1313 Sherman Street, Room 821, Denver CO 80203-2026

1. Begin by accessing the form through our platform. Click ‘Get Form’ to open it in the editor.
2. Fill in the date when the Colorado State Engineer issued your well permit number. This is crucial for processing your application.
3. In the designated area, provide your well permit number. If you are unsure of this number, utilize the well permit search tool available on the DWR website.
4. Complete the statement confirming that a permanent pump was installed prior to the expiration date of your water well permit.
5. Sign and print your name along with your title if applicable. Ensure that all entries are clear and legible, as poor quality forms may be returned.
6. Once completed, save your document as a PDF and follow online submission instructions to email it to dwrpermitsonline@state.co.us.

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