'GitDale:G. A1,00 iOSOAD; AS; LOT A A)M,02D B_OLm nrLs01: RSBUiVISIOu 'LT.F?IPTIOV ACCORDING CD :Ji2 PLAT R^.CO7a,23 OCIO-r E!I ), 200C, UInEE P.ECL•PTIOII 7.10, 5702:!7 CO' -P' O. OA'.IVIEL? LT.4TE OF COLORAD•i # 9504043 K-kor-""--' GWS -38 600 FOOT WELL SPACING STATEMENT DEC OS'15 �) II wSTATE ENGINEERS I (we) _ lA IV.I!'i (C�. �v1()hh�� OLENWOop state as follows: 1. I (we) own real property described as S21 1) ('1' I C)9 in the ':LJ Y4 of the ,9UJ '/4, Section 2-9', Township ') S., Range $1� U_ P. M., i4-irr IJ County, Colorado. We own the right and easement to the following well: Actual Actual Distance from Distance from Permit # 1/4 114 Sec, Twp. Rng. NIS Sec. Line EM/ Sec. Line a9t)G0-Fl n -L) / 2-� -S. -- cl1 S ft. 9551AI ft. 2. 1 (we) have been apprised that "/e y1�D the present owners of a parcel of land in the SIA '/, of the 5j-�J y,, Section Township -7. ) , Range P.M., desire to drill a new well or extend the use of an existing well. I (we) also understand that the purpose of such well is set forth in the well permit application, and that I (we) have reviewed the application that was submitted to the State Engineer and receipted by him under receipt no. 97-q v, . # 50404: 3. The proposed location for the subject well will be 600 feet or less from my (our) well. 4. By this statement I (we) am (are) specifically waiving any objection to the issuance of a well permit for the subject well, as set forth in the referenced application, and would request that permit issuance not be postponed or denied because of any concerns by the Division or others that the proposed well will materially affect my (our) well or water right. I (we) am (are) also specifically waiving my (our) right I (we) may have to participate in a hearing before the State Engineer pursuant to Section 37-90-137(2), C.R.S. I ` r Dated this day of N(Jf/Pni�c t U1 950404 GWS -38 600 FOOT WELL SPACING STATEMENT GEC 0 8 '15 WATER I (we) S Yl(�li/G �viUbb�SOURCES STA FENGINEER state as follows. GL ENwaQo 1. I (we) own real property described as SC1`-)0 (' 1 n9 in the % of the 5W Y4, Section 2C', Township I S •, Range r68\,0 , +( P. M., aiP- '-fid County, Colorado. We own the right and easement to the following well: Actual Actual Distance from Distance from Permit # 1/4 1/4 Sec. Twp. Rng. NIS Sec. Line EM/ Sec. Line 233529 &,I '5—W %� '7.S- s—vv IoSOS•ft. (07SVJ ft. 2. 1 (we) have been apprised that 1 rru 4 Lar ra( D , the present owners of a parcel of land in the S_ Y4 of the ;LO Y4, Section Zl�-, Township `).S •, Range SEW �_ P.M., desire to drill a new well or extend the use of an existing well. I (we) also understand that the purpose of such well is set forth in the well permit application, and that I (we) have reviewed the application that was submitted to the State Engineer and receipted by him under receipt no. r # 9504043 3. The proposed location for the subject well will be 600 feet or less from my (our) well. 4. By this statement I (we) am (are) specifically waiving any objection to the issuance of a well permit for the subject well, as set forth in the referenced application, and would request that permit issuance not be postponed or denied because of any concerns by the Division or others that the proposed well will materially affect my (our) well or water right. I (we) am (are) also specifically waiving my (our) right f (we) may have to participate in a hearing before the State Engineer pursuant to Section 37-90-137(2), C.R.S. Dated this S:!' day of _ `IJi em�rr , c2o GWS -38 600 FOOT WELL SPACING STATEMENT 'DEC 0 8 '15 WATER RESOURO£-,8 �+ STATE ENGINEER I (we) l fh'1�� �t mP 'fie i lEN4v00D �f{�,/ state as follows: I (we) own real property described as IDS in the % of the SVS Y4, Section 7,T, Township 16 -, RangeSt��1A% , P.M., Op(-GIed County, Colorado, We own the right and easement to the following well: Actual Actual Distance from Distance from Permit # 1/4 1/4 Sec. Twp, Rng. N/S Sec. Line ENV Sec. Line 7.335x 0 -a�o Li z! `7_S -S-Q� e ft. �g S -D Wft. 2. 1 (we) have been apprised that 1 Rrry G- Lnf. rP( GA D , the present owners of a parcel of land in the & !) y, of the q,()_ A Section Zsi�, Township 7 S ., Range WVJ , )off- P.M., desire to drill a new well or extend the use of an existing well. I (we) also understand that the purpose of such well is set forth in the well permit application, and that I (we) have reviewed the application that was submitted to the State Ftpgineerd receipted by him under receipt no. 5n4043 3. The proposed location for the subject well will be 600 feet or less from my (our) well. 4. By this statement I (we) am (are) specifically waiving any objection to the Issuance of a well permit for the subject well, as set forth in the referenced application, and would request that permit Issuance not be postponed or denied because of any concerns by the Division or others that the proposed well will materially affect my (our) well or water right. I (we) am (are) also specifically waiving my (our) right I (we) may have to participate in a hearing before the State Engineer pursuant to Section 37-90-137(2), C. R.S. Nated this —5— day of a auH—WE®vV"R8 # 9504043 FM 29'18 GWS -38 600 FOOT WELL SPACING STATEMENT WATtrq RESOURCES PFATR ENGINEER / rr 9LENwooD �V I (we) l�'CgkV kcx' S -iv -C i' 1 state as follows: 1. 1 (we) own real property described as (0\2�)S C`'- 1 iJ(�l in the �w) 1/4 of the IVIA/ %, Section 33, Township 7S ., Range , 1st P.M., C-0r�fe(A County, Colorado. We own the right and easement to the following well: Actual Actual Distance from Distance from Permit # 1/4 1/4 Sec. Twp. Rng. N/S Sec. Line ENV Sec. Line N�) a3 I.S. 55w —a 1� ft. goo UJ ft. 2. 1 (we) have been apprised that 4 Ui(A C-CCLD , the present owners of a parcel of land in the & K) 1/4 of the &A)_'/4, Section Township 7.S Range 9_, 1o4� P.M., desire to drill a new well or extend the use of an existing well. I (we) also understand that the purpose of such well is set forth in the well permit application, and that I (we) have reviewed the application that was submitted to the State Engineer and receipted by him under receipt no. # 9504043 3. The proposed location for the subject well will be 600 feet or less from my (our) well. 4. By this statement I (we) am (are) specifically waiving any objection to the issuance of a well permit for the subject well, as set forth in the referenced application, and would request that permit issuance not be postponed or denied because of any concerns by the Division or others that the proposed well will materially affect my (our) well or water right. I (we) am (are) also specifically waiving my (our) right I (we) may have to participate in a hearing before the State Engineer pursuant to Section 37-90-137(2), C.R.S. Dated this day of CL - D J (� GWS -38 600 FOOT WELL SPACING STATEMENT I (we) rylrew —?-) -n.Je r state as follows - 6 1 T ollows:61TP - 1. 1 (we) own real property described as C IZ 1 hal in the hLJ '/, of the .1� '/<, Section '3, Township �J. S, Range (o� P.M., i-x�zF-field County, Colorado. We own the right and easement to the following well: Actual Actual Distance from Distance from Permit # 1/4 1/4 Sec. Twp. Rng. N/S Sec. Line E/W Sec. Line S`( ci2- --�Aj 33 I . S 14 ft. _ I I m \n/ ft. 2. 1 (we) have been apprised that 4 La('t' 5'xk0 , the present owners of a parcel of land in the ,fit A) '/a of the ,cLO %, Section 2, 6', Township 7.S •, Range �UJ (n P.M., desire to drill a new well or extend the use of an existing well. I (we) also understand that the purpose of such well is set forth in the well permit application, and that I (we) have reviewed the application that was submitted to the State Engineer and receipted by him under receipt no. Pi 14!?R`? 44–. 9504043 5004 3. The proposed location for the subject well will be 600 feet or less from my (our) well. 4. By this statement I (we) am (are) specifically waiving any objection to the issuance of a well permit for the subject well, as set forth in the referenced application, and would request that permit issuance not be postponed or denied because of any concerns by the Division or others that the proposed well will materially affect my (our) well or water right. I (we) am (are) also specifically waiving my (our) right I (we) may have to participate in a hearing before the State Engineer pursuant to Section 37-90-137(2), C.R.S. Dated this f day of WEST DIVIDE - WATER(:0NS1:RVANCY DISTRICT November 30, 2015 Jeffrey W. Sabo 5889 County Road 109 Carbondale, CO 81623 Dear Jeff: 818 T:tuehcnbaugh Blvd., Suire lot P.O. Box 1478 Rifle. Colorado 81650-1478 Tel: (970) 625-5461 Vkb: we w.wdwcd.or8 Email: ware [Y. vdwcd.otg NOV 3 0 '15 WATER RESOURCES STATE EgGINEER GLENWOOD Enclosed is approved amended contract .4990113BHWHA(c). amendin the contract to include commercial use, You should now contact the Colorado Division of Water ResourceS in Glenwood Springs to update permit #051463-17. Sincerely yours, WEST DIVIDE WATER CONSERVANCY DISTRICT 0504043 Janet Maddock 818 T:tuehcnbaugh Blvd., Suire lot P.O. Box 1478 Rifle. Colorado 81650-1478 Tel: (970) 625-5461 Vkb: we w.wdwcd.or8 Email: ware [Y. vdwcd.otg NOV 3 0 '15 WATER RESOURCES STATE EgGINEER GLENWOOD Enclosed is approved amended contract .4990113BHWHA(c). amendin the contract to include commercial use, You should now contact the Colorado Division of Water ResourceS in Glenwood Springs to update permit #051463-17. Sincerely yours, WEST DIVIDE WATER CONSERVANCY DISTRICT Enclosure cc Division No, 5 Water Resources w/enclosure Wilson Water Group w/enclosure Dimectors: Samuel B. Potter Kelly Couey Roben J. Zandla Bruce E. Wampler Dan R. Harrison Janet Maddock Enclosure cc Division No, 5 Water Resources w/enclosure Wilson Water Group w/enclosure Dimectors: Samuel B. Potter Kelly Couey Roben J. Zandla Bruce E. Wampler Dan R. Harrison APPLICATION T Ajjjj�EASE N_ 9 3 Q HW A A Cc) WEST DIVIDE WA Y DISTRICT 818 Taughenbaugh Blvd, N101, P. 0. Boz 1478, Rifle, Colorado 81650 Name: Mailing 2. COURT CASE #a: Decree Case No. Augmentation Plan Case No. 3. USE OF \VATER RESIDENTIAL Number ofmain residences: z. No, ADU's Subdivision: No. constructed units:_ No. vacant lots Homa garden/lawn irrigation of 1771 000 total sq. ft. Method of irrigation: flood ^ sprinkler ✓ other Non-commercial animal watering ofanimals Fire Protection v� Evaporation: Maximum watersurface to be exposed: Description of any use, other than evaporation, and method of diversion, rate of diversion, end annual amount of diversion of any water withdrawn from the pond: Well Sharing Agreement for mulipfe owner wells must be subm fined if grader than the onwmn•, application must be made under a homamwners arsnciatlan. COMMERCIAL Numberof units: Total sq. ft. of commercial units: I 00 Description of use: O-,K:Cr_ I rccM 4tu' �"j�✓nr�✓ . INDUSTRIAL Description of use: Evaporation: Maximum water surface to be exposed: Description ofany use, other than evaporation, and method of diversion, rate of diversion, and annual amount ordiversion Dfany water withdrawn from the pond: DIRECT PUMPING Tributary: Location: 4. SOURCE OF WATER Structure: Wek\ Structure Name..1D2 zLu P, Source: surface_ storage_ ground water Current Permit It 0� Ot„3 F (attach copy) Form: WDWCD 2009 AMEND APPLICATION OF #302 Date Activated 1/28/99 Date Amended 11/19/2015 Distance of well front section lines: �' r) ri turn S r In urn Elevation: ((n!`ril f t �.Lf Welllocntienaddress: f22jtt I 10� G.rh yr l rn RIC�7 (rlrtach additiornlpagesfor tmdtiple strucnnyak, 3 0 ie 6. LAND ON WHICH WATER WILL BE USED 11YYUUVV IV aegolSdescrlption��nay baataclune'WATER RESOURC" C,_rod-STATE GLENWOOD Number of acres in tract Inclusion into the District, al applicants expense. nury be required 7. TYPE OF SEWAGE SYSTEM Septic tank/absorption leach field ✓ Central System_ Other_ District name: S. VOLUME OF LEASED WATER NEEDED IN ACRE FEET: Amended from a. of to� of (minimum of I acre fact except augmentation from Alsbury Reservoir where a lesser amount is allowed) A rut e n cI G[\ -'' V Commerce\ (Lgv Provide ertgineeriurg darn to supparf valuate of roarer reyrrerfed. Commercial, municipal, and industrial users must provide diversion and consumptive data on a monthly basis: A totalking flow meter mitt renrore, readout is required to be installeri and usage reported to West Divide. Applicant arpressty acknowledges it has had the uppornunio• In revienn the DistricN.s form (Yater Allotment Couiract mut agrees his application is made ursunnt rtnd sahjecl flre loan., math conditions contained Ilei . C_ Applict t Sn atm Applicant Signature Application Date: DATE APPROVED: " �,_,rlorm,-mmornmmr� 0000*-��•-000OA ® 0 0 0 0 0 0 C 0 0 0 0 0 0 4 m V tpN�t+J7 rV-ID �Ipmo OOOOOr r.-0000 P Lij N CooCdCC00000c �`l Of+lp mNt�NNN f� OM1 00� C p N¢ =— a z_ CccoC000C000.- LIJ pop `wz3 M �WZ T O m y 00 WI W � dc_i? \J Q z r r< (J9 �m N G N �Ud 0000000000000 O V to N M N OON C G 00 ^000 ��`LdodddddCCodCo .E a m j0 m U¢ 0 0 0 C 0 0 0 0 0 0 C CIC O U V- o 2 O N N N N N N N N N N N N N U o. 0....0000000000000 ti 3 d p LL C1 o r � %� to ^t�mrmrm�l�mr pL'LL000000000aoon m� G a so d D p per.- W OM W 00 ® V � II N dCddddo W stm mtpm� O� m C C � O O N > cV+l 66 ci > —a �N IS9 C m F' Cl)Q 6I® LU v N `3 q w r E 8 E � m$ H N C D Ca U m m 'dam Q H � M � p- a Um 9 m W 0 D Q s C O G •+ T=T=00 w > z @ m M 0r0� j a WL) 9 =U _ c y c z 3 tME masm$ N co N v N W LYZ W K v v y c0i 7 > R .r_..N...�. 'at! C C Waa Q J W fU„��UJ `a CO1 jNNOz OQV ¢vWO W W J Jr. J cg w Q 3p�0 D o�VOW Z y O W �0 U E " �,_,rlorm,-mmornmmr� 0000*-��•-000OA ~ VCy 0 0 0 0 0 0 C 0 0 0 0 0 0 4 m V tpN�t+J7 rV-ID �Ipmo OOOOOr r.-0000 P C=LL t -V Q CooCdCC00000c �`l Of+lp mNt�NNN f� OM1 00� C p N¢ o00r.-N N N'' CccoC000C000.- E b N y T O m y 00 000000000000a � dc_i? oCooCCdocCooC Q 00000.-r0000t0 G N �Ud 0000000000000 O V to N M N OON C G 00 ^000 ��`LdodddddCCodCo .E a m .` pp U¢ 0 0 0 C 0 0 0 0 0 0 C CIC O U 40 G 2 O N N N N N N N N N N N N N E�¢000000000000N o. 0....0000000000000 (E.1 0 0 0 0 0 0 0 0 0 0 0 0 d p LL = U a 0 0 0 0 C C G G C C O C6IO C to ^t�mrmrm�l�mr pL'LL000000000aoon m� G a so d D p per.- W OM W 00 >= C O N Y V W �-tV`' dCddddo W stm mtpm� O� m C C � O O N > cV+l 66 ci > —a c; 0000d CV J zm<mrzn)w >Ua QLLMp, nU�WUOWr Ali rC 6��� Q U 0 2 0 0 0 c t 3 Q n � E b N y T O m y nCm � m cc� + v'S + N �' + °iE E^ J h m mom. D O N C O E E E E j Ny ? )D U U :n V U U o. e c m � ;d m� so � go 8 m N C .{m p 0 ON• C m m'm N n N E N 6 e w r E 8 E � m$ H N C D Ca U m m 'dam j C v m r/i W M � p- a Um 9 m O E o o n y F Nm s C O G •+ T=T=00 m� w m vy ' & m M 0r0� j 0 j 9 =U _ c y c z 3 tME masm$ v N CO R S � v v .r_..N...�. 'at! C C M Q SUut of Colorado Wetar Resources -View Wall Details: Rceeipl 0442748C # 9 5 0 4 ® 4 3 Jew 1 aft Campo De U"a arNaaa31 Rw=ea �Aa+ I Cutrdt Us fv'JiJ' 3111 .U]Vi�i,)Ji �7 " frRt cats Calomdo's Well Permit Search Well Constructed Receipt: Permit A: Designated Basin: On Number. WDID: 3806041- BEULAN WILSON WELL A 04427480 51963 -F - Division: Water D4DttD Well Name / #: Uunm 19anagemaMDiatrict: Help Last Refresk 108/2015121:25 AM 5 38 �7ED RECEIVED N ApplIant/Drmers Nirtd ry Date Ranga AppBawo nt/oer Name Address city/statellip U*bn>,a-Relva S'A ;sffM W6 WIEL1 61292MRD CARBON)" m 61621 (-] Location Inforinatlon Approved Wall Location; Q40 Q160 Section Township Raaga PM Footage from Section lines SW SW 26 7.05 BELOW SfMh 2005 650W Northing (UTM y): 43648M S Easting (Mx): 307557.7 LCCA110n ACCU Mey: Spotted hum section Ones Physical Address Subdivision NameSO WRN FAAOLY TRUST WKP MN City/State/Lp Filing Block Lot A Penal MI 23.2393.283.00.397 Use(s): DOMESTIC Special Use: AUGMENTED Area Which may be Irrigated: 12000 SQ. FT. Matdmum annual volume of appropriation: Statute: Permit Requirements: Totalizing Flow Meter Tea Acres In Their 2 Data Expires: 03/1 031 �(serALLUNNAMED AQUIFERS GeophysicalLog Abandonment Report No No Cross Reterana Permit Number RDcalpt Description Permlt(s): Commeuts:Pump trsta66d • Well not Put to beneficial the - AOT. Tax 9ROOSM Phy address 5889 LR 109, Urbandale, CD 81623. WDWCD 9920113-BHWOA Limit use to 2 SFD, 12,000 sq R WOVIlarden Ing & water domestic anMaL%, dome OW06/IS Wall coltstrudion Data: 10/07/1999 Pump Installation Data: 10/07/1999 WWI Plugged: 1st BeneNdal Use: Elevation Depth Perforated Casing (Top) Perforated Casing (Bottom) Static Water Levet Pump Rate 28 23 20 IS 15 Llc# Name Address Phone Number Wier ;291 WWNSFMMW. 14755 NWT' 6324 ra2Nw= SR", CD 91601AR 970-34:100 (•3 Appliallon/Permit Nktory Late NoBrs Sent 06/14/2005 Welt Ccr&ucUon Report Received 17/06/1999 Pump installed 10/07/1999 Well Constructed 10/07/1999 Fendt Issued 03/12/1999 AppBadon Received 02/17/1999 (-3 Imaged Documents me Document NaData Imaged Annotated NOV 3 D '15 WATERRESOURCES ENGINEERS GLENWOOD hop//mvw.dwr.sate, w.us/WrilPumlrSearrlJVievr.aspz7rcaipt�442748r. 1082015 04427480 51963 -F - Division: Water D4DttD Well Name / #: Uunm 19anagemaMDiatrict: Help Last Refresk 108/2015121:25 AM 5 38 �7ED RECEIVED N ApplIant/Drmers Nirtd ry Date Ranga AppBawo nt/oer Name Address city/statellip U*bn>,a-Relva S'A ;sffM W6 WIEL1 61292MRD CARBON)" m 61621 (-] Location Inforinatlon Approved Wall Location; Q40 Q160 Section Township Raaga PM Footage from Section lines SW SW 26 7.05 BELOW SfMh 2005 650W Northing (UTM y): 43648M S Easting (Mx): 307557.7 LCCA110n ACCU Mey: Spotted hum section Ones Physical Address Subdivision NameSO WRN FAAOLY TRUST WKP MN City/State/Lp Filing Block Lot A Penal MI 23.2393.283.00.397 Use(s): DOMESTIC Special Use: AUGMENTED Area Which may be Irrigated: 12000 SQ. FT. Matdmum annual volume of appropriation: Statute: Permit Requirements: Totalizing Flow Meter Tea Acres In Their 2 Data Expires: 03/1 031 �(serALLUNNAMED AQUIFERS GeophysicalLog Abandonment Report No No Cross Reterana Permit Number RDcalpt Description Permlt(s): Commeuts:Pump trsta66d • Well not Put to beneficial the - AOT. Tax 9ROOSM Phy address 5889 LR 109, Urbandale, CD 81623. WDWCD 9920113-BHWOA Limit use to 2 SFD, 12,000 sq R WOVIlarden Ing & water domestic anMaL%, dome OW06/IS Wall coltstrudion Data: 10/07/1999 Pump Installation Data: 10/07/1999 WWI Plugged: 1st BeneNdal Use: Elevation Depth Perforated Casing (Top) Perforated Casing (Bottom) Static Water Levet Pump Rate 28 23 20 IS 15 Llc# Name Address Phone Number Wier ;291 WWNSFMMW. 14755 NWT' 6324 ra2Nw= SR", CD 91601AR 970-34:100 (•3 Appliallon/Permit Nktory Late NoBrs Sent 06/14/2005 Welt Ccr&ucUon Report Received 17/06/1999 Pump installed 10/07/1999 Well Constructed 10/07/1999 Fendt Issued 03/12/1999 AppBadon Received 02/17/1999 (-3 Imaged Documents me Document NaData Imaged Annotated NOV 3 D '15 WATERRESOURCES ENGINEERS GLENWOOD hop//mvw.dwr.sate, w.us/WrilPumlrSearrlJVievr.aspz7rcaipt�442748r. 1082015 NOV 3 D '15 WATERRESOURCES ENGINEERS GLENWOOD hop//mvw.dwr.sate, w.us/WrilPumlrSearrlJVievr.aspz7rcaipt�442748r. 1082015 09 a uj > Go JJ it w [tQww o UA Z)zo c.j 0- .Zogyp z w U) E U) U .-U DQ Ln iii O ra U CL 0 0 u U 0 -0 W 0 r (D 5. m E WEST DIVIDE WATER CONSERVANCY DIS'ni1CI- 818 Taughenbaugh Blvd., Suite lol P.O. Box 1478 Rifle, Colorado 81650.1478 Tel: (970) 625-5461 \Yreb: wt w.wdwcd.org Email: asater@svdwcd.org November 30, 2015 Jeffrey W. Sabo 5889 County Road 109 Carbondale, CO 81623 Dear Jeff. - Enclosed is approved amended contract #990113BH W#A(c). amending Cite contract to include commercial use. You should now contact the Colorado Division of Water Resources in Glenwood Springs to update permit #051463-F. Sincerely yours, WEST DIVIDE WATER CONSERVANCY DISTRICT Janet Maddock Enclosure ce Division No. 5 Water Resources A,/enclosure Wilson Water Group w/enclosure Directors: Samuel B. Porter Kelly Coucy Robert J. &nella Bruce E. Wampler Dan R. Harrison APPLICATION TO AMEND WATER LEASE # 9 9 d 1 "W 1F P� CC) WEST DIVIDE WATER CONSERVANCY DISTRICT 818 Taughenbaugh Blvd. #101, P. O. Box 1478, Rifle, Colorado 81650 Name: Mailing 2. COURT CASE #a: Decree Case No. Augmentation Plan Case No. 3. USE OF WATER RESIDENTIAL Number of main residences: No. ADU's Subdivision: No. constructed units:_ No. vacant lots Home garden/lawn irrigation of 17,000 total sgsq. ft. Method of irrigation: flood_ sprinkler ✓ other— Non-commercial animal watering of_'animals Fire Protection e - Evaporation: Maximum water surface to be exposed: Description of any use, other than evaporation, and method of diversion, rate of diversion, and annual amount of diversion of any water withdrawn from the pond: Weft Sharing Agreement fm• malri de owner melts crust be subtnrtred If greutar than tura owners, application most be made under a homeowners amwialiou. COMMERCIAL Numberofunits: i Total sq. ft. of commercial units: I DOO Description of use: t�'Ce- )Z1 c�,-YrcdM --rn,` n'ymrr Yael INDUSTRIAL Description of use: Evaporation: Maximum water surface to be exposed: Description of any use, other than evaporation, and method of diversion, rale of diversion, and annual amount of diversion of any water withdrawn from the pond: DIRECT PUMPING Tributary: Location: 4. SOURCE OF WATER Structure: Wek\ Structure Name:-LraQ st. &0, 1 44etl f4 Soumc: surface_ storage_ ground water Current PcrmitIf F (attach copy) From: WDWCD20NAMEND OF Contract #990113BHW#A(c) Map #302 Date Activated 1/28/99 Date Amended 11/19/2015 Distance of well from section lines: Elevation: (. IR I Well location address: S&Bet C.Z Irk rn rh -rD ftlk7 (Atlach additional pagesformuhlple structures) 6. LAND ON WHICH WATER WILL BE USED (Legal description may be jpr`ovido as`a�rt a�tac`hment.) S t- 'F TC'LCCI p r� Number of acres in tract: Inclusion into the District, at Applicant's expense, any be required. 7. TYPE OF SEWAGE SYSTEM Septic lank/absorption leach field t" Central System_ Other District name: 8. VOLUME OF LEASED WATER NEEDED IN ACRE FEET: Amended from oyL of to —,-,_att(minimum of 1 acre foot except augmentation from Alsbury Reservoir where a lesser amount is allowed) Amencied'Fc� the\v de, C o m rr% e V, Provide engineering data rn support volume of meter requested. Catnnrercidl, mrmieipal, and inh"strial users Masti'mride diversion ,,it consumptive data an u mothly basis. A foalfcingyfmv meter nvitb reurore readout is required to be fitsaildl and usage reported m Wast Dinvde- Applicant arpreWy achnmrdedges it has had the appa'tiodo, a ren'ienp lheDistrier's form Water Ailoureat Contract mrd agrees this application is made an. uaat and subyeef rile teraus and conrfflions contained Applic t Si y atu Applicant Signature Application Date: 1 1 �41� T �J DATE APPROVED: // -/ q -/S w U Q � w p \U } F/ Z LNi� a y y w z ww0 U 7 > R Ul WF. a apo o~ 0 W U 0Ld r os 'u ~LLL LLi0 co ZQao� < Z vawO J � K J Q LU Qa LL C, 0 r oFVOw Z C7 Erw Q � zmxx Y Z J U` a. F- <Lu<(L ]»wUOwF- � N j �.� N heo roam OG1 (O tOhr F•oE..d00000cocoocc U (0 V' t0 tD 0 m m , iL1 O N O � m U`-'00000 H C 000 00 GG mwm�mvmO0) O O MQ F ->N � oo O000,cciNoNoNNrh000[7 - oc000h. 0 C U 00 Iy'hU�00000000000 `y 00000000000 g Ci .-00000000000 � 0 J + C J N � LL OOOp Oc-r'-000ON ,tUaoocd000000000 mm c o Rq �¢00000d000do 0 .E c c Q w m E�Q0000000000000 0000000000o®R EV.�0000cci0000000 W W F J U C C m Pi e E 1¢ 0 0 0 0 0 0 0 0 0 0 0 N 0 0 0 0 0 0 0 0 0 0 0 Q G .. 00 v � r.-rr r� rr rrN O OOOOOOOO OO r0 OO OOOO OO =:U� vLL OO OO R€ C, m C � � O P LL h`ohmhmhn<o hfD m 0 0 0 0 0 0 0 0 0 0 0 h =z?ooao0oc0000 c C Q � c ONC V: V0 N0 W EE 0000000 � — s} op pmp tO N(O 00p0 m V a'N > c 3 0 0000000 .�•EOv 066 N ni zmxx Y Z J U` a. F- <Lu<(L ]»wUOwF- c 1 � � m C 0 T Q + t c mm pry `u Rq 6tEE a'U+ m:e c c W W F J C C .E .E Pi e + + s >�>>> R€ C, UtJzUUU ut 0 Eo c 3 0 E v v� c m a m m � m c £c v N U � O n N N �u C W E m E `a �o Em E = W t5 mt v$5 R a bb � c NN N o9 a c c n m am m(i o c.2 c E a w$ w$ u m 2°00 0o p� wmmm-N.m. 2a �C s Ceci c K 9504043 Sudo Of Colorado Water ROS01=1-View Well Details: Rewipt 0442748C Pella 1 of 2 coromm Doubnentof Netaw Pascmei Co�eda.SaY I �tauUs Colorado's Well Permit search wen conshuded Receipt 0442748C Division: Permit A: 51463•F - Water DIaMeC Well Name / S: County: Management Dlehlct hayJ/wxnr.dweneta,w.us/WaBPermiaSearcFJView.aspxireNyr6442748C t0d,'201 liffiP last Rehesh:l0%r/201512.M:2SAM 5 38 GARFIEID 1-7 pOmnt/own Nbslory Data Range APPlicant(Damec Hama Address qty/steps/tip undress-A"Ont S4a0�Mwautd Wl 631 SURWRD O1ABO�A3E, co 81623 C-7 Location2Dtormation Approved Well Locations Q40 Q160 Section Tm mhlp Range pH footage from Section tines SW SW 28 7.05 88.0W Sixth 200 5 650 W Nosihing (UTM Y)l 43648095 Fasting (UTM x): 307557.7 LOeatisn AauracT: Spoaedfmmsectlon Ones PACs! Address Subdivision Name VaMN FAMILY TRUST EI(EMPMN Qty/Stale/lip PUrng Bladc Let A Parcel TDs 23.2393.283-00-397 Date 2ssuedl 03/12/1999 Use(:): DOMESTIC spatial uses AUGMENTED Area which may be Irrigated: 12000-% pr. Mmdmum annual volume of appropriations Statute: Permit Requirements: Totalizing Row Meter Yes Acres in Tracts 2 (fer ALL UNNAMED AQUIFERS Geophysical tog Abandonment Report NO No Cross Raference Penult Number Receipt Description pemdt(s): Comments:Pump batalled - Well not put to besselidal lee -AOT. Tax #R00SM Phy address 889 5CR 109, Carbondale, CD 01623. WD=09911113.8HWSA. Unit use to 2 SPD, 120110 sq it awn/gtc ardan Mg B water dense animals, door 02106/15 Well Construction Date: 10/07/1999 Pumptastallatlan Dates 10/07/1999 Wen Plugged: 1st aeeeHdal Use: Mastodon Depth Perforated Casing (Top) Perforated Casing (Bottom) static Water Level pump Rate 28 23 28 15 LS LIc3 Name Address Phone Number Driller n57 MUN5,PROMW. *755 KWY 6124 GLUMOD jMMM, CO e:6o1A682 WD445.1034 C-3 Application/permB: History Late Notice Sent 06/14/2005 Weil Constmctlon Report Received 12/06/1999 Pump lrvzkd 2WO711999 Well Constructed 10/07/1999 Pemdtlsaed 03/1211999 Application Received 02/17/1999 Document Name Data Imaged Annotated ; Document Name Data Imaged Annotated ; 9 co rn LOm m N n 0 rn N N N 0 O C: L) L) p M C7 yG O N U_ {� U L C o =; -o N. L9 "J- m N L @ U U N O= CO ro N to ��Ecm L � •?— L c N N L 7 N � Q ciilOi(A 5 J N N 0 O C: L) L) p M C7 yG O N U_ {� U L C o =; -o N. L9 "J- m Contract# 901138HW#A(c) Total Dwelling Units Contractee: Sabo, Jeffrey W. and Laurel J. Phone Number Actual Dwelling Units Fax Number Address P. O. Box 1822 Email Address: 12000 Date Activated 28 -Jan -99 Carbondale, CO 81623 Date Amended Authorized Agent Augmentation Plan or SSP 02CW123 Total Dwelling Units 2 Conservancy District WDWCD Actual Dwelling Units 0 Acre Feet 2 Total Area Irrigated (sq ft) 12000 Waste Water Treatment Septic System/Leachfield Actual Area Irrigated (sq ft) 0 Type of Irrigation Total Commercial Space (sq ft) 0 Use Code Domestic Actual Commerical Space (sq ft) 0 Source Ground Water Total Livestock 10 Activity Active Actual Livestock 0 Geologic Zone B3 Elevation 6160 Other. Original Contract: Beulah H. Wilson Family Co. Comments: Assigned: Carol A. Henson, Cheryl Nathan, and Ralland S. Stevens Assigned: Jeffrey W. and Laurel J. Sabo Structure Name Map lD State /D Well Permit # Wafer Disirict Water court Case # Beulah Wilson Well A 302 3608041 051463 r 38 Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Total Diversion (AF) 0.068 0.062 0.068 0.081 0.182 0.232 0.247 0.208 0.166 0.093 0.066 0.068 1.541 Consumptive Use (AF) 0.062 0.063 0.063 0.063 0.062 0.062 0.061 0.061 0.06 0.061 0,061 0.062 0.741 Map /D # Structure Name 302 Beulah Wilson Well A 302 Beulah Wilson Well A 302 Beulah Nilson Well 302 Beulah Wilson Well A 302 Beulah Wilson Well A 302 Beulah Wilson Well A 302 Beulah Wilson Well A 302 Sedan Wilson Well A 302 Beulah Wilson Well A 302 Beulah Wilson Well A 302 Beulah Wilson Well A Date Meter Reading 10115/2002 Water Taken, No Information Available 10/1512005 Water Taken, No Information Available 10/25/2007 113100 10/15/2008 601000 10/1/2009 1053720 9/22/2010 1661090 10/15/2011 2239160 9/15/2012 2787560 10/15/2013 3581360 10/1/2014 4314750 10/20/2015 5022130 Wednesdqv, November 25, 2015 Page 344 of 467 District Court, Water Division No. s Case No. 02CW281(1 of 2) Concerning the Application ofthe West Divide Water Conservancy District Findings of Fact, Conclusions of Law, Ruling of Referee & Decree of Court Page 3 Canal and Siphon when said water right is in priority. When the Avalanche Canal and Siphon is out of priority, Applicant will provide augmentation water via releases from Ruedi, Wolford Mountain and/or Green Mountain Reservoirs. CLAIM FOR CHANGE OF WATER RIGHTS 8. Claim for Alternate Points of Diversion. A. Decreed name of structure for which change is sought: Avalanche Canal and Siphon. From previous decree: Date entered: June 20, 1958. Case No.: C.A. 4613. Court: Garfield County District Court. 2. Headgate No. 1, being the initial point of diversion for the Avalanche Canal and Siphon, is located on the right bank of the Crystal River at a point whence the witness comer at the Southwest Comer of Section 9, Township 10 South, Range 88 West, 6th P.M. bears North 03deg9' West 546 feet, said point being at the outlet of the Osgood Reservoir. 3. Headgate No. 2, being the second point of diversion for the Avalanche Canal and Siphon, is located on the right bank of Avalanche Creek at a point whence the West Quarter Corner Section 28, Township 9 South, Range 88 West, 6th P.M. bears North 67degl5' West 4,538.1 feet. B. Source: Crystal River or Avalanche Creek or both sources. C. Appropriation Date: April 22, 1957. D. Amount: 830 efs, conditional. E. Use: Generation of electric energy, domestic and municipal, industrial, irrigation and stockwatering. YF. Proposed change: Applicant seeks alternate points of diversion for the Avalon .h . Canal and Siphon to the Points of diversions referenced in Table 1 attached hereto and incorporated herein by this reference. District Court, Water Division No. 5 Case No, 02CW281 (I of 2) Concerning the Application ofthe West Divide Water Conservancy District Findings of Fact, Conclusions of Law, Ruling of Referee & Decree of Court Page 4 G. Remarks: When water is not legally and physically available at the decreed points of diversion for the Avalanche Canal and Siphon, depletions at the alternate points of diversion will be augmented via releases from Ruedi, Wolford Mountain and/or Green Mountain pursuant to the plan for augmentation described below. CLAIM FOR APPROVAL OF PLAN FOR AUGMENTATION{ 9, Structures to be augmented: See Table 1 attached hereto and incorporated herein by this reference. 10. Water rights to be used for augmentation: Ruedi Reservoir, Green Mountain Reservoir and Wolford Mountain Reservoir. A. Ruedi Reservoir. 1. Source: Frying Pan River, tributary to Colorado River. 2. Legal Description: On -channel reservoir located in Sections 7, 8, 9, 11, and 14 through 18, Township 8 South, Range 84 West, 6a' P.M. 3. Adjudication date: July 20, 1958. 4. Appropriation date: July 29, 1957. 5. Case No.: C.A. 4613. 6. Court: Garfield County District Court. 7. Decreed Amount: 102,369 acre feet. 8. Uses: Generation of electric energy, domestic, municipal, piscatorial, industrial, irrigation and stock watering. 9. Remarks: Applicant has an interest in 600 acre feet of water from Ruedi Reservoir pursuant to Contracts between Applicant and the Bureau of Reclamation. By Water Service Agreement between Applicant and the Colorado River Water Conservation District, Applicant has contracted for 100 acre feet of additional Ruedi Reservoir water and further has obtained an option on another 900 acre feet of Ruedi Reservoir water. B. Green Mountain Reservoir, I. Source: Blue River, tributary to Colorado River. 2. Legal Description: Located approximately 16 miles Southeast of the Town of Kremmling, Colorado in all or parts of Sections 11 through 15 and 24 of Township 2 South, Range 80 West, and in Sections 17 through 21, 28, 29 and 34, Township 2 South, Range 79 West, 6a' P.M. 3. Adjudication date: October 12, 1955 LM a 1219/2015 Account R005782 Account Location Owner Information $235.00 06/08/2005 W—�\ Account Nu grk;05782 Owner Name SABO, JEFFREY W & Parcel Numb 2393-283-00-397 LAUREL J Situs Address 109 CO NTY RD Owner Address 5889 COUNTY HARDWICK BRIDGE RD ROAD 109 City Carbondale CARBONDALE, CO 81623 Carbondale Tax Area 010 - 1R -DF - 010 Legal Summary Section: 28 Township: 7 Range: 88 A TR. OF LAND IN LOTS 11 & 14 CONT 2.12 ACRES. AKA LOT A BEULAH WILSON EX. Transfers Assessment histo Actual (2015) $1,114,020 Assessed $88,670 Tax Area: 010 Mill Le 2960 Type Actual Assessed Acres QFT Units Improvement $9144,020 M,A 0.000 0.000 1.000 Land $170,000 $13,530\2.12 0.000 0.000 Sale Price Sale Date Doe Type $235.00 06/08/2005 W—�\ 01/24/2001 PRD ` 1020/1999 LTR 10/172000 BSD Tax Histoma Images Tax Year Taxes . Man *2015 $6,144.48 , photo 2014 $4,424.56 . Sketch * Estimated • GIS https://act.garfield-county.mm/assessor/taxweb/account.jsp?accmntNum=R005782 Book Page B: 1695 P: 148 B: 1232 P: 244 B: 1232 P: 243 B: 1215 P: 826 1/2 m 9 L a _ e V N C O 0 F = � m m Z m ae sG O F- F- oa g C O CS N O n IL � A o® O ® > o U medN W N O h Ln O d� i0 3C r U m q O D 111 O U) G cdo-ma C D aARri K a°� ® � ®❑ Z C� F u LC ® ]NO o. ry Zii L� c C O � Nwt0 0° Zm0 9Ee`m"e 'off C LY N O i 5 ®®00®00 ® a -m .H. IL o Hm �3mrta� o w ® f rs Q m 8€ a n O L N f0 C r .01 U® V oa3�so -:O W f0 O d�m�N 3' lb x m O 4 ✓ J C o M e;io m=vS :U m¢ o c dB a o _ �•qt _- O h oo CaN- ❑ m 0055 • t0 W ® 6 O N T 67 j T� � r O O - M U 0 N N d Ni v 00 ♦� OroOJ lO UM M V m Q IL Z N co Ln ti _... Q F • u u 4 a N m ma mn o N u V 9 � o� � G W O a ► y pn�R 5 w� ❑ ❑ ® ❑ 9 c E v a� ► E m m���°€fit u y gg 9 ry Z m m L% ? E�utyti N L' N m ¢nm•�m W y O W v arc � S I r°UaPP® d �� o r€a•>d :o pvG �q �q mI_J tO1 ❑❑ ®❑ C d¢ p v u'm'c rC D u ® qgE$ C y „ 00 m► O m&deo W Z N N O ca„ao .Q Q N o m mom Cn :V -y a 3 m v® a o' S y+ ra X80 m 3 a € 300 m ❑ N O F Z� N 0 9 0 � osz's N m mO N wy m T� a� 00 r. of � c o _ N N � m � 'O m Q SR co I, - to O r ORDER OF THE STATE ENGINEER IN THE MATTER OF WELL PERMIT NO. 51463-F APPLICATION RECEIPT NO. 0442748C LOCATION: SW 1/4, SW 1/4, SECTION 28, TOWNSHIP 7 SOUTH, RANGE 88 WEST, 6th P.M., GARFIELD COUNTY, (BEULAH WILSON WELL A) (WDWCD CONTRACT #990113BHW#A) APPLICANT: JEFFREY W & LAUREL J SABO THE STATE ENGINEER FINDS: The well permit was issued on March 12, 1999, with an expiration date of March 12, 2000, and later extended until March 12, 2001. A well construction report was submitted on December 6, 1999, indicating that the well was constructed on October 7, 1999, to a depth of 35 feet, and a pump installation and test report (Form no. GWS -68, Existing Well Information and Inspection Form) was submitted July 1, 2005, showing that a pump was installed in the well on October 7, 1999, all under permit no. 51463-F (WDWCD #990113BHW#A). On December 8, 2015, the current well owner (Jeffrey Sabo) submitted an application to expand the use of the existing well, permit no. 51463-F. The new permit (permit no. 79714-F) allows for the change of use of the existing well (Beulah Wilson Well A) in accordance with the West Divide Water Conservancy District contract no. #990113BHW#a(c) (amended November 19, 2015). The well permit is hereby canceled and is of no further force or effect. Dated March 7, 2016 Nck VV'v-C fe- bg Dick Wolfe State Engineer By: Dwight M. Whitehead Engineering Tech (Ground Water) cc: Division Applicant :dmw/051463-F existing well order to cancel; Sabo, Jeffery W & Laurel J, (Beulah Wilson Well A WDWCD CONTRACT #990113BHW#A) 12-09-15.doc Laboratory Services Division 8100 Lowry Boulevard, Denver CO 80230-6928 US Mail: PO Box 17123, Denver CO 80217 Colomdol7�•um�mt (303) 692-3090 fax (303) 344-9989 of PuNic H. andEmghmmen. Legacy Homes 5889 CR 109 Carbondale Co 81623 Contact Name Legacy Homes Contact Phone 970.618.6096 Collected Received Reported Collected By 7f Lab ID No, 2/2/2016 3:15:OOPM 2/3/2016 11:06:OOAM ENV -2016001168 Matrix Ground Water Purpose Routine Chlorine residual Payment Type Receive Temperature 14.8 Test Name Result Method Name Total coliforms PA Coliform ABSENT or less than one (<I), indicates SM 9223 B.2.b. a microbiologically safe sample Escherichia coli PA E. coli NOT DETECTED SM 9223 B.2.b. If you have ordered Chemistry Tests: Results will be finalized in 2-3 weeks, For more information contact Water Lab at 303-692-3490 LSD Interent Address: http://www.cdphe.state.co.us/Ir/lrhom.htm Modification Date:2/4/2016 #203 John W. Hickenlooaer, Governor STATE OF COLORADO Dr. Larry Wolk, Executive Director Dedicated to protecting and improving the health and environment of the people of Colorado Laboratory Services Division8100 MIN Lowry Boulevard Denver, CO 80230 PO Box 17123 Denver, CO 80217 Colorado Department303-692-3090 of Public Health w .cdphestale.coxs/Ir and Environment Laboratory Results For Sample Number: ENV -2016001168-1 Site ID/PWSID Contact Legacy Homes Site Phone 970-618-6096 Address Fax Email jeflsabo@comcast.net Site Description Collected By JS Customer ID 00018305 Collected 02/02/2016 15:15:00 Customer Legacy Homes Received 02/03/2016 11:06:00 5889 CR 109 Reported 02/24/2016 00:00:00 Bottles 1 -CUBE 1-13ACT 1-250NUT 1-250M 1-LNEUT Matrix Ground Water Carbondale Co 81623 Field Fluoride Residual Chlorine Temperature at Receipt 14.8 iTest Name Result Units MCL iMRL Method Name '.:Date Analyzed Qualifier Deluxe Colorado Package` Alkalinity, Phenolphthalein < 5 mg/L no limit 5 SM 23208 02/04/2016 establishE 00:00:00 Alkalinity, Total 30 mg/L no limit 5 SM 2320B 02/04/2016 establishE 00:00:00 Arsenic, Total <0.001 mg/L 0.01 0.001 EPA 200.8 02/04/2016 00:00:00 Cadmium, Total <0.001 mg/L 0.005 0.001 EPA 200.8 02/04/2016 00:00:00 Calcium (Carbonate) 74 mg/L No limit 0.02 EPA 200.7 02/05/2016 establishE 00:00:00 Chloride 1.2 mg/L [250] 0.4 EPA 300.0 02/10/2016 00:00:00 Conductivity 250 us/cm No Limit 0.5 SM 2510 B 02/04/2016 Establish( 00:00:00 Copper, Total 0.036 mg/L 1.3 0.004 EPA 200.7 02/05/2016 00:00:00 Corrosivity-Langlier -1.76 D 3739-83 02/16/2016 00:00:00 Fluoride 0.052 mg/L 4.0 0.05 EPA 300.0 02/04/2016 00:00:00 Hardness Total 93 mg/L No limit 1 Calculation 02/05/2016 establish( 00:00:00 Iron, Total <0.003 mg/L [0.3] 0.003 EPA 200.7 02/05/2016 00:00:00 Lead, Total <0.001 mg/L 0.015 0.001 EPA 200.8 02/04/2016 00:00:00 MRL - Minimum Reporting Limit. MCL - Maximum Contaminant Limit per EPA regulations. BDL - Below Detection Limit. H - Holding Time exceeded. Q - Quality Control limit exceeded. NT - No Test. Units: mg/L - milligrams per liter (ppm), ug/L - micrograms per liter (ppb), pCi - picoCuries LSD Internet Address: coloradostatelab.us John W. Hickenlooper, Governor STATE OF COLORADO Dr. Larry Wolk, Executive Director Dedicated to protecting and improving the health and environment of the people of Colorado pf Cpl �E p49. � g Laboratory services Division 8100 Lowry Boulevard Denver, CO 80230 PO Box 17123 Denver, CO 80217 - Colorado Department 303-692-3090 of Public Health www.cdphe.state.co.us/Ir and Environment Laboratory Results For Sample Number: ENV -2016001168-1 Test Name ;Result Units MCL ;MRL !.Method Name Date Analyz_ e_d_ Qualifier Magnesium, Total 5.7 mg/L No limit 0.02 EPA 200.7 02/05/2016 establishE 00:00:00 Manganese, Total 0.0032 mg/L [0.051 0.002 EPA 200.7 02/05/2016 00:00:00 Nitrogen, Nitrate/Nitrite <0.05 mg/L 10 0.05 EPA 353.2 02/05/2016 00:00:00 pH 6.8 [6.5-8.5] NA SM 4500 -H+ -B 02/04/2016 H 00:00:00 Sodium Adsorption Ratio 0.23 mg/L Calculation 02/16/2016 00:00:00 Sodium, Total 5.2 mg/L No limit 0.1 EPA 200.7 02/05/2016 establishE 00:00:00 Solids, Dissolved 150 mg/L 500 10 EPA 160.1 02/08/2016 00:00:00 Sulfate 84 mg/L [250] 0.4 EPA 300.0 02/10/2016 00:00:00 Uranium, Total <0.001 mg/L 0.03 0.001 EPA 200.8 02/04/2016 00:00:00 Zinc, Total <0.01 mg/L [5] 0.01 EPA 200.7 02/05/2016 00:00:00 Test Group -Total Coliform ug/L PA** Total coliforms PA Coliform ug/L SM 9223 B.2.b. 02/03/2016 ABSENT or less 00:00:00 than one (<1), indicates a microbiologically safe sample Escherichia coli PA E. coli NOT ug/L SM 9223 B.2.b. 02/03/2016 DETECTED 00:00:00 Gross Alpha/Beta Package (Water)* Gross Alpha <3 pCi/L 15 3 EPA 900.0 02/18/2016 00:00:00 Gross Beta <4 pCi/L 50 4 EPA 900.0 02/18/2016 00:00:00 Comments: HUMAN HEALTH Arsenic, Cadmium, Copper, Lead, Uranium, Fluoride, Nitrate/Nitrite concentrations are below EPA health -based standards. Iron, Manganese, Zinc, pH, Solids -Dissolved, Sulfate and Chloride levels meet EPA aesthetic -based standards. Based on these results, the water is safe for human consumption. MRL - Minimum Reporting Limit. MCL - Maximum Contaminant Limit per EPA regulations. BDL - Below Detection Limit. H - Holding Time exceeded. Q - Quality Control limit exceeded. NT - No Test. Units: mg/L - milligrams per liter (ppm), ug/L - micrograms per liter (ppb), pCi - picoCuries LSD Internet Address: coloradostatelab.us John W. Hickenlooper, Governor STATE OF COLORADO Dr. Larry Wolk, Executive Director Dedicated to protecting and improving the health and environment of the people of Colorado ,,Laboratory r*-po'% Services Division8100 Lowry Boulevard Denver, CO 80230PO Box 17123 Denver, CO 80217 Colorado Deparnnent 303-692-3090 of Public Health w .cdphe.state.co.us/Ir and Environment Laboratory Results For Sample Number: ENV -2016001168-1 CORROSIVITY -1.76 < -0.5 The Corrosivity Index is -1.76, which indicates that the water is considered aggressive and may deteriorate plumbing IRRIGATION The sodium adsorption radio (sodicity) is 0.23. The conductivity (salinity) is 250 us. The sodium and chloride concentrations (toxicity) are 5.2 mg/L (recommended level <46mg/L) and 1.2 mg/L (recommended level < 140 mg/L), respectively. The alkalinity is 30 mg/L (recommended level <92 mg/L). Based on the measured sodicity, salinity, toxicity and alkalinity the water is considered a slight irrigation risk and may have detrimental effects on sensitive crops such fruit trees, clover, radishes, celery and green beans. Registry Comments: MRL - Minimum Reporting Limit. MCL - Maximum Contaminant Limit per EPA regulations. BDL - Below Detection Limit. H - Holding Time exceeded. Q - Quality Control limit exceeded. NT - No Test. Units: mg/L - milligrams per liter (ppm), ug/L - micrograms per liter (ppb), pCi - picoCuries LSD Internet Address: coloradostatelab.us rR «19TR � ratondg Depalgnmr TFJR,bIicHntdl � PY C'PYi[OMINI Laboratory Services Division 8100 Lowry Boulevard, Denver, CO 80230-6928 (303)692-3090 fax (303) 344-9989 REQUEST FOR ANALYTICAL SERVICES Collection No: �❑ ❑ CLISTO •3 :4 171 FT I I IS CustomerlD : 00018305 Name Name : Legacy Homes Address: 5889CR 109 City/St/Zip : Carbondale Co 81623 �❑ _ Collected: r� Z D z ) Time b month day year hour Collected by:_ & F'F S0'r�o Water Type: o [Ip. m e min i p'm z Phone : 970-618-6096 Email: jeffsabo@comewt.net Contact: Legacy Homes Fax:SAMPLE Purpose: Routine F] special Purpose ,,-,f Compliance I7(I Personal Information r� Repeat SITE Chlorine residual:r�� mg/L Water Temperature 00 Q PWS ID: coo ❑ ❑ ❑ 11 ❑ _ [I ❑ Fluoride 0' 11on mg/L u F System Name: Address: Temperature Comments: at Receipt: City County State Ip Description: Location Source ❑Real EstatelHUD (Coliform Bacteria, Lead, Nitrate and Nitrite) ❑Annual Colorado Package (Coliform Bacteria, Nitrate/Nitrite) 'xpanded Annual Colorado ckage (Coliform Bacteria, Nitrate/Nitrite, pH, TDS) ❑General Colorado Package (Arsenic, Coliform Bacteria, Hardness, COMPLIANCE DRINKING WATER TESTS Organic Chemicals Rule ❑EDB/DBCP ❑Chlorinated Pesticides 13PGBS(Subcontracted) ❑Chlorinated Herbicides ❑Volatile Organic Compounds (VOCs) ❑SemivDlatile Organic Compounds (SVOCs) ❑Carbamate Pesticides 1 Inorganic Parameters ❑Alkalinity O BOD ❑CBDD ODO El Chemical Oxygen Demand (COD) ❑Chloride []Chlorine ❑Chromium, hexavalent (Cr«s) []Corrosivily (Langlier) Cyanide O Direct D Distilled Organic Parameters ❑Oil and Grease ❑VOCs Screen OSVOCS/Pesticide Screen OBTEX Radiochemistry ❑Gross Alpha/Beta ❑Radium 226 Copper, Fluoride, Iron, Lead, Nitrate/Nitrite, Uranium) Deluxe Colorado Package ODiquat (Subcontracted) ❑Endgthall []Glyphosate O WAD ❑Fluoride ❑Hardness ❑Radium 228 ❑Uranium OC -14 (Alkalinity, Arsenic, Cadmium, Calcium, Coliform Bacteria, Chloride, Conductivity, Capper, Corrosivity, Fluoride, Hardness, Iron, Lead, Magnesium, Manganese, Nitrate/Nitrite, pH, Sodium, Sodium Inorganic Chemicals Rule ❑Primary Metals (Sb, As, Be, Be, Cd, Cr, Hg, Ni, Se, Na TI) + Fluoride ❑Primary Metals (Sb, As, Be, Be, Cd, Cr, Hg, Ni, Se, Ne TI) + Fluoride + Cyanide Nitrogen, []Nitrate O Nitrite ❑Mercury Individual Metals DAluminum ❑Antimony ❑Arsenic OBarium ❑Beryllium ❑Cadmium OCalcium ❑Chromium []Cobalt OCopper ❑Iron ❑Lead []Magnesium ❑Radon ONi-63 ❑Gamma Spectromel Specific Isotopes (list) Adsorption Ratio, Sulfate, Total Lead and Cogger Rule ❑Manganese❑Molybdenum _ Food Testina Dissolved Solids, Uranium, Zinc) ❑Mining Baseline Package (pH,ionuci ❑Lead and Copper uta ❑Nickel ❑Potassium ❑Selenium []Silver OSodium []Strontium ❑Equilibrium pH ❑Starch Nitrate/Nitrite, Aluminum, Arsenic, Gross Alpha/Beta []Sulfur OThallium OTin ❑Fat Cadmium, Copper, Iron, Lead, Magnesium, Manganese, Potassium, Selenium, Sodium, Sulfur, Uranium, Sulfate, Gross Alpha/Beta) ❑Radium 226 ❑Radium 228 ❑Uranium Disinfection Byproducts ❑Tungsten OUranium []Zinc Nitrogen, []Ammonia ❑ Nitrate/Nitrite O Total Kjeldahl ❑Nitrate ❑ Nitrite ❑Water Activity Preservatives (list): OM lning Baseline Package without ❑Total Trihalomethanes (TTHMs) []pH _ ❑Mercury Gross Alpha/Beta ❑Drilling Baseline Package (Volatile Organic Compound Screen, pH, Total Dissolved Solids, Chloride, Fluoride, ❑Haloacetic Acids (HAA5s) []Alkalinity []Bromate ❑Bromide []Brom he ❑Chlorate ❑Chlorite ❑Phenol Phosphorus ❑Phosphate, Ortho ❑Phosphate, Total Metals (list): _ ❑Bacteria in Food Alkalinity, Sulfate, Nitrate/Nitrite, Organic Carbon ❑Total O Dissolved ❑Sodium Adsorption Ratio Suspect:___ Arsenic, Barium, Calcium, Chromium, OUV @ 254 Solids ❑Dissolved ❑Settleable Suspect:___ Iron, Magnesium, Selenium, Sodium, Sulfur, and Uranium) Total Coliformle Microbio o /Bac er' ❑Suspended []Total ❑Volatile EI Specific Conductance Miscellaneous ❑Soils/Filters - XRF ❑Total Coliform (Present/Absent, w/ E. coli) ❑Drilling Baseline Package without VOC screen. OE. colf (Enumerated, w/ Total Coliform) ❑Total Coliform (Multiple Tube enumeration) ❑Sulfate ❑Sulfide metals (list): ❑Metals Scan: (Aluminum, Arsenic, OColiform, Fecal (Multiple Tube enumeration) ❑Turbidity Barium, Beryllium, Cadmium, Calcium, omium, Copper, Iron, Lead, OHeterotrophic Plate Count []Other Microbiology: ❑Other Inorganic: ❑Unknown Substan CE Identification (FTIR) ( ,rneslum, Manganese, Molybdenum, Nickel, Potassium, Selenium, Silver, Sodium, Uranium, Zinc CHAIN OF CUSTODY: - RELiNOUI5HED8Yr DATEmME: P,ECEIVED aY: DATE/TIME. RELiNDU15HED BY. DATEMME: RECEIVED BY: DATEm ME: ncun,.0 mn.o o,. I uAILI ME: I RECEIVEDaY. DATE/TIME T Qn Teta—p AA.l.a..... Jeff Sabo From: form_engine@fs8.formsite.com on behalf of Iawrence.garner@state.co.us <fo rm_eng ine@fs8.fo rmsite.com> Sent: Tuesday, January 26, 2016 8:56 AM To: jeffsabo@comcast.net Subject: Private Citizen/Well Owner/Realtor Water Testing Supplies Order Result #8898602 Reference #: 8898602 Status: Complete Customer Number: New Customer First Name: Jeff Last Name: Sabo Company Name: (if applicable): Legacy Homes PRIMARY Street Address: 5889 County Road 109 City: Carbondale State: Colorado Zip Code: 81623 Phone Number: (970) 618-6096 2nd Phone Number (if available): (970) 704-1950 FAX Number: (970) 704-1952 E-mail: jeffsabo@comcast.net Confirm E-mail & Receive Order Receipt: jeffsabo@comcast.net Residential address Ship -To Address: Same as primary customer address above Bill -To Address: Same as primary customer address above Results -To Address: Same as primary customer address above Deluxe Colorado Package: 1 Alpha/Beta Radioactivity: 1 Request a FedEx Tracking Number by checking below(Valid E-mail address is required): E-MAIL a FEDEX TRACKING NUMBER Check the box below regarding urgency of testing:: N/A - Not required for compliance or real estate transaction. Date: 2016-01-26 08:56:20 Start Time: 2016-01-26 08:51:08 Finish Time: 2016-01-26 08:56:20 Duration: 5m 12s User: 74.95.117.69 Browser: Firefox OS: Windows Referrer: http://fs8.formsite.com/cohealth/form542518383/index.htmi 1