HomeMy WebLinkAbout1.12 Well Permit Info.Form COLORADO DNISION OF WATER RESOURCES
No DEPARTMENT OF I TTA AL RESOURCES
GW5-11 1313 Sherman St., Ste 821, wornrer, CO 80203
11/201 I _ mein: (3C) r 35U1 Fax: (3q11366-2223 dwroermllsonllna b ,00.tre
CHANGE IN QWNER NAME/ADDRESS
CORRECTION OF THE WELL. LOCATION
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instructions i be reverse side prier to completing the forme,
4211 2, addr1sa anal n2nc p S14111�€fl�i t�7 rstii .2r th 51d tt1rrr 1
Name(s): LINDA L HELMICH & DONALD B. HELMICH
' Melting Address: 40°6 Cot,lrnyr Road 115
city. SI, ZEp Gleet OOd. Springs CO 91501
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ee Use Only
RECEIVED
?eV 1 8 '15
MIVIZR RESOURCES
GLIBIRODO
This form Is filed by the named indite claiming Mai they are Iii cher of the welt pem l as referenced below, Ns fling is made
unwell to C-R.S. 37-9 0-1 .
County
4005 County Road 115
ATI&WWI Pernik Number 5951F14->
Receipl h10.1. 95°01157 Case Number Di I W031O5
Will Name or* (optional) HELM WELL
Glenwood Springs CO 816.01
(Address) Ply )
NW 1/4 of theNE 1/4, Sec 29 Twp 6.175 Q Ire. or 0 s., Rang* 88° De. go lftf.,
4H;rlancifrpn1 SOoblyrLLI-ine ,t3(? t Ft From N. or( S,, 230°
(State) (Zip)
Nth
Ft. Roma E. ora W. fate:.
DR; GPS YAWN Wenn Information In U-Th1 format. Yate must Check GPS unit for required settings as fellows:
Formai rnkiat be Ufl.t 0 Zeno 12 or 0' zone 13 : Unrts must be meters, Datum must be NAM; Und nerst be eel le True north
Easling 30709.3 Northing 4375791,8
S1rbd.lviskcsn Nath SPRING VALLEY RANCH
Lot , ®bock -- , Fiiireg/Unii
I
P.M.
The above listed owner(s)say(s) thin rhe, she (they) own the well permit destaibed herein. The existing record is being amended far the
Fallowing mons.
•Change In name of enyner El Change In railing address CI Correction oflocation Jlerexemptwwells permitted prior to May 9, 1972 and
lin-exemptvectis permitted before May 17. 1965.
S set flee rertnersraslge ice further infvrrrratlan lin wdIrert correction of the well location.
(we) clakn end soy that 1 (we) (am) (are) the, owner{sj of the well permit described above, know the contents of Si# statements made herein.
state that ih are Irw+e to o knowled
Ston or enter the name(s) of life new owner(s)
LINDA IT HELMI I & DONALD S. HELMIC-I
tf signing print name & tI firs
tt is the respGrtsbbtlity of the new owner of this well permit to complete and/or sign
Lease Me instructions.
Pleasesend confirmation of acceptance of charge In ovwnernarneladdress wit
fatale Engineer
Dale (rityyM
11110A5
s form. If en agent Is signing or entering Information
Emelt address listed above - LMS Mail
RC.f4i.01..I.JIAS A CI tYSoeu' t)TitaiLI4S.HJF
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State of Colorado Water Resources - View Weil Details: Receipt 9501187 Page 1 of 2
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Calor itices WiNI Permit Search
We I C ria 1JCtcd
Receipt 9S011S, DJ O 5
Permit a: 53504•F • Water Mow: 38
Well Name / County: GARt=1ELD
tesipralAdlLosier NanapatolotDi*Ict;
CaseNumfren 0::WC305
W DIp; 3605514 - Hetrocx WELL
s-1 Anon ror /ouwtgrg: histo rp
LakRtfra0:11/21241s1� 1.3SAM
Data Ring AppfkxR1Dtwti a Name
uermaike mew 141.1401 OVAL
Location information
"Wooed Well L4iatlerLc
Q40 Q1.66 Section Tpavrrehlp Ralgge PN F4ota9s Mord Setdon Limas
Mee N= 29 6.05 $$.OW Stxth 7.33 N 2300 E
Address aty/Stata/Zip
R at gym..
Northing [MN y):
1+aoatian
Accuracy:
Phys}rar Address
City/state/no
SulxdIYIslon Neme
lh3VA-LEY PAN[_H
Filing Bind{ Lot
Parcel ID: 73.2187-292-OG109
Acres In Trac#; 7.B
43751'41.H
User sips . t
Easting (UT7I xj; 307029,3
r[lj Permit Details
Dane Issued; e�129J2003 Dile #pkoi: O4/2/204
I05gs}: a{:41F5EIC
Sped e l User AUGMENTED
Area whI(.h mey tie Irrigated! 5000 50, FT.
Maximum annual volume of appropriation:
Statute;
Aquifer
ALL UNNAPEDAC.1]FE S
P$rmlt Requirements: Totalising flow Meter Geophysical Log Abandonment Report
Yes No Nu
Cress Reference
Permit(s);
PennFt Number Rei:elpt Description
CaarirnentS:F+'+' -:: R S6U subri!!ed 3.e8/04. Expand use cf ex14i; ..,:; well perrr t r!c. 1 5.vgi5
(CA) 91293-vE{EP) 154065-AtiEP;, L}l'Ic:D #29:). L.91i; use to 1 S=D.: a:attn- -i L &
%Goo s rl irrigation. Tax ;ai050233. t-rtw 10137.!15
[-] Ca+tlrhuCklen/Usiipa Dttilib
Well Construction note: :19V120/ 1591
Win Pllagyed;
Elevation Depth
1oa
Pump Instiliaitttpra Date: LT.3r 1 y,1,992
sat Pen ender thie:
Perforated Casing CTop) Perf®rated GaBinp (bottom) Static Waier Level Pump Rete
85 1 39 6
Lk # Bache
ori lies $9s SILLY rt,5-r4F
Pump Installer 1196 1-001...F 11.10400F-
�Appllosticr/Rermlt History
Add res$
resax HIS or1 acsTA,coSalk;
$II 'MAD •t I7CiEMOGV SPCA. coEI6pi
Phone Number
L2te NnItre Seri( 03/14t2004
StawrientI uF 6enrfrcial Lse Rere-ve1 0108140e
Permfr issued 04.;2412003
AFplica o- Received 07,t3/20102
http://r ww-Livr•r-state.ccs.us/WeIIPerrnit i hi"View.aspx r eipt=9501187 11/2.2015
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I01142, 21**2 Sii(rRf
MEMORANDUM l D OF WATER ALLOTMENT T CO TTRAC'T
The Basalt Water Conservancy District (the -District') has granted Water Allotment
Contract No. 2S0, dated the 9th day of September, 1996, ("Contract"), to extend to the
owner(s) of the real property described on Exhibit A attached hereto and incorporated
herein by this reference, the right to beneficially use water of water rights owned, leased,
or hereafter acquired by the District for such real property located in the Con,rty of
Garfield, State of Colorado_
The Contract is subject to various coriditions which may include well permit
requirements of the Colorado Division of Water Resources and Water Court approval of
an
augmentation plan or substitute supply Flan. Assignment of the Contract requires the
District's consent and Applicant's payment of an assignment fee..
Inquiries rn ay be directed to: Basalt Water Conservancy District, do Christopher L,
Geiger, Baicomb & Green, P.C., F.O. Drawer 790, Glenwood Springs, Colorado 81602;
Telephone. (970) 945-6546; Fax: (970) 9-B9O .
This Memorandum is subject to the terms and provisions of the Contract which are
incorporated herein by this reference, Upon recording, this -Memorandum shall constitute
notice to bona fide purchasers of the Contract affecting the above.described property.
Date: September 9, 2Q03
STATE OF COLORADO )
) ss.
COUNTY OF GARFIELD )
BASALT WATER CONSERVANCY DISTRICT
Arthur Bowles., President
The foregoing instrument was acknowledged before me this 9th day of September,
2003, by Arthur Bowles, President of the Basalt Water Conservarrcy District.
WITNESS my hand and official seal_
onunission expires: — 7--ct
Notary Public
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1111011111111111 11Ii 111111111111111911141111 11!
641792 11/26,02003 01:40P 91542 P395 M ALOOF
2 o f 2 R /1,00 0 0.0E GARFIELD COUNTY 00
PARCEL A:
:T A
A TRACT OF LAND SITUATFD IN LOTS 9 AND 10 OF 92tTION 2!, TONNOSIP 6 SCUM
r.wag 18 WEST or THE Sir're FRINcIPAL NE> IDIAN, G ARV NLD =NTT, COLORADO, BRIM
MORE FARTiCULARLT DESCRIRZD AS FOLLOWS:
commEINcxNG AT A room STONE IN PLACE FOR rwz NORTH WART= COMBS OF UID
SECTION 29;
THENCE 8 07 DEDR*U 46' 240 N 473.26 MT)
T E.r x 11 51 moms 06' 009 E 78.45 MIT TO TSS TRU* POINT OF •9EGINSINGi
TRBNC 2 61 DSA 06' 04" 2 136.55 FEST/
TRANCE S 2.1 =GM= 541 999 I 364.00;
THENCE 8 92 DEGRzES IB' 900 R 163.49 MT TO A POINT 011 TRE ASSTMLY LINE 01 A
24 FOOT WIGS ROAD AND UTILITY RAIMENT. '11 CRNTIRLTNE OF WHICH 10 =SCRIBED
rN 1002 779 AT Ppm. 958 or TEZ RECORDS OF TAN/CARPI'S= COUNTY =ERR AND
RIECORMEN. BRIO PO'IN'T BEING TEZ ENGTHNIN4 or Jl NON-TANGSAT Ct RVM TO TRX LRI►T
HAVING A RADIUS OF 55.25 MEET'
TSENC8 ALONU A 5A7.D NEST ULY LINK AND AAO OF SAID CURVE 39.09 FRET (CHORD
Sg14.RS S 24 »BOR R8 351 04' W 38.28 FEET);
TRENCE ALONG SAID W$STTRLT L1 S 44 =ORRIS 111' 43'' N 149.94 7YtS'a
THENC1 I.RAVINU SAID WASTRALY LINN N 82 Dimas 36' 00" w 394.25 'MEET,
THENClC N 10 =GRINS 111 03' E 151..05 /SET;
TEENCR N 71 =urns 54' 00" W 104.85 FEW;
THEN= N ES DEGRIES 06' 00' E 78.43 FEET
TENNC8 H 21 DEGREES 54' 00" W 177.13 FEET TO TIM TRUE POINT OF BUMMING.
COUNTY ar GARFIELD
'MATE OF COLORADO
PARCHL, Et
TOONTEZR WITH A TWEN'T'Y FOOT EAssmsN1' FOR R0?.D AND UTILITY FURFOSRS IN 00INT USN
MIT» 'RAID PARTIES 4F THE FIRST PART, SYR RYIP.L SU'CCES24R8 AND 8$51(885, TER
CENTERLINE OF HEWN SAID ROAD IS DEACRIa2D AS POI.LOAEa
ERGfl Nflr3 AT A POINT INCE THIN MET= COIN= CONNOS TO MUM! 20 Amn 29 IN
521D TOWNSHIP AND RAS= BLARE $ 24 DIM= 04' 38' x 1/122.17 mint
TNINCE N 04 DRGRESS 18' 43" E 1.30.41 7EET1
TNINCR 55..43 rimy ALONG TSB ARC OF A CURVE TO TEE RIO$'T RAVING A RADIUS 4r
45.25 FIRT. '1 E CHORD OS NNICH BEARS 11 39 IJ RE'S 24" 21" Y 52.03 FN$Ti
THNUCK H 74 DEGRE;B 39' 60" S 37.16 PIQaj
TRENGE 46.47 IEET ALoNG THE ARC 0? ]1 C11RVZ TO TEN LICIT BAYING A RAW= or 58.75
rArT, TE2 CHORE or "MCI SE71RB N 31 DRa3.EEB 50' 17" 8 45.27 r rr
=NCR N 29 AERIES 10' 34. 1 64.64 1SRTa
rHINCE 155.93 f1ET ALONG T$! ARC 0! A COVE TO TSF RIGHT RAVING A RADIOS OF
841.44 rEKT, TSI CHORD OP W ICI =APB N 34 DESRKE9 13' 96' Y 155.71 FEET)
TOSNC1N 33 D1GRa!S 47' 389 S 54. 31 11871
TSR 171.2.2 FENT ALONG TIN AR(". 011 A COAVA TO 683 LIFT HAVING A R#OICT9 09
330.09 72ET, THI CHORD or wmcg SIARB N 24 CINCAEZS 55' 49 E 169.30 'ETD
=NCI 7i 10 =GENES 04' ad* 2 73.65 ram
SCE 119.21 FEET ALONG TEN A= O! A CORVN TO TES LRP! RAVE A RADIUS Of
1542,09 FEST. THI CHORD OF MICR 'ACS H 07 =COMA 911 071 R 119.10 F2, ?
TRENCH N 05 DE0k2 2 38' 13" R 42.41 7127 TO A POINT ON TM' SOUTURLY BOUNDARY
LINE OF A COUNTY ROAD A9 COASTAUCT= AND IN PIACI.
COUNTY 07 GARFIELD
STATE OF 'CSO L O RA1?0
EIIBIT B
TO ASSIGNMENT OF BASALT WATER CONSERVANCY DI TIC f
CONTRA CT
The Assignment to which this Exhibit is attached to and made a part of is approved and
made subject to the following conditions:
1. In the event the District includes the Assignees` water allotment in the Districts
Application fora plan of augmentation, Assignees will provide such information and assistance,
including testimony, as may be needed for judicial approval of the plan. The District makes
no warranty that it will secure approval of the plan. The District may establish an
augmentation plan fee to be paid by the holder of any Contract or amended Contract to be
included within a plan of augmentation to be filed by the District, which fee shall be payable
in advance of the inclusion of such Contract in a District plan of augmentation and may he
based on the District's good faith estimate of the anticipated expense of such ]Man of
augmentationif such augmentation plan fee paid by a Contract holder exceeds the Contract
holder's pmrata portion of the actual expenses incurred by the District in completing said plan
of augmentation, the District shall refund such excess to the Contract holder. Conversely, if
such augmentation plan fee paid by the Contract holder does not cover the Contract holder's
prorata portion, of the actual expenses incurred by the District in completing said plan of
augmentation, then Assignees shall pay the remaining balance of its portion of the actual
expenses upon the District's providing the holder with a statement for they same. To the extent
that the District is caused additional costs because of objections filed specifically due to thc
inclusion of Assignees' Contract in the filing, such additional costs may be charged specific -ally
to Assignees and not shared on a prorata basis by all Contractees.
2. Any and all conditions imposed upon the release and diversion of water allotted
hereunder in any water rights plan of augmentation or other water rights decree of the Water
Court for Water Division No. 5 shall be incorporated herein as a condition of approval of this
contract. Granting of this allotment contract does not constitute the District's representation
that the Assignees will receive a well permit or water rights decree for the land to be benefitted
hereby,
3. In lieu of recording the Water Allotment Contract or this Assignment, a
Memorandum of Water Allotment Contract will be recorded with the Garfield County Clerk
and Recorder's Office.
4. PA IvrEN T:.Assignees shall pay annually for the IA,a ter service described herein
at a price to be fixed annually by the Board of Directors of the District for such service.
Payment of the annual fee shall be made, in full, within fifteen (15) days after the date of a
notice from the District that the payment is due. Said notice will advise the Assignees, among
other things, of the water delevery year to which the payment shall apply and the price which
is applicable to that year. If a pay rent is not made by the due date, a late fee of $50 (or other
amount as the Board may set from time to time) will be assessed and final written notice of the
delinquent account and late fee assessment will be sent by the District to the Assignees at
Assignees' ;neer address set forth in the Assignment attached. If payment is not made within thirty
(30) days after said final written notice, the District may, at its option, elect to terminate all of
the Assignees' right, vi or interest under this Contract, in which event the water right allotted
hereunder may be Iran (erred, leased or otherwise disposed of by the District at the discretion
of its Board of Directors.
5. EI.L P"I £{l+wll'I': If Assignees intends to divert through a well, then Assignees
must provide to District a copy of Assignees' valid well permit before the District is obligated
to deliver any water hereunder, and it is the Assignees' continuous duty to maintain a valid
well permit. Assignees shall also comply with all restrictions and limitations set forth in the
ell permit obtained from the Colorado Division of ter Resources. Assignees must comply
with the well -spacing requirements set Forth in C.R.S. §37-90-137, as amended, if applicable.
Compliance with said statutory well -spacing criteria shall be an express condition of the
extension of service hereunder, and the District shall in rio way be liable for an Assignees'
failure to comply. Assignees agrees to mark the well in a conspicuous place with the permit
nu mmber.
6. MEASURING C DEVICE OR METER: Assignees agrees to provide, at its own
expense, a totalizing flow meter with remote readout to continuously and accurately measure
at all times all water diverted pursuant to the terms of Assignees' water right and the terms of
this Contract. On or before November 15 of each year, Assignees will provide accurate
readings from such device or meter (recorded on a monthly basis for the period Not n,her 1
through October 30 of each year) to District, the Division Engineer and Water Corilini'sioner,
Assignees acknowledges that failure to comply with this paragraph could result in legal action
to terminate Assignees' diversion of water by the State of Colorado Division of Water
Resources. By sil;,,in ; this Contract, Assignees hereby specifically allows District, through its
authorized agent, to enter upon Assignees' property during ordinary business hours for the
purposes of determining Assignees' actual use of water.
7,
COMPLIANCE WITH SECTION 404 OF TIHg_CLE N WATER ACT. Assignees
shall comply with Section 404 of the Clean Water Act and consult with the Arrnv Corps of
Engineers to complete any Section 404 compliance that may be required as a result of the
construction of any facilities necessary to use contract water.
8. CONTRACT TERMINATION:
A. Termination by District:
1. `1'he District may terminate this Contract for any violation or
breach of the terms of this Contract by Assignees.
2, The District may terminate this Contract if, in its discretion, any
judicial or administrative proceedings initiated by Assignees threaten the
District's authority to contract for delivery or use of the District's water rights, or
threaten the District's permits, water rights, or other interests of the District.
B. Termination by Assignees:
1. Assignees may terminate this Contract in its entirety for any
reason by notifying the District in writing of the termination on or before
April 1. Notice by said date will prevent the Assignees' liability for the
next annual contract charge_
EAWT,VocalreaDIOCKUDITSditkrikkOlinignaldni21pDCRAtiwpd
ASSIGNMENT OF ALLOTMENT CONTRACI NO. 2S0
BASALT WATER CONSERVANCY DISTRICT
FOR VALUE RECEIVED, Robert H. Walker and Grace B. Walker ("Assignors"),
hereby sells, assigns, transfers, arid sets over to Donald B. Helrnich and Linda L Helmich
("Assignees") all of Assignorsright, title, and interest in and to that certain Water Allotment
Contract No. 280 with the Basalt Water Conservancy District dated September 9, 1996,
which Contract allots 0.033 cubic feet of water per second from the District's direct flow
rights and 0.9 acre feet of water per year of storage and/or other augmentation water
owned or controlled by the District for use on that real property described in Exhibit A,
attached hereto and incorporated herein by this reference,
This Assignment is conditioned upon the consent thereto by the Basalt Water
Conservancy District as hereinbelow provided. Assignees hereby assume and agree to pay
and perform Al of the obligations of the Allottee under said Contract.
This Assignment shall be effective upon Assignors' conveyance of the above
described property to Assignees.
Dated this Zr ° day of ci,21L-..i.4„, , 2003.
/1 4,649 Iv --
Robert H. Walker, Assignor
Ctsi. r„.
C''orace 13. Walker, Assignor:
Donald B. Helmich, Assignee
Linda L. Helmich, Assignee
Assignees' trialling Address:
Donald B. Helmich and Linda L. Helmich
P.O. Box 2382
Aspen, CO 81612
Telephone No. (970) 925-7945
E \WP,Ductlareaw0CLF-ENTS'OrtmicK.Aulgrrnenl wpd
CONSENT TO ASSIGNMENT
The Basalt Water Conservancy District hereby consents to the foregoing Assignment
subject to the terms of and conditions of said Contract and the District's receipt of all
charges related thereto. This Assignment is subject to the additional conditions set forth
on Exhibit J attached hereto,
Dated this 9th day of September, 2003.
13y:
F,AWr-DockSlyn5144NvirELLENFSIleireikiMmigrirgivni
T WATER CONS.,_,RV
CY DISTRICT
Chris tophe L. Geiger, Attor ey fo ; asalt Water
Conservancy District