Free Well Search Information Requirements (Records Request) - Colorado

CO DIVISION OF WATER RESOURCES RECORDS SECTION 1313 Sherman St., Rm. 821, Denver, CO 80203 Telephone (303) 866-3447; FAX (303) 866-2223 (24 hrs) DWR Records Access Hours: 10:00 A.M. to 3:30 P.M.

WELL PERMIT REQUEST FORM
In order to assist us in providing you with timely and efficient service, please try to have all of the information listed below BEFORE YOU CALL OR WRITE REGARDING AN EXISTING WELL. This information is necessary in order to do a thorough search for the desired well information. 1. PERMIT NUMBER__________________________________

If you do not have the permit number, then the following information is needed:
2. SUBDIVISION NAME: __________________________________________________________________

COUNTY______________________________________ LOT # _____________________________________ BLOCK# _____________ FILING # (Unit #, Amendment, or Addition #)________________________________ 3. 1/4, 1/4, SECTION, TOWNSHIP, RANGE_________________________________________________________ 4. NAMES OF CURRENT AND ALL PREVIOUS OWNERS (Please have correct spelling.)
_____________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________

5. YEAR HOUSE WAS BUILT __________________________ 6. SIZE OF PARCEL ____________________acres_ 7. USE OF WELL ( Residential, Commercial, Municipal, Livestock, Irrigation, etc.)__________________________ 8. ADDRESS OF PROPERTY _______________________________________________________________________

PLEASE (check one) FAX

MAIL

MY REQUEST TO THE FAX # / ADDRESS BELOW.

DOCUMENTS REQUESTED (Please check all items that you are requesting:)
Well Permit Well Construction Report / Log Pump Installation Report

Complete Well Permit File

(to include any letters, worksheets, maps, copies of deeds, etc.)

To obtain a copy of well permit file documents, please include a Visa or MasterCard number with the expiration month and year. Charges: Mailed documents are $.50/pg, min. $3.00; Local FAX = $1.00/pg, min. $3.00; Long-distance FAX = $1.50/pg, min. $3.00. Please indicate below where you would like your request mailed/FAXed, and sign to authorize charges to your credit card. Send your requests to above address or FAX #. Once received by DWR, allow up to 2 weeks to receive your file. REQUESTOR'S NAME___________________________________________________________________________ ADDRESS:_____________________________________________________________________________________ CITY, STATE, ZIP:_______________________________________________________________________________ DAYTIME PHONE#____________________________________FAX #_______________________________________ Visa or Mastercard # __________________________________________________ Expires: ____________________ Authorized Cardholder's Signature: _______________________________________Date:_ __________________