District Court, Water Division ___________________, Colorado Court Address: ________________________________________________________ CONCERNING THE APPLICATION FOR WATER RIGHTS OF Applicant: In the ____________________________River or its Tributaries In ________________________________________ COUNTY Attorney or Party Without Attorney (Name and Address): COURT USE ONLY Case Number: Phone Number: FAX Number: E-mail: Atty. Reg. #: Division: Courtroom: APPLICATION FOR CONDITIONAL ABSOLUTE WATER STORAGE RIGHT It is the applicant's responsibility to provide the location for each structure in this application. For structures that are already decreed, use the location from the most recent decree that adjudicated the location. UTM coordinates (for example from a GPS device), or measured distances in the field from known section lines are acceptable. The Division Engineer, the Water Referee, or the Water Judge, may order the applicant to confirm the location of any structure with UTM coordinates, a survey, or other method. 1. Name, mailing address, email address, and telephone number of applicant(s) (if there are multiple applicants, and the space provided is not adequate to list all of the applicants, the names, addresses, telephone numbers and available email addresses must be provided as an attachment): Name of Applicant Mailing Address Email address Telephone Number 2. Name of Reservoir: 3. Legal description of location of dam centerline. Attach legal description if necessary. Location information in UTM format (Preferred): UTM Zone must be 12 or 13; Units must be Meters; Datum must be NAD83; and Units must be set to true North. Include the source of the UTM coordinates, for example: GPS device; GIS System such as DWR AquaMap or CDSS MapViewer; scaled from USGS topographic map; or other source. In areas having generally recognized street addresses, also include street address, and if applicable, the lot, block, and subdivision. Attach a legible 8 ½ x 11 inch map to this application illustrating location of the structure. JDF 297W R5-15 APPLICATION FOR WATER STORAGE RIGHT AND CERTIFICATE OF NOTICE © 2013, 2014, 2015 Colorado Judicial Department for use in the Courts of Colorado Page 1 of 7 American LegalNet, Inc. www.FormsWorkFlow.com UTM coordinates Easting ___________________ Northing _____________________ Zone 12 Zone 13 Subdivision: Street Address:_______________________________________________________________________ Lot Block Source of UTMs (for example, hand-held Garmin GPS): Accuracy of location displayed on GPS device (for example, accurate to within 200 feet): Legal Description Using the Public Land Survey System (PLSS) (Optional; Please include both UTM and PLSS descriptions if known): Include perpendicular distances from section lines, and indicate ¼ ¼, section number, township, range, meridian and county; mark the location of the structure on a USGS topographic map and attach to this application a legible 8 ½ x 11 inch copy of the applicable portion of the map. In areas where section lines have not been established, a bearing and distance to an established government monument is acceptable. Include the source of PLSS information, for example: GIS system such as DWR AquaMap or CDSS MapViewer; field survey; scaled from USGS topographic map; or other source. In areas having generally recognized street addresses, also include street address, and, if applicable, the lot, block, and subdivision. Legal Description: County ______1/4 of the _____1/4 Section Township _______ N or S Range _______ E or W Principal Meridian Distance from section lines (not from property lines) ____________ Feet from N S and _____________ Feet from E W Source of PLSS information: __________________________________________________________ Street Address:_______________________________________________________________________ Subdivision: Lot Block 4. Source: (for example, unnamed tributary to North Clear Creek, tributary to Clear Creek, tributary to the South Platte River) 5. If filled from a ditch: A. Name(s) of ditch(es) used to fill reservoir and capacity in cubic feet of water per second (cfs): B. Legal description of each point of diversion: Location information in UTM format (Preferred): UTM Zone must be 12 or 13; Units must be Meters; Datum must be NAD83; and Units must be set to true North. Include the source of the UTM coordinates, for example: GPS device, GIS system such as a DWR AquaMap or CDSS MapViewer; scaled from USGS topographic map; or other source. In areas having generally recognized street addresses, also include street address, and if applicable, the lot, block, and subdivision. Attach a legible 8 ½ x 11 inch map to this application illustrating location of the point of diversion. JDF 297W R5-15 APPLICATION FOR WATER STORAGE RIGHT AND CERTIFICATE OF NOTICE © 2013, 2014, 2015 Colorado Judicial Department for use in the Courts of Colorado Page 2 of 7 American LegalNet, Inc. www.FormsWorkFlow.com UTM coordinates Easting ___________________ Northing _____________________ Zone 12 Zone 13 Subdivision: Street Address:_______________________________________________________________________ Lot Block Source of UTMs (for example, hand-held Garmin GPS): Accuracy of location displayed on GPS device (for example, accurate to within 200 feet): Legal Description Using the Public Land Survey System (PLSS) (Optional): Include perpendicular distances from section lines, and indicate ¼ ¼, section number, township, range, meridian and county; mark the location of the structure on a USGS topographic map and attach to this application a legible 8 ½ x 11 inch copy of the applicable portion of the map. In areas where section lines have not been established, a bearing and distance to an established government monument is acceptable. Include the source of PLSS information, for example: GIS system such as DWR AquaMap or CDSS MapViewer; field survey; scaled from USGS topographic map; or other source. In areas having generally recognized street addresses, also include street address, and if applicable, the lot, block, and subdivision. Legal Description: County ______1/4 of the _____1/4 Section Township _______ N or S Range _______ E or W Principal Meridian Distance from section lines (not from property lines) ____________ Feet from N S and _____________ Feet from E W Source of PLSS information: __________________________________________________________ Street Address:___________________________________________