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O L O R A D O
WELL PERMIT NUMBER
142066--A
Division of Water Resources
Department of Natural Resources
RECEIPT NUMBER
10044571
ORIGINAL PERMIT APPLICANT(S)
REBECCA J. LUCERO
PERMIT TO REPLACE EXISTING WELL
APPROVED WELL LOCATION
Water Division: 5 Water District: 39
Designated Basin:
Management District:
County:
Parcel Name:
Lot: 1
N/A
N/A
GARFIELD
ROLD EXEMPTION (RESOLUTION # 77-
119)
Block: Filing:
Physical Address: 1000 COUNTY ROAD 252 RIFLE, CO 81650
SW 1/4 SE 1/4 Section 1 Township 5.0 S Range 93.0 W Sixth P.M.
Well to be constructed on specified tract of land
ISSUANCE OF THIS PERMIT DOES NOT CONFER A WATER RIGHT OR GUARANTEE WATER AVAILABILITY
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 and Ground Heat Exchanger Contractors in accordance
with Rule 18.
3) Approved pursuant to CRS 37-92-602(3)(c) for the relocation of an existing well, permit no. 142066-A (receipt no. 3686861).
4) THE OLD WELL (PERMIT NO. 142066-A (RECEIPT NO. 3686861) AND THE ORIGINAL WELL, PERMIT NO. 142066 (RECEIPT NO.
0260123)) MUST BE PLUGGED IN ACCORDANCE WITH RULE 16 OF THE WATER WELL CONSTRUCTION RULES (2 CCR 402-2) WITHIN
NINETY-ONE (91) DAYS OF COMPLETION OF THE NEW WELL. It is the ultimate responsibility of the well owner to have the old
well properly plugged, sealed, and abandoned. The Well Abandonment Report a -Form available at:
https://dwr.state.co. us/eforms must be submitted to the Division of Water Resources to verify the old well has been properly
abandoned. For additional information or questions contact the Division of Water Resources,
https: / /dwr.state.co.us/Portal/dwr/AskDWR
5) WELL OWNERS SEEKING TO ABANDON THEIR OWN WELLS MUST CONSULT WITH A LICENSED WATER WELL CONSTRUCTION
CONTRACTOR OR STAFF OF THE BOARD OF EXAMINERS PRIOR TO ABANDONING THEIR WELL TO DETERMINE IF THE WELL
QUALIFIES TO BE PLUGGED, SEALED AND ABANDONED BY THE WELL OWNER.
6) Approved as the only well on a residential site of 4.19 acre(s) described as parcel 1, Rold Exemption (Resolution # 77-119),
Garfield County.
7) The use of groundwater from this well is limited to ordinary household purposes inside one single-family dwelling. The
groundwater shall not be used for irrigation or other purposes.
8) The pumping rate of this well shall not exceed 15 GPM.
9) The return flow from the use of this well must be through an individual wastewater disposal system of the non -evaporative type
where the water is returned to the same stream system in which the well is located.
10) Pursuant to Rule 6.2.3 of the Water Well Construction Rules, the well construction contractor shall submit the as -built well
location on work reports required by Rule 17.1 within 60 days of completion of the well. The provided as -built well location
must be accurate to within 50 feet of the actual well location.
11) ADVANCE NOTICE REQUIRED - Pursuant to Construction Rule 6.2.2.1 (2 CCR 402-2), licensed or private drillers and pump
installers must provide advance notification (by 11:59 pm the day before) to the State Engineer prior to each of the following
for this well: the start of well construction, the initial installation of the first permanent pump, and the initial installation of a
cistern connected to the water well supply system. Any change in the date of construction/installation must be re -noticed prior
to the activity (by 11:59 pm the day before). Information regarding the notification process and a link to the electronic
notification form can be found on the Division of Water Resources website at dwr.colorado.gov
Lit
Printed 08-20-2025 For questions about this permit call 303.866.3581 or go to https://dwr.coLorado.gov Page 1 of 2
WELL PERMIT NUMBER 142066--A RECEIPT NUMBER 10044571
NOTE: Permit no. 142066 (receipt no. 0260123) was previously issued for this tract of land.
NOTE: Parcel Identification Number (PIN): 2129-014-00-050
NOTE: Assessor Tax Schedule Number: R210253
NOTE: This permit will expire on the expiration date unless the well is constructed by that date. A Well Construction and Yield
Estimate Report (GWS-31) must be submitted to the Division of Water Resources (DWR) to verify the well has been constructed.
An extension of the expiration date may be available. Contact DWR for additional information or refer to the extension request
form (GWS-64) available at: dwr.colorado.gov
y�xy Date Issued: 8/20/2025
Issued By DWIGHT WHITEHEAD Well must be constructed by 8/20/2027
Printed 08-20-2025 For questions about this permit call 303.866.3581 or go to https://dwr.cotorado.gov Page 2 of 2