Free gws-58 - Colorado

Colorado Division of Water Resources 1313 Sherman St. Rm. 818 Denver, CO 80203 (303) 866-3581 http://water.state.co.us/default.htm

Application Receipt No. _______________________ Applicant's Name ____________________________

SUPPLEMENTAL INFORMATION FOR SMALL CAPACITY COMMERCIAL WELL PERMIT APPLICATIONS (For Wells Located Within Designated Groundwater Basins)
Small capacity commercial well permit applications are evaluated pursuant to the provisions of CRS 37-90-105, which allows for one well in one commercial business. Pending approval, the use of this proposed well for a commercial business having another small capacity commercial well is prohibited. This supplemental information form is necessary in order to determine whether your application qualifies within the provisions of this statute. Please answer the following questions using type or black ink. If additional space is needed, identify the question number on a separate sheet, then attach to this form. This form must be signed and dated below.

1. 2.

Name the type of business this proposed well will serve. ________________________________________________ Will you own and operate this proposed well and the commercial business __________________________________ · If not, please explain who will own and operate this well and the business served by this well? _______________ __________________________________________________________________________________________ __________________________________________________________________________________________

3.

Do you qualify as one commercial business as defined under CRS 37-90-105(1)(c)(II) (see below for referenced statute). ______________

4.

Do you currently have a valid permit for any other small capacity commercial well inside any Designated Ground Water Basin in Colorado? _______________ · If so, please provide the permit number(s) of any valid permit(s) you have. __________________________________________________________________________________________ __________________________________________________________________________________________

I (we) have read the statement made herein, know the content thereof, and state that they are true to my (our) knowledge. [Pursuant to section 24-4-104 (13)(a) C.R.S., the making of false statements herein constitutes perjury in the second degree and is punishable as a Class 1 misdemeanor.] Name/Title (print or type):____________________________________________________________________________ Signature:__________________________________________________________ Date: _________________________

_________________________________________________________________________________________________ Under CRS 37-90-105 - Small Capacity Wells, paragraph (1)(c) (II) reads as follows: To qualify as a "commercial business" under this paragraph (c), the business shall be: (A) A business that will be operated by the well owner and that will have its own books, bank accounts, checking accounts, and separate tax returns; (B) A business that will use water solely on the land indicated in the permit for the well and for the purposes stated in such permit; (C) A business that will maintain its individual assets and will own or lease the property on which the well is to be located or where the business is operated; (D) A business that will have its own contractual agreements for operation of the business; (E) A business that agrees not to transfer a permit issued under this paragraph (c) to another entity that also holds a small capacity commercial well permit under this paragraph (c); and (F) A business that agrees to notify any potential buyer that such buyer shall notify the state engineer of any change in ownership of such business within sixty days after any such change in ownership.
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