District Court, Water Division , Colorado Court Address: CONCERNING THE APPLICATION FOR WATER RIGHTS OF Applicant: In the River or its Tributaries In COUNTY COURT USE ONLY Attorney or Party Without Attorney (Name and Address): Phone Number: E-mail: FAX Number: Atty. Reg. #: Case Number: Division: Courtroom: APPLICATION FOR CORRECTION FOR AN ESTABLISHED BUT ERRONEOUSLY DESCRIBED POINT OF DIVERSION PURSUANT TO 247 37 - 92 - 305 ( 3.6) , C.R.S. An 223established but erroneously described point of diversion224 means a point of diversion of either surface or groundwater: (1) that has been at the same physical location since the applicable decree or decrees confirmed the water right, unless it was relocated pursuant to 247 37-86-111, C.R.S., or, in the case of a well, relocated according to a valid well permit; (2) that is not located at the location specified in the applicable decree or decrees confirming the water right; and (3) from which the diverter has diverted water with the intent to divert pursuant to the decree or decrees confirming the water right. 247 37-92-305(3.6)(a)(II), C.R.S. A 223diverter224 is the owner or user of a decreed water right. 247 37-92-305(3.6)(a)(I), C.R.S. To proceed with a correction in point of diversion for an established but erroneously described point of diversion that is due to a clerical mistake in the decree but does not fall within the 3-year period set forth in 247 37-92-304(10), C.R.S., for the water clerk to correct the mistake, the diverter of the established but erroneously described point of diversion may file a petition with the water clerk within 3 years after the diverter became aware of the mistake. 247 37-92-305(3.6)(c), C.R.S. To proceed with a correction in point of diversion for an established but erroneously described point of diversion that is not due to a clerical mistake, the diverter has the burden to prove that a point of diversion is an established but erroneously described point of diversion. 247 37-92-305(3.6)(d), C.R.S. This process only applies to points of diversion that are already in place and if one or more water rights are diverted at the corrected point of diversion. 247 37-92-305(3.6)(d)(IV), C.R.S. An application for correction for an established but erroneously described point of diversion is subject to all the provisions of Article 92, including sections 37-92-302 to 37-92-305, except as specifically modified by 247 37-92- 305(3.6), C.R.S. 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 Telep hone Number JDF 240W 7-13 APPLICATION FOR SIMPLE CHANGE IN A SURFACE POINT OF DIVERSION Page 1 of 5 251 2013 Colorado Judicial Department for use in the Courts of Colorado American LegalNet, Inc. www.FormsWorkFlow.com 2. Decreed water right for which correction is sought: A. Name of structure: B. Date of original and all relevant subsequent decrees: Case No: Court: C. Legal description of structure as described in most recent decree that adjudicated the location: Provide a verbatim legal description from the most recent decree that adjudicated the location. Mark the location of the structure on a USGS topographic map and attach to this application a legible 8 275 x 11 inch copy of the applicable portion of the map. D. Decreed source of water: E. Appropriation Date: F. Total amount decreed to structure in gallons per minute (gpm) or cubic feet per second (cfs): Absolute G. Decreed use or uses: H. Amount of water decreed: Absolute 3. Detailed description of proposed correction to an established but erroneously described point of diversion: A. Complete statement of correction to an established but erroneously described point of diversion, including whether it is erroneously described. See 247247 37-92-305(3.6)(a) & (b), C.R.S. The applicant is encouraged to provide evidence to support such information with this application. B. The legal description of the corrected 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, a 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 8 275 x 11 inch map to this application illustrating location of the new point of diversion structure. JDF 240W 7-13 APPLICATION FOR SIMPLE CHANGE IN A SURFACE POINT OF DIVERSION Page 2 of 5 251 2013 Colorado Judicial Department for use in the Courts of Colorado American LegalNet, Inc. www.FormsWorkFlow.com UTM coordinates Northing Easting Zone 12 Zone 13 Street Address: Subdivision: 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 the PLSS if known): Include perpendicular distances from section lines, and indicate 274 274, 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 8 275 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 a 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 Descript ion: 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. Name(s) and address(es) of owner(s) or reputed owners of the land upon which any new diversion or storage structure, or modification to any existing diversion or storage structure is or will be constructed or upon which water is or will be stored, including any modification to the existing storage pool. The applicant must notify these persons that the applicant is applying for this water right, and certify to the Court that the applicant has done so. Name of Owner Mailing Address Signature of Applicant (if self-represented) or Attorney Date JDF 240W 7-13 APPLICATION FOR SIMPLE CHANGE IN A SURFACE POINT OF DIVERSION Page 3 of 5 251 2013 Colorado Judicial Department for use in the Courts of Colorado American LegalNet, Inc. www.FormsWorkFlow.com VERIFICATION AND ACKNOWLEDGMENT OF APPLICANT OR OTHER PERSON HAVING KNOWLEDGE OF THE FACTS STATED IN THIS APPLICATION I being first duly sworn, hereby state that I have read this Application, that I have personal knowledge of the facts stated and, that I verify its contents to the best of my knowledge, information, and belief. Signature Date The foregoing instrument was acknowledged before me in the County of , State of Colorado, this day of , 20, by the person whose signature appears above. My Commission Expires: Notary Public/Deputy Clerk The person signing this verification is: Applicant Engineer Other (describe) Verifications of other persons having knowledge of the facts may be attached to this application. JDF 240W 7-13 APPLICATION FOR SIMPLE CHANGE IN A SURFACE POINT OF DIVERSION Page 4 of 5 251 2013 Colorado Judicial Department for use in the Courts of Colorado American LegalNet, Inc. www.FormsWorkFlow.com District Court, Water Division , Colorado Court Address: CONCERNING THE APPLICATION FOR WATER RIGHTS OF Applicant: In the River or its Tributaries In COUNTY COURT USE ONLY Attorney or Party Without Attor