Form Gws 44 PDF Details

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QuestionAnswer
Form NameForm Gws 44
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesdivision of water resources, well permit search colorado, co well permit, colorado gws 44

Form Preview Example

B. # of acres in parcel

COLORADO DIVISION OF WATER RESOURCES DEPARTMENT OF NATURAL RESOURCES

1313 SHERMAN ST., Ste 821, DENVER, CO 80203

Main: (303) 866-3581 Fax: (303) 866-2223 dwrpermitsonline@state.co.us

RESIDENTIAL Note: Also use this form to apply for livestock watering

Water Well Permit Application

Review form instructions prior to completing form.

Hand completed forms must be completed in black or blue ink or typed.

1. Applicant Information

Name(s)

Mailing address

City

State

Zip code

 

 

 

 

Telephone (w/area code)

 

E-mail

 

 

 

 

 

2.Type Of Application (check applicable boxes)

Construct new well

Change source (aquifer)

Replace existing well

Reapplication (expired permit)

Use existing well

Rooftop precip. collection

Change or increase use

Other: _________________

3.Refer To (if applicable)

Well permit #

Water Court case #

 

 

Designated Basin Determination #

Well name or #

 

 

4. Location Of Proposed Well (Important! See Instructions)

County

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1/4 of the

1/4

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section

 

Township

N or S

 

 

Range

E or W

Principal Meridian

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Distance of well from section lines (section lines are typically not property lines)

 

 

 

 

 

Ft. from

N

S

 

 

 

 

 

 

Ft. from E

W

 

 

 

 

 

 

 

 

 

 

 

For replacement wells only distance and direction from old well to new well

 

 

 

 

 

feet

 

 

 

 

 

 

 

 

Direction

Well location address (Include City, State, Zip)

 

 

Check if well address is same as in Item 1.

 

 

 

 

 

 

 

 

 

 

 

Optional: GPS well location information in UTM format. GPS unit settings are as follows:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Format must be UTM

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Zone 12 or

Zone 13

 

 

 

 

 

Easting:

 

 

 

 

 

 

 

Units must be Meters

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Datum must be NAD83

 

 

 

 

 

Northing:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Unit must be set to true north

 

 

 

 

 

REMEMBER TO SET DATUM TO NAD83

 

 

 

Was GPS unit checked for above?

YES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5. Parcel On Which Well Will Be Located

(You must attach a current deed for the subject parcel)

A. You must check and complete ONE of the following:

Subdivision: Name

 

 

Lot

Block

Filing/Unit

County exemption (attach copy of county approval & survey)

Name/#

 

Lot #

Parcel less than 35 acres, not in a subdivision attach a deed with metes & bounds description recorded prior to June 1, 1972, and current deed Mining claim (attach copy of deed or survey) Name/#: ______________

Square 40 acre parcel as described in Item 4

Parcel of 35 or more acres (attach metes & bounds description or survey) Other: (attach metes & bounds description or survey)

C. Are you the owner of this parcel?

YES

NO _________________________

D. Will this be the only well on this parcel? YES NO (if no list other wells)

E.State Parcel ID# (optional):

Office Use Only

Form GWS-44 (7/2012)

 

 

6.Use Of Well (check applicable boxes)

See instructions to determine use(s) for which you may qualify

A. Ordinary household use in one single-family dwelling (no outside use)

B. Ordinary household use in 1 to 3 single-family dwellings: Number of dwellings: ___________

Home garden/lawn irrigation, not to exceed one acre:

area irrigated __________

sq. ft.

acre

Domestic animal watering (non-commercial)

C. Livestock watering (on farm/ranch/range/pasture)

7. Well Data (proposed)

Maximum pumping rate

Annual amount to be withdrawn

gpm

acre-feet

 

 

Total depth

Aquifer

feet

 

 

 

8. Water Supplier

Is this parcel within boundaries of a water service area? YES NO If yes, provide name of supplier:

9. Type Of Sewage System

Septic tank / absorption leach field

Central system: District name: ________________________________

Vault: Location sewage to be hauled to: ________________________

Other (explain) ____________________________________________

10.Proposed Well Driller License #(optional):

11.Sign or Enter 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 are true to my knowledge.

Sign or enter name(s) of person(s) submitting application

Date (mm/dd/yyyy)

 

 

If signing print name and title

Office Use Only

USGS map name

DWR map no.

Surface elev.

 

 

 

Receipt area only

AQUAMAP

WE

WR

CWCB

TOPO

MYLAR

SB5

DIV _____ WD _____ BA _____ MD _____

COLORADO DIVISION OF WATER RESOURCES

GWS-44 RESINST (7/2012)

DEPARTMENT OF NATURAL RESOURCES

 

RESIDENTIAL WELL PERMIT APPLICATION INSTRUCTIONS

Applications must be computer generated online, typewritten, or printed in BLACK or BLUE INK. ALL ITEMS in the application must be completed. Incomplete 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. Reproductions must retain margins and print quality of the original form. If filing online see online filing instructions! You may also save, print, scan and email the completed form to: dwrpermitsonline@state.co.us

DO NOT use this form for the registration of an existing well in use prior to May 8, 1972; (use Form GWS-12).

FEES: This application must be submitted with the appropriate filing fee. The filing fee for applications is $100. Exceptions are as follows:

1)An application to replace or deepen an existing permitted well that is in the same source (aquifer) which does not have a -F” or -R” suffix after the original permit number is $60. 2) Applications to register an existing well (use Form GWS-12), and replace or deepen the well (use Form GWS-44) into the same aquifer is $100 if submitted together. Fees are nonrefundable. Acceptable forms of payment are check or money order, payable to the Colorado Division of Water Resources. Payment by Visa, MasterCard or Discover cards can be accepted by phone through the Records Office at 303.866.3581.

USES: This form (GWS-44) is to be used when applying for a permit for the following types of uses:

A.Ordinary household use inside one single-family dwelling (NO outside water use allowed): Generally, this is all that can be approved on parcels less than 35 acres.

B.Ordinary household use in 1 to 3 single-family dwellings, irrigation of up to one acre of home garden and lawn, and watering of domestic animals: Generally, permits can be approved on parcels of land of 35 or more acres, or in areas inside the Designated Basins, the Denver Basin, limited areas on the Western Slope, and for subdivisions under a court- approved plan for augmentation that allow outside uses.

C.Livestock watering on farm, ranch, range, or pasture (on parcels of 35 or more acres).

ITEM INSTRUCTIONS: (numbers correspond with those on the front of this form)

1.The applicant is the entity for whom the permit is to be issued. Since the well owner is ultimately responsible for the use of the well, their name should be in this area. The mailing address is where the applicant currently receives mail.

2.Check all boxes that apply. If you check the box for Rooftop precip. collection, you must also complete and submit Form No. GWS-78.

3.Complete all boxes that apply.

4.You must provide a well spot location under the following circumstances: (a) the location is decreed by a water court; (b) the well will be inside the Denver Basin or other location where a site- specific well depth restriction will apply; (c) your application is for a permit to use an existing well. When a spot location is required, you must provide the county, ¼ of the ¼ section designation (example: NE ¼ of the SE ¼), section #, township, range, principal meridian, and either distances from section lines or a GPS location (UTM coordinates). If providing a GPS location, the required GPS unit settings must be as indicated on this form. Colorado contains two UTM zones (12 & 13). Zone 13 covers most of

Colorado. The boundary between Zone 12 and Zone 13 is the 108th Meridian (longitude). West of the 108th Meridian is UTM Zone 12 and east of the 108th 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 measurement, e.g. 12T0123456. Check the appropriate box for the zone.

For all other applicants, you must provide the following minimum information: (a) the county, section #, township, range and principal meridian; and, (b) the subdivision lot, block & filing/unit designations as applicable if in a subdivision. You do

not need to provide distances from section lines or a GPS location (UTM coordinates).

Provide the property address of the well location if one exists. If it is the same as the mailing address, check the box next to the well location address.

5.A current deed for the subject parcel must be attached. If the

subject parcel is 35 or more acres, a complete metes and bounds type legal description or surveyor’s plat map that references a section point is required to enable us to plot the parcel in our mapping system. If the parcel is less than 35 acres and not in a subdivision, a deed with metes and bounds legal description, recorded prior to June 1, 1972 is required. Complete Items 5A through 5E (5E is optional). If you answered NO to Item 5C please indicate who the landowner is. If you are under a contract to purchase the subject property, please state this as well. If the parcel is inside the Denver Basin, the application must be in the name of and signed by, or their name entered by, the current landowner. If filing online please see online filing instructions for how to submit deed and or legal description attachments.

6.See above comments under USES to determine those uses for which you may qualify, and then check the applicable box or boxes.

7.The maximum pumping rate is limited to 15 gpm for most residential type well permits. The annual amount of water to be withdrawn is a volume measured in acre-feet. One acre-foot equals 325,851 gallons. For ordinary household use inside one single-family dwelling and no outside use, the annual amount will be about 1/3 acre-foot. For ordinary household use in three single-family dwellings, one acre of home garden/lawn irrigation, and watering of domestic animals, the annual amount will be about 3 acre-feet. For 100 head of livestock, the annual amount will be about 1.35 acre-feet. Please indicate the estimated depth of the proposed well. The proposed aquifer for the well must be indicated if the well is to be located within the Denver Basin (the approximate area of the Denver Basin extends south from Greeley to an area east of Colorado Springs and from Golden east to Limon), the San Luis Valley, the Southern High Plains basin in Baca or Prowers Counties, or in areas where it is believed the well will penetrate a confining layer. Aquifer information should be provided if known, for well locations outside of these areas.

8.The issuance of well permits may depend on the availability of another source of water, pursuant to CRS 37-92-602(6), such as water from a municipality or water district. (Statutes can be accessed through the CDWR web site.)

9.Check the applicable box, and complete or attach any additional information as requested in this item.

10.Wells must be constructed by a Colorado licensed well driller, or under the “private driller” provision as defined in CRS 37-91- 102(12). A listing of licensed well drillers/pump installers is

availableat http://water.state.co.us/groundwater/BOE/Pages/LicensedContract ors.aspx

11.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 identified as the applicant or their attorney. An authorized agent may also sign or enter their name on 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 if filing online at 303.866.3581 (Records Office) prior to processing the application.

IF YOU HAVE ANY QUESTIONS please call the Colo. Division of Water Resources (303-866-3581), or the nearest Division Field Office 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 Durango (970-247-1845), or refer to the CDWR web site at http://www.water.state.co.us for general information, additional forms, and access to state rules or statutes.

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3. Completing Parcel less than acres not in a, Square acre parcel as described, Parcel of or more acres attach, C Are you the owner of this parcel, AQUAMAP, CWCB, TOPO, and MYLAR SB DIV WD BA MD is essential for the next step, make sure to fill them out in their entirety. Don't miss any details!

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