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Home My WebLink AboutWater Well Observation & Monitoring Permit AppCOLORADO DIVISION OF WATER RESOURCES DEPARTMENT OF NATURAL RESOURCES l3l3 SHERMAN ST., Ste 821, DENVER CO 80203 Phone: (303) 866-3581 dwrpermitsonline(Ðstate.co.us Office Use Only Form GWS-46 (0112020) MON ITORI NG/OBS E RVATION Water Well Permit Application Review instructions on reverse side prior to completing form. The form must be typed, completed online or in black or blue ink. l. Well Owner Information Name ofwell owner High Aspen Ranch HOA c/o Zancanella and Associates, lnc. 6. Use Of Well Use of this well is limited to monitoring water |evels and/or water quality samplingMailing address PO Box 1908 7. Well Data (proposed) Total dåpth 220 feet Aquifer Tributary Basalt City Glenwood Springs State Zip code 81 6û1 8. Consultant Information (if applicable)Telephone # 970 945 5700 E-Måil (lf filing online it is required) taz@za-engi nee ri n g. com Name of contâct person Thomas A Zancanella2. Type Of Application (check applicable boxes) J Use existing well E Construct newwell ! Other: E Replacement for existing monitoring well: Permit no': 136g17-A Company name Zancanella & Associates Ma¡ling address PO box 19083. Refer To (if applicable) Mon¡toring hole acknowledgment MH- Well name or #City Glenwood Spriings State Cplorado Zip Code 81 601 4. Location Of Proposed Well (lmportant! See lnstructions)Telephone # 970 945 5700County 136817-A 'll4 of the 1t4 9. Proposed Well Driller License #(optional) 10. Name of Well Owner or Authorized Agentsecl¡on 36 Tomsh¡p 6 NorS NF: Range 88 EorW nffi Pr¡nc¡pal Meddian 6th The making of false statements herein constitutes perjury in the second degree, which is punishable as a class I misdemeanor pursuant to G.R.S. 24-4-104 (13Xa). I have read the statements herein, knowthe contents thereof and state that thev are true to mv knowledoe.Distance ofwell ftom section lines (section lines aro typically not property lines) Ft. rromn N [J S Ft. rrom Jl E il W Sign or enter full name here Thomas A Zancanella Datê (mmidd/yyyy) 08t18t2021For replacement wells only - distance and direct¡on from old well to new well feet direction lf signing print name. Print tiüê if other than land owner, 'Jl,¡ o"ç. o"5 ^ Zqøccrn ø I I qWell loætion address (lnclude City, state, zip) Ll Check if well âddress is same as ltem 1 Office Use Only Optional: GPS well location information in UTM format You must check GPS unit for required settings as follows:usGs map name DWR map no.Surface elev. Format must be UTM l'"1 Zone 12 orñ Zone 13 Units must be Meters Datum must bs NAD83 Un¡l must be set to true north Was GPS unit checked for abovo? ! YES easting 313942 Northing 4374129 Remember to set Datum to NAD83 Receipt area only 5. Property Owner Information Nâme of property oMsr High Aspen Ranch HOA Mailing address 'lan Dean' <HAR.mana ger12@gmail.com> DIV WD BA MD Clty Glenwood Springs State Co Zlp Code B1 601 Telephone # N/A coLoRADO DtVtStON OFWATER RESOURCES GWS46 MONINST (0112020) DEPARTMENT OF NATURAL RESOURCES M ON ITORI NG/OBSERVATION WELL PERM IT AP P LICAT¡ON I N STRU CTIONS Applications must be computer generated online, typewritten or printed in BLAGK or BLUE lNK. ALL ITEMS in the application must be completed. lncomplete applications may be returned for more information. Applications are evaluated in chronological order. Please allow approximately six weeks for processing. This form may be reproduced by photocopying or computer generation. Reproductions must retain margins and print quality of the original form. lf filing online, see online filing instructions for further information. You may also save, print, scan and email the completed form to: dwrpermitsonline@state.co.us FEES: This application must be submitted with a $100 filing fee. (The fee for an application to replace or deepen an existing permitted rnonitoring/observation well is $100 for locations outside Designated Ground Water Basins, and $60 inside Designated Ground Water Basins.) Fees are nonrefundable. Please visit our website (dwr.colorado.gov) for acceptable payment information or contact DWR at (303) 866-3581. USES: This form (GWS-46) is to be used when applying for a permit where the only uses are monitoring of water levels and/or water quality sampling. For well construction criteria refer to the Colorado Water Well Construction Rules, 2CCR 402-2. A copy of the Rules may be obtained from any Division of Water Resources Office for a fee of $5, or you may access them online on our website (dwr.colorado.gov) ITEM INSTRUCTIONS: (numbers correspond with those on the front of this forq) 1. Provide the name of the well owner and the mailing address where all correspondence will be sent. 2. Check and complete all boxes that apply.3. Provide the MH number assigned by the Division of Water Resources in response to the notice of intent to construct a monitoring/observation well. Complete the well name if the structure has a name or identifying number. 4. lf applying for a permit to construct a new well, you !!!E! provide the county, section #, township, range and principal meridian. You do not need to provide the lo of the % section designation, distances from section lines or an optional GPS location (UTM coordinates). lf a permit is issued and a well constructed, the authorized individual will be required to provide an accurate GPS location (UTM coordinates) of the "as-built" well location. lf applying for a permit to use an existing well you ry! provide the well location information stated above, as well as either a GPS location (UTM coordinates) of the existing well site, or distances from section lines (including the % of the % section designation) as follows: ln a typical case, a township is comprised of 36 sections, with each section ideally one mile square, or 5,280 feet on each side. Sections are further divided into quarter sections. Each Tt Section is 2,640 feet by 2,640 feel and comprises 160 acres. Each /+ section can be further divided into additional quarters. Each lt o1 lhe /o Section is 1,320 feet by 1,320 feet and comprises 40 acres. The distances are measured from the section lines. ln the following example, the well is located 2,500 feet from the South Section line and 1,400 feet from the East Section line: 5280 ft T 2640fi rI1320 ft L lf providing a GPS location (UTM coordinates), the required GPS unit settings must be as indicated on this form. Colorado contains two UfU zones (12 & 13). Zone l3 covers most of Colorado. The boundary between Zone 12and Zone l3 is the 108th Meridian (longitude). West ot the í OSth Meridian is UTM Zone 12 and east of the 1 08h Meridian is UTM Zone 13. The 108th Meridian is approximately 57 miles east of the Colorado-Utah state line. On most GPS units, the UTM zone is given as part of the Easting measuremenl, e.g. 1210123456. Check the appropriate box for the zone. Provide the property address of the well location if one exists. lf it is the same as the mailing address, check the box next to the well location address. 5. Provide property owner information.6. Use of this well is limited to monitoring water levels and/orwater quality sampling only. 7. Theactual oranticipatedtotal depthmustbeprovided. Providethenameoftheaquiferinwhichthewell will becompleted. 8. Provide consultant information (if applicable). Note: A consultant mav sign this application on behalf of their client.g. Monitoring/observation wells must be constructed by a Colorado licensed well construction contractor or authorized individual, as defined in the Well Construction Rules, 2CCR 402-2. Only a licensed contractor may construct any monitoring/observation well that penetrates a confining layer, or, is to be converted into a future production well. The well must be constructed in compliance with the Well Construction Rules, unless a variance has been approved allowing an alternative construction design. I 0. The individual signing the application or entering their name (and title if applicable) must be the applicant or an officer of the corporation/company/ agency identifìed as the applicant, their attorney or consultant. An authorized agent may also sign the application, if a letter signed by the applicant or their attorney is submitted with the application authorizing that agent to sign or enter their name on the applicant's behalf. Payment must be received via phone, fax or mail prior to processing the application. lf fìling online please call the Records Section at 303.866.3581 to pay via credit card. lF YOU HAVE ANY QUESTIONS regarding any item on the application form, please call the Division of Water Resources Ground Water lnformation Desk (303-866-3587), or the nearest Division of Water Resources Field Office located in Greeley (970-352-8712), Pueblo (719-542-3368), Alamosa (719-589-6683), Montrose (970-249-6622), Glenwood Springs (970-945-5665), Steamboat Springs (970-879-0272), or Durang o (970-247-1845), or refer to the CDWR web site at dwr.colorado.oov for general information. II fI Well Location Example: NW1/4 of the SE1/4 of Section 3, being 2500 feet from the South Section Line and 1400 feetfrom the East Section Line.NE1i4 sE1i4 sE1/4 sE'l/4 NE1/4 SW1/4 NW1/4 -a swt t4 sEl/4 NW1/4 sEt/4