Application for a Permit to Use Ground Water Oregon Water Resources Department 725 Summer Street NE, Suite A Salem, Oregon 97301-1266 (503)-986-0900 www.wrd.state.or.us Water-Use Permit Application Processing 1. Completeness Determination The Department evaluates whether the application and accompanying map contain all of the information required under OAR 690-310-0040 and OAR 690-310-0050 (www.oregon.gov/owrd/law). The Department also determines whether the proposed use is prohibited by statute. If the Department determines that the application is incomplete, all fees have not been paid, or the use is prohibited by statute, the application and all fees submitted are returned to the applicant. 2. Initial Review The Department reviews the application to determine whether water is available during the period requested, whether the proposed use is restricted or limited by rule or statute, and whether other issues may preclude approval of or restrict the proposed use. An Initial Review (IR) containing preliminary determinations is mailed to the applicant. The applicant has 14 days from the mailing date to withdraw the application from further processing and receive a refund of all fees paid minus $200. The applicant may put the application on hold for up to 180 days and may request additional time if necessary. 3. Public Notice Within 7 days of the mailing of the initial review, the Department gives public notice of the application in the weekly notice published by the Department at www.oregon.gov/owrd. The public comment period is 30 days from publication in the weekly notice. 4. Proposed Final Order Issued The Department reviews any comments received, including comments from other state agencies related to the protection of sensitive, threatened or endangered fish species. Within 60 days of completion of the IR, the Department issues a Proposed Final Order (PFO) explaining the proposed decision to deny or approve the application. A PFO proposing approval of an application will include a draft permit, and may request additional information or outstanding fees required prior to permit issuance. 5. Public Notice Within 7 days of issuing the PFO, the Department gives public notice in the weekly notice. Notice includes information about the application and the PFO. Protest must be received by the Department within 45 days after publication of the PFO in the weekly notice. Anyone may file a protest. The protest filing fee is $350.00 for the applicant and $700.00 for non-applicants. Protests are filed on approximately 10% of Proposed Final Orders. If a protest is filed, the Department will attempt to settle the protest but will schedule a contested case hearing if necessary. 6. Final Order Issued If no protests are filed, the Department issues a Final Order consistent with the PFO. If the application is approved, a permit is issued that specifies the details of the authorized use and any terms, limitations or conditions that the Department deems appropriate. Revised 2/1/2012 Ground Water/I RECEIVED BY OWRD MAY 13 2015 WR SALEM, OR
Transcript
Application for a Permit to Use
Ground Water
Oregon Water Resources Department 725 Summer Street NE, Suite A Salem, Oregon 97301-1266 (503)-986-0900 www.wrd.state.or.us
Water-Use Permit Application Processing
1. Completeness Determination
The Department evaluates whether the application and accompanying map contain all of the information required under OAR 690-310-0040 and OAR 690-310-0050 (www.oregon.gov/owrd/law). The Department also determines whether the proposed use is prohibited by statute. If the Department determines that the application is incomplete, all fees have not been paid, or the use is prohibited by statute, the application and all fees submitted are returned to the applicant.
2. Initial Review
The Department reviews the application to determine whether water is available during the period requested, whether the proposed use is restricted or limited by rule or statute, and whether other issues may preclude approval of or restrict the proposed use. An Initial Review (IR) containing preliminary determinations is mailed to the applicant. The applicant has 14 days from the mailing date to withdraw the application from further processing and receive a refund of all fees paid minus $200. The applicant may put the application on hold for up to 180 days and may request additional time if necessary.
3. Public Notice
Within 7 days of the mailing of the initial review, the Department gives public notice of the application in the weekly notice published by the Department at www.oregon.gov/owrd. The public comment period is 30 days from publication in the weekly notice.
4. Proposed Final Order Issued
The Department reviews any comments received, including comments from other state agencies related to the protection of sensitive, threatened or endangered fish species. Within 60 days of completion of the IR, the Department issues a Proposed Final Order (PFO) explaining the proposed decision to deny or approve the application. A PFO proposing approval of an application will include a draft permit, and may request additional information or outstanding fees required prior to permit issuance.
5. Public Notice
Within 7 days of issuing the PFO, the Department gives public notice in the weekly notice. Notice includes information about the application and the PFO. Protest must be received by the Department within 45 days after publication of the PFO in the weekly notice. Anyone may file a protest. The protest filing fee is $350.00 for the applicant and $700.00 for non-applicants. Protests are filed on approximately 10% of Proposed Final Orders. If a protest is filed, the Department will attempt to settle the protest but will schedule a contested case hearing if necessary.
6. Final Order Issued
If no protests are filed, the Department issues a Final Order consistent with the PFO. If the application is approved, a permit is issued that specifies the details of the authorized use and any terms, limitations or conditions that the Department deems appropriate.
Check that each of the following items is included. The application will be returned if all required items are not included. If you have questions, please call the Water Rights Customer Service Group at (503) 986-0900.
~ SECTION I: applicant information and signature
~ SECTION 2: property ownership
~ SECTION 3: well development
~ SECTION 4: water use
~ SECTION 5: water management
~ SECTION 6: storage of groundwater in a reservoir
~ SECTION 7: use of stored groundwater from the reservoir
~ SECTION 8: project schedule
~ SECTION 9: within a district
~ SECTION I 0: remarks
Attachments:
~ Land Use Information Form with approval and signature (must be an original) or signed receipt
~ Provide the legal description of: (1) the property from which the water is to be diverted, (2) any property crossed by the proposed ditch, canal or other work, and (3) any property on which the water is to be used as depicted on the map. Example: A copy of the deed, land sales contract or title insurance policy.
Fees - Amount enclosed: $2.500 See the Department's Fee Schedule at www.oregon.gov/owrd or call (503) 986-0900.
Provide a map and check that each of the following items is included:
Permanent quality and drawn in ink
Even map scale not less than 4" = I mile (example: l" = 400 ft, I"= 1320 ft, etc.)
North Directional Symbol
Township, Range, Section, Quarter/Quarter, Tax Lots
Reference corner on map
Location of each well, and/or dam if applicable, by reference to a recognized public land survey corner (distances north/south and east/west). Each well must be identified by a unique name and/or number.
Indicate the area of use by Quarter/Quarter and tax lot clearly identified
Number of acres per Quarter/Quarter and hatching to indicate area of use if for primary irrigation, supplemental irrigation, or nursery WAD L . f . l d" h . l" fl "f 11 • "d f h f BJ ECEIVED BY 0 ocat1on o mam cana s, 1tc es, pipe mes or um es ( 1 we is outs1 e o t e area o use
Other -G--c~ 'f( Revised 2/1/2012 Ground Water/2
MAY 13 2015 WR
SALEM, OR
Application for a Permit to Use Oregon Water Resources Department 725 Summer Street NE, Suite A Salem, Oregon 97301-1266 (503) 986-0900 Ground Water www.wrd.state.or.us
SECTION 1: APPLICANT INFORMATION AND SIGNATURE
A li I i ,DD cant n ormahon NAME PHONE(HM)
EVAN KARP, CFO FOXGLOVE PROPERTIES LLC AND DOMAINE SERENE
CITY I STATE I ZIP I E-MAIL* FOREST GROVE OR 97116 [email protected]
Note: Attach multiple copies as needed *By providing an e-mail address, consent is given to receive all correspondence from the department electronically. (paper copies of the final order documents will also be mailed.)
By my signature below I confirm that I understand: • I am asking to use water specifically as described in this application. • Evaluation of this application will be based on information provided in the application. • I cannot use water legally until the Water Resources Department issues a permit. • Oregon law requires that a permit be issued before beginning construction of any proposed well, unless
the use is exempt. Acceptance of this application does not guarantee a permit will be issued. • If I get a permit, I must not waste water . • If development of the water use is not according to the terms of the permit, the permit can be cancelled. • The water use must be compatible with local comprehensive land-use plans. • Even if the Department issues a permit, I may have to stop using water to allow senior water-right holders
to get water to which they are entitled.
e affirm. that the information contained in this application is true and accurate.
EV AN KARP, CFO r!t /o-Applicant Signature Print Name and title if applicable Date
Applicant Signature Print Name and title if applicable Date
RECEIVED y OWAD
App. Nc6=ra:J Jr" Revised 211/2012
For Department Use
Permit No. ------Ground Water/3
Date ------ MAY 18 2015 WR
SALEM, OR
SECTION 2: PROPERTY OWNERSHIP
Please indicate if you own all the lands associated with the project from which the water is to be diverted, conveyed, and used.
l8I Yes
D No
(81 There are no encumbrances. D This land is encumbered by easements, rights of way, roads or other encumbrances.
D I have a recorded easement or written authorization permitting access. D I do not currently have written authorization or easement permitting access. D Written authorization or an easement is not necessary, because the only affected lands I do not
own are state-owned submersible lands, and this application is for irrigation and/or domestic use only (ORS 274.040).
D Water is to be diverted, conveyed, and/or used only on federal lands.
List the names and mailing addresses of all affected landowners (attach additional sheets if necessary).
You must provide the legal description of: 1. The property from which the water is to be diverted, 2. Any property crossed by the proposed ditch, canal or other work, and 3. Any property on which the water is to be used as depicted on the map.
SECTION 3: WELL DEVELOPMENT
IF LESS THAN 1 MILE:
NAME OF NEAREST DISTANCE TO NEAREST ELEVATION CHANGE WELL NO. BETWEEN NEAREST SURFACE SURFACE WATER SURFACE WATER WATER ANO WELL HEAD
Well #7 Headwater of no-name creek, South- 1,571' +192' southeast of Well, tributary to Hess Creek and to the Willamette River.
Well #7 Headwater of no-name creek, northeast 2,564' +220' of well, tributary to Millican Creek and to the Yamhill River.
Well #7 Hess Creek, Northeast of well location, 3,222' +350' tributary of the Willamette River.
Well #7 Headwater of no-name creek, 3,682' +480' Southwest of well location, tributary of Millican Creek and the Yamhill River.
Well #7 Headwater of no-name creek, South- 3,814' +320' southwest of well location, tributary of Millican Creek and the Yamhill River.
Well #7 Headwater of no-name creek, South- 4,039' +350' southeast of well location, tributary of the Willamette River.
Well #7 Headwater of no-name creek, Southeast 4,214' +300' of well location, tributary of the Willamette River.
Well #7 Headwater of no-name creek, 4,398 +200' Southwest of well location, tributary of the Yamhill River.
Well #7 Headwater of no-name creek, 4,907' +460' Northwest of well location, tributary of RECEl\i ED BYOWRD Millican Creek and the Yamhill River.
6-lBo~ Revised 2/1/2012 Ground Water/4
MAY 13 2015 WR
SALEM, OR
Please provide any information for your existing or proposed well(s) that you believe may be helpful in evaluating your application. For existing wells, describe any previous alteration(s) or repair(s) not documented in the attached well log or other materials (attach additional sheets if necessary). See attached well logs for wells# 1.2.3.4 and 5. Wells 1-4 are on this winery and well #5 is on the contiguous property to the east referred to as Triple Crown Winery by the owners.
RECEIVED BY OWRD
MAY 13 2015
Revised 2/1/2012 Ground Water/5 SAL~OR
~ECTION 3: WELL DEVELOPMENT, CONTINUED
@ ~otal maximum rate requested: __ (each well will be evaluated at the maximum rate unless you indicate well-specific rates and annual volumes in the table
below).
The table below must be completed for each source to be evaluated or the application will be returned. If this is an existing well, the information may be found on the applicable well log. (Jf a well log is available, please submit it in addition to completing the table.) If this is a proposed well, or well-modification, consider consulting with a licensed well driller, geologist, or certified water right examiner to obtain the necessary information.
PROPOSED USE
WELL ID OWNER'S
~ * (WELL TAG)
0 ~ PERFORATED SEAL
MOST RECENT WELL-CASING TOTAL ANNUAL
WELL g r... NO.• 2'i 0 CASING OR SCREENED STATIC WATER SOURCE AQUiFER,....
· SPECIFIC 0 ~ ~ INTERVALS
INTERVALS INTERVALS WELL
RAT£ VOLUME
NAME OR ·~ OR DIAMETER LEVEL&DATE R: {INFEET} {INFEET} DEPTII (ACRE-FEET)
NO. WELL LOG {INFEET) {INFEET) (GPM)
ID**
#7 IZI D NIA D 6" 50' 40' 50' NIA Unknown 375' 75gpm 40
D D D
D D D
D D D
D D D
D D D
D D D
D D D
* Licensed drillers are required to attach a Department-supplied Well Tag, with a unique Well ID or Well Tag Number to all new or newly altered wells. Landowners can request a Well ID for existing wells that do not have one. The Well ID is intended to serve as a unique identification number for each well.
** A well log ID (e.g. MARI 1234) is assigned by the Department to each log in the agency's well log database. A separate well log is required for each subsequent alteration of the well. *** Source aquifer examples: Troutdale Formation, gravel and sand, alluvium, basalt, bedrock, etc. RECEIVED BY OWRD
Revised 2/1/2012 Ground Water/5 MAY 13 2015 WR
SALEM, OR
SEF Job # 314-082 Demaine Serene, Winery Hill, GW Application
SECTION 4: WATER USE
USE PERIOD OF USE ANNUAL VOLUME (ACRE-FEET)
Irrigation March 1 through Oct. 31 36 acre feet
Commercial Year around when needed 4 acre feet
Exempt Uses: Please note that 15,000 gallons per day for single or group domestic purposes and 5,000 gallons per day for a single industrial or commercial purpose are exempt from permitting requirements.
For irrigation use only: Please indicate the number of primary and supplemental acres to be irrigated (must match map).
Primary: 65.1 Acres Supplemental: 6.9 Acres
List the Permit or Certificate number of the underlying primary water right(s): Permit S-54831
Indicate the maximum total number of acre-feet you expect to use in an irrigation season: 36 acre feet
NOTES:
This application includes 30.9 acres that bas two existing primary water rights, certificates #87834 and #88371, the certified rate that these rights can pump is 0.27 cfs. The 30.9 acres at 1/801
h cfs equals 0.39 cfs. This leaves a deficiency of 0.12 cfs or 53.9 gpm. For this reason, deficiency in rate, we are asking for an additional primary right for these acres. The area of new potential new plantings for this vineyard is 34.2 acres, we are asking for a primary water right for these acres. Total primary acres is 65.1 acres.
Permit S-54831 bas 6.9 acres of primary rights on this vineyard, we are asking for 6.9 acres of supplemental water rights from well #7 on those acres. The source for this water is the Quarry Pond, Permit# R14968.
Permit S-54831 bas supplemental water rights on the 30.9 acres mentioned above. The permit specifically states that it is allowed to be used before the primary ground water right to conserve the ground water.
• If the use is municipal or quasi-municipal, attach Form M
• If the use is domestic, indicate the number of households: NI A
If the use is mining, describe what is being mined and the method(s) of extraction: NIA
SECTION 5: WATER MANAGEMENT
A. Diversion and Conveyance What equipment will you use to pump water from your well(s)?
~Pump (give horsepower and type): Est. 4 hp submersible.
D Other means (describe): __
Provide a description of the proposed means of diversion, construction, and operation of the diversion works and conveyance of water. Pump will be sized and installed in well given the final yield and static water level. The mainline pipe will be installed to the existing pump house to be routed to the irrigation system or the winery supply system. The irrigation mainline will be installed underground 'Jt~C!itf ED vineyard grapes are planted. BY OWRD
&-teo-n Revised 3/4/2010 Ground Water/7
MAY 13 2015 WR
SALEM, OR
SEF Job # 314-082 Domaine Serene, Winery Hill, GW Application
B. Application Method What equipment and method of application will be used? (e.g., drip, wheel line, high-pressure sprinkler) Drip for grapes, For landscaping the methods will be a mix of drip, shrub nozzles, impact and rotor sprinklers.
C. Conservation Please describe why the amount of water requested is needed and measures you propose to: prevent waste; measure the amount of water diverted; prevent damage to aquatic life and riparian habitat; prevent the discharge of contaminated water to a surface stream; prevent adverse impact to public uses of affected surface waters. We area asking for a duty of 0.5 foot per acre which is 1/Sth the standard maximum. We consider this duty to be an absolute maximum for the irrigation needs. Most irrigation will be done with drip irrigation to avoid waste. The landscape irrigation is on an automatic timer and conservation is stressed by the owners to the landscape crew because high water use can result in low water quality at the winery.
SECTION 6: STORAGE OF GROUND WATER IN A RESERVOIR
Note: There are no plans to store the water from this well in a reservoir. If at some date they decide to use the irrigation system already in the Quarry Pond it would be as 'overnight storage' only as a bulge and not storage in the reservoir.
If you would like to store ground water in a reservoir, complete this section (if more than one reservoir, reproduce this section for each reservoir).
Reservoir name: NIA Acreage inundated by reservoir: __
Use(s): __
Volume of Reservoir (acre-feet): __ Dam height (feet, if excavated, write "zero"): __
Not,e: If the dam height is greater than or equal. to 10. O' above land swface AND the reservoir will store 9.2 acre feet or more, engineered plans and specifk:ations must be approved prior to storage of water.
SECTION 7: USE OF STORED GROUND WATER FROM THE RESERVOIR
If you would like to use stored ground water from the reservoir, complete this section (if more than one reservoir, reproduce this section for each reservoir).
Annual volume (acre-feet): __
USE OF STORED GROUND WATER
NIA
Revised 3/4/2010
PERIOD OF USE
NIA
Ground Water/8
RECEIVED BY OWAO
MAY UZDt5
0.AI -· -
SEF Job# 314-082 Domaine Serene, Winery Hill, GW Application
SECTION 8: PROJECT SCHEDULE
Date construction will begin: July 2015
Date construction will be completed: August 2020
Date beneficial water use will begin: August 2015
SECTION 9: WITHIN A DISTRICT
0 Check here if the point of diversion or place of use are located within or served by an irrigation or other water district.
Irrigation District Name Address NIA City State I Zip
SECTION 10: REMARKS
Use this space to clarify any information you have provided in the application (attach additional sheets if necessary).
The owners are applying for this well because they are now highly dependent on the water from Well #2 for the winery and ifthe well has mechanical problems or ifthe water quality is degraded on a dry year the winery could be disrupted. The owners have been working with a professional well driller and tried to locate the well to hopefully hit a separate aquifer to both supply irrigation to the new plantings and supply good fresh water source for the commercial use at the winery.
Revised 3/4/2010 Ground Water/9
RECEIVED BY OWRD
MAY 13 2015 WR
SALEM, OR
SEF Job # 314-082 Domaine Serene, Winery Hill, GW Application
Oregon Water Resources Department 725 Summer Street NE, Suite A Salem, Oregon 97301-1266 (503) 986-0900 (For staff use only) www.wrd.state.or.us
WE ARE RETURNING YOUR APPLICATION FOR THE FOLLOWING REASON(S):
0 SECTION 1: ~~~~~~~~~~~~~~~~~~~-
D SECTION2: ~~~~~~~~~~~~~~~~~~~-
D SECTION 3: ~~~~~~~~~~~~~~~~~~~-
D SECTION 4: ~~~~~~~~~~~~~~~~~~~-
D SECTIONS: ~~~~~~~~~~~~~~~~~~~-
D SECTION6: ~~~~~~~~~~~~~~~~~~~-
D SECTION7: ~~~~~~~~~~~~~~~~~~~-
D SECTION 8: ~~~~~~~~~~~~~~~~~~~-
D SECTION9: ~~~~~~~~~~~~~~~~~~~-
D Land Use Information F onn ~~~~~~~~~~~~~~~~~~~-
D Provide the legal description of: (1) the property from which the water is to be diverted, (2) any property crossed by the proposed ditch, canal or other work, and (3) any property on which the water is to be used as depicted on the map.
D Fees ~~~~~~~~~~~~~~~~~~~-
MAP
0 Permanent quality and drawn in ink
D Even map scale not less than 4" = 1 mile (example: 1" = 400 ft, l" = 1320 ft, etc.)
0 North Directional Symbol
D Township, Range, Section, Quarter/Quarter, Tax Lots
D Reference comer on map
D Location of each well, and/or dam if applicable, by reference to a recognized public land survey comer (distances north/south and east/west). Each well must be identified by a unique name and/or number.
0 Indicate the area of use by Quarter/Quarter and tax lot clearly identified
D Number of acres per Quarter/Quarter and hatching to indicate area of use if for primary irrigation, supplemental irrigation, or nursery
D Location of main canals, ditches, pipelines or flumes (if well is outside of the area of use)
D Other
Revised 3/4/2010
__________________ R--'E=-C-EIVED BY OWRD
MAY 13 2015
Ground Water/13 SALEM~
SEF Job #314-082, Doamine Serene, Winery Hill GW Application
Oregon Wnterltetoureea DepArtment 725 SUmmcr Slrcel NH, Suite A Salem, Oregon 97301·1266 (503) 986·0?00 www.wrd.stole.or.us
.El~ <Stugtzncr Englncerlng & Forc:strv) L1u1
(Agent for owners: Poxglove Pl'Ope1tlC11, U.C ond Domolne Serene Winery.)
9711~ Zip
Daytime Phone: ~03-939-8381 ·
Please Include tlle following Information for all tax Iota where water wm be diverted (taken from fts source), conveyed (transported), and/or used or developed. Applicants for munJclpal use, or irrigation uses within Irrigation di11trlcu may subi1tltute existing and proposed servJce-aroa boundarie.s for the tax~lol Information requested below. Town~hfp R.1m3c Section ~~ Tax Lolli Plan Ocslgr1111lon (o.g., WPtcrto be: Proposed
Rural R.ctfdcntlol/RR•S) I.and tJso;
3S JW 33 nclnw 3011 BF·BO ~Diverted 181 Convoyed II Used Grapc11
JS 3W .33 so I mv 319 SF'-80 0Dlvcrtcd 181 COllVOylX1 IBI Usod Orapos
List all counties and cities where water Is propo$cd to be diverted, conveyed, and/or used or developed:
I Yamhill Caunly.
B. Description of Proposed Use
Typo ofapplicotlon co be filed with the Water Resources Dopanmont: Im Pennlt tn Uso or Store Water 0 W3tor Right Translbr 0 Pcnntl Amendment or Ground \Voter Regllltrallon Modlflcallotl 0 Limited Water Use JJlcen!lo D Allocation ofConacTVcd Wate1· 0 Exohangc of Willer
Source ofwatel': 0 Re.'lervolr/Pond 181 Groul)(i Water 0 Surf1100 Water (name) __
Estlmntcd quantity of water needed: _ 0 cubic feet por second D ga11on9 por mlnuto 0 acre·feet
lntended use of watel': 181 Jn·lgatlon D Munlolpal
Briefly describe:
l8I Commorciol D Quasl-Munlclpnl
0 lndu$1rl!ll D Jnstrcam B Domestic for __ buuschold(s)
Other __
AppllcatfCln for ground water for supplemental Irrigation of grapes and commercial use at wine1y.
-------·----.. ------------······---.. ·-·-···------------·--... --··-··~----····-···-·· ............................. "•'!$~~ Note to applh:nt1t: If the J .. and Use Tofo1matlon Form cannot be completed while you wait, please have a local government representative sign the rccel1lt at tl1e bottom of the next poso and include It with tJie application filed with tbe Water R.e$ources DopRrtment. RECEIVED BY OWRD
See bottom of Page 3.--+
Revised 3/4/2010 Oround \Vater/9 MAY 13 2015 WR
SALEM, OR
12/29/2014 17:08 5033575698 STUNTZNER PAGE 05/05
SEF Job# 314-082 Domaine Serene, Winery Hill, GW APl>llcatlon
for Local Government Use OnlI The following section must be completed by n planning official from caoh county and city listed unless the project will be located entirely within the city limits. In that cnse, only the city planning agency must complete this form. This dents only with the local land-\tso plan. Do not Include appl'Oval for activities such ns bufldlng 01· grading pennlls.
Please check the appropriate box below and proylde the reaussted information
li}t'iind uses to be served by the proposed water uses (Including proposed constntctlon) are allowed outright or are not regulated by your comprohonslvo plan. Cito applfonblc ordinance section(11): ~2- • .::.·z...
0 Land uses to be served by tho proposed water uses (Including proposed cQnsttuction) involve dlscrotlonary hind-use approvals as Hsted in tho table below. (Please attach documentation of applicable land-use approvals wJ1ich have alrendy boon obtnlnod. Record of Action/land-use decision and accompanyJng findings are 1.1ufficlcnt.) If approvals hnve been obtained but All Appeal periods have not ended, checl< "Being pursued.''
Type ofLand·Uso Approval Needed Cito Most Slgnlficonl, A11pllcahlo Ph1n Lond·Uso Approval: (e.g., plan Rmcndmonts. rozonos, condlllono.l·uso 11crmlt5. cto.l Policies & 01dlnanoo Section Rcfcrcnec!I
00\ll~!ncd 0 Bcilng l'v1111ic4 [JDcnlod D Nol Being P11raucd -D 0111nlncd D Deina Purmcd ODcnlcd D Nol Being Pu1111cd
OOl>Jnlnod Cl Bclhl! P11r~1K1d [J Denied Cl Mot l)oln11 f'ln'3Uecl
OObtn!ned Cl 9olm1 J•nrtned 0Denled D Nnl Being Pu1"1111cd
1J Obtained Cl Beine PU1'1111Cd D o.nlod D Not 'Qel~.11 l>ul'fucd
Local govemment!I Are invited to express special land-use concerns or make recommendations to the Water Re&ources Department regarding this proposed use of water below, or on a separate $heat.
Name: __ Title: <;-\- ~r.'k~,"'t cC-i.v-"-4~ ~'i. o<~t0-L Y \.co~i--......-r--'.- ~ ~- s-o>· ... ~?.4 .,'S"l(,... I
Signature;-~ = PJ1one: __ .Date: l 2-- -S ~l l 'f Govemment Entity: ~W\.~· l l b ..... f'\. ~y Note to local government .reprcscnt1ttlve: Please complete this fbl11l or sign the rece.lpt below and return it to the applicant. J.f you sign the receipt, you wlll have 30 days from the Wntcr Re$ources Department's notice date to return the completed Land Use lnfo1matlon Form 01· WRD may presume the land use associated with tho propo~ed use of water Is compatible witl1 local
~~~~~~~~~~-~~~~~~•••-••-•••••••••••"•-.••••-•••••••"--··-••••••••M•-••••••••••-•-••••-•••••••••••~-·-••-•••• 'f-~I Recelttt for Request for Land Use Information
Applica11tname: ______________________________ _
City or County: ---------~---- Staff contact: -----~---~~~
Signature: __________ ,~-- Phone:---~- Date: RECEIVED BY OWR
Revised 3/4/201 O MAY 13 Z015
WR 01·oltnd W11tor/I 0
SALEM, OR
First American Title Company Of Oregon McMinnville Office
775 NE Evans Street McMinnville, OR 97128
Tel (503) 472-4627 Fax (866) 800-7294
Newberg Office 515 E. Hancock
Newberg, OR 97132 Tel (503) 536-7361 Fax (666) 600-7290
This title information has been furnished, without charge, in conformance with the guidelines approved by the State of Oregon Insurance Commissioner. The Insurance Division cautions intermediaries that this service is designed to benefit the ultimate insureds. Indiscriminate use
only benefiting intermediaries will not be permitted. Said services may be discontinued. No liability is assumed for any errors in this report.
RECEIVED BY OWRD
MAY 13 2015
SALEM, OR
First American Title Company Of Oregon McMinnville Office
Building Sq Ft Living SqFt 1stFloorSF 2ndFloorSF 2nd+FloorSF Cellar SF BsmtTotalSF Garage SqFt Garage Type Stat Class :161 ONE STORY
Lot Acres Lot SqFt Foundation Wall Material Roof Material Roof Shape Floor Cover Floor Base Year Built
:12.10 :527,076
MH and Lot APNs
Dimensions Skirt
Page 2 of 2
This title information has been furnished, without charge, in conformance with the guidelines approved by the State of Oregon Insurance Commissioner. The Insurance Division cautions intermediaries that this service is designed to benefit the ultimate insureds. Indiscriminate use
only benefiting intermediaries will not be permitted. Said services may be discontinued. No liability is assumed for any errors in this report.
RECEIVED BY OWRD
MAY 13 2015
SALEM, OR
RECORDING REQUESTED BY:
GRANTOR'S NAME: David B. Kahn
GRANTEE'S NAME: Foxglove Properties, LLP, a Minnesota Limited Liability Partnership
SEND TAX STATEMENTS TO: Foxglove Properties, LLP, a Minnesota Limited Liability Partnership 6701 Evenstad Drive Maple Grove, MN 55369
AFTER RECORDING RETURN TO: Foxglove Properties; LLP, a Minnesota Limited Liability Partnership 6701 Evenstad Drive Maple Grove, MN 55369
Foxglove Properties, LLP, a Minnesota Limited Liability Partnership, a Minnesota Limited Liability Partnership, Grantee, the following described real property, free and clear of encumbrances except as specifically set forth below, situated in the County of Yamhill, State of Oregon:
Lots 1, 2 and 3, REPLA T OF PORTIONS OF BREYMAN ORCHARDS, County of Yamhill, State of Oregon.
Subject to and excepting:
Roadway, as set forth in Deed recorded June 3, 1936 In Book 111, Page 349; Easement as shown on the recorded plat.
BEFORE SIGNING OR ACCEPTING THIS INSTRUMENT, THE PERSON TRANSFERRING FEE TITLE SHOULD INQUIRE ABOUT THE PERSON'S RIGHTS, IF ANY, UNDER ORS 195.300, 195.301 AND 195.305 TO 195.336 AND SECTIONS 5 TO 11, CHAPTER 424, OREGON LAWS 2007. THIS INSTRUMENT DOES NOT ALLOW USE OF THE PROPERTY DESCRIBED IN THIS INSTRUMENT IN VIOLATION OF APPLICABLE LAND USE LAWS AND REGULATIONS. BEFORE SIGNING OR ACCEPTING THIS INSTRUMENT, THE PERSON ACQUIRING FEE TITLE TO THE PROPERTY SHOULD CHECK WITH THE APPROPRIATE CITY OR COUNTY PLANNING DEPARTMENT TO VERIFY THAT THE UNIT OF LAND BEING TRANSFERRED IS A LAWFULLY ESTABLISHED LOT OR PARCEL, AS DEFINED IN ORS 92.010 OR 215.010, TO VERIFY THE APPROVED USES OF THE LOT OR PARCEL, TO DETERMINE ANY LIMITS ON LAWSUITS AGAINST FARMING OR FOREST PRACTICES, AS DEFINED IN ORS 30.930, AND TO INQUIRE ABOUT THE RIGHTS OF NEIGHBORING PROPERTY OWNERS, IF ANY. UNDER ORS 195.300, 195.301 AND 195.305 TO 195.336 AND SECTIONS 5 TO 11, CHAPTER 424, OREGON LAWS 2007.
THE TRUE AND ACTUAL CONSIDERATION FOR THIS CONVEYANCE IS $1,600,000.00. (See ORS93.030)
DATED: May 27, 2008
RECEIVED BY OWRD
I 1~ MAY 13 2015
SALEM, OR
Stateof~W Countyof \jAMw1U....
ce;~£S@~~of 'm~ , 20 ~, before me personally appeared
(proved to me on the basis of satisfactory evidence) (personally known to me) to be the person whose
name is subscribed to the within Instrument (Type of Document: \..)A'2:eA~ 'DG~D
as the attorney In fact otDPwlt>'B. \LAHLl. , and acknowledged that~ (she) subscribed the name
ort:e.Vtnn \44wq thereto as principal, and(@) (her) own name as attorney In fact.
Nola Public - State of Oreg~ My commission expires: 10\0?0\.;2..
if 4~1.t~ :l~:·;'.:~:±~:'f:'"~··'~:i::,::=~~~::~:, ~.:~::~~«•hip. ;t'.t'./f!;";:::;;.f~!{I\'k !;r:L;<:·> ·. ,. · · ·.:. · .. see At~ached _Legal Description hereby attached and made a part ...... , "'"'"'··'·'~"·•·•·"·•··· ')"·'·'·· ·· · .... · of.this instrument ..
..
. ...
..
.. .
. .
;,,;~"(:J<: /:~1 ·::f~~ L· '. ro .. T~llS iNSTRUMENT WILL NOT ALLOW USE b~ ~HE PROPERTY DESCRlBED JN THJS INSTRUMENT JN VIOLATION OF '.:\i·"~:-·:,.: .-.··"::":_;'f:.:,.U i.·j ... · .. ·.·APPLICABLE LAND USE LAWS AND REGULATIONS. BEFORE SIGNING OR ACCEPTING THIS INSTRUMENT, THE :-.~/ . .-J<·.'.:· J':i:!~;~ .::~l. :'i,);:i PERSON ACQUIRING FEE TITLE TO THE PROPERTY SliOUW CHECK WITH THE APPROPRIATE CITY OR COUNTY <<:·:.:}.~(:.>J _)·'.:.,'.: .'.,·{~~,. ~LA~N.IN~. ~~P~RTMENT TO VERIFY APPROVED USES. .
·: .. :.· <·.'·:~·~·;.: .. . :;~~:·;.:t:J. "J.;·~ . '.f'he !rue 11ncl actu.al consideration ror1hi~ lrnn~for Stilled in terms ordollnrs is$ ~25,000.0~ . However, . :, ... "; .~.:: .:, ... :3:.;J,£ .,j· ·. ~ . 1f the uctunl cons1dcrntlon. co~5Js1s of.or mclu~c.~ otl~crpropcrty or other vnluc given or p,ro1mscd, such other property or vnluc was part ',., ... ;. · :!.:- ,'.;::.,:·;:J: <;t} -~1 · -~ · o~ !he/ the whole_ of_ the. (md1cme wh!ch) cons1dernt1on. ': /.. ....... .,. ,. •••• ·•!•'''• \-··t-·-i:T-1.- , .. , ··.~1 ·'' t
::/~._·f,':)_':·:r:fr:'·'.11~ ?i :: .. '.,. · If grunter '.s'u corpor11tioil, this hus bi:cn signed by mllhority of the llourd ur ()ircclnr~. . "'" ....... \ ...... ,. .• !1.J ... 1... . ) ~;·:,;,,;:.;";", .. , .. ~,~;,.:.l~~: .... ~ .. ,. . " ::.->::<·/'"'";'J}:'Tl;;: ·.·i··r · "·aRANTOR: Laurent-Perrier, us., Inc, a·Delaware Corporation as to Pa'rcel 1 ~):'.:;•_.-:": ::.- :,.; ~~lJ'. ·~.": . Laµrent-Perrier Estates of Oregon, Inc., a Delaware Corporation as to Parcel 2 t.~· >~·7:._:~;;~·,-~~- :i".:~~~~~f~ -.. ~t~.. . . . . . •• ,.·~.-~· ~ ••• ·-· T""- •• • • •
~~ll1 itx'',;;,: ~ . •·•.' ·•~.~~~~~~?it~l;::!~~EDJ I ·l~·~. ' •;:·
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. ·, i
1',
)/ 13
.·· ...... .-.·_::.
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RECEIVED BY OWRD
MAY 13 2015
"· SALEM, OR
£:·=.· . . ,· . .. , .·•
EXHIBIT "A"
. .. ·'
~ .... . : .. PARCEL l: : :··.
A tra·ct. of ·land in. the Heat Half of Section 33, Township 3 South, Range 3 West ... : ·<" . ·of:· the Willamette Meridian in Yamhill County, Oregon, being more particularly
'r··: ~ · · 'described as:· follows: .. . .... ··
18 1 Eaat· 1655.80 ~eet from the on the Heat line of Brayman ·thence south 14° 38 1 42 11 East
;ps:'''.:t:..S::~'.\~:.:-;.' ·C;.':}:';-:::1e.o,oo ... feet; .then~e .. N:ort}l 03°. 22 1 Heat 373.56 feet 1 thence south 70° 59' West
~;nz:fr:.r~;~i.It'.)\.> 1>.<::;::.-.,d~scr.~ed.center lin~:. Beginning at a:point on the t!est line of County Road '.,''.1.tYi·~·~·''.~:°::·:·~f.·:·.~~~·~:.1 ·: '.' · ~ :.: .NC>·: .. 92·,: th .. at. is West .. so. ~eet and: South 01• ·os •.·west 257 .4 feet from the . " ;/:/~·;,_;;:A'~\~~; .·j .-: :; '/· ~,Northea!if.t .:corne.r. of Lot S9, Breyman Orchards; thence West. 444 .43 feet; thence :. .:.·~~·-:· ;;:~-:.~ 1.:~~:'. •: · ·, ". -:. ·Northwesterly ·301, SB: feet along the arc of a 191 foot radius curve right i;;~;:Y}b~g;~~.r: .. )Ll..->>'.:through a.central angle .of 90° 28' (chord bears North u• 45' west 211.21. :/:;;/.i'X,~·::·;::::;h:~~:·,-.:'.:·.-.·._·f.~e.tl;. thence North. oo• 28' East;-_64.60 feet to the North line of Lot SB in
:I;~;,/;i,);.'~;:'..i-~/iti~~: '.:L( ..... ' ... : ~~: .tra~·t·,·~~ .. ·;ar1d .in tbe1.west Hal~ of section 33, Towsfiip1~ South, Ran~e 3 west : :;:;':~::-.~:·'.,,»!::.:·.:;.:.c:~.;l:'l:' 1··,:": :·: ·.of··the.·Willamette Meridian in Yamhill County, Oregon, being more particularly
i~.:'.1;isZ!.';;;{;·\f:~imf ~J:::~+,:,~i:':.;:;:~~~ .. 0X7(et ~~ io:,~~:~: :· · · , .. · · · · · · ~- · ';~'/:'.:.~·~:\','.".'~'.~~'':!t.;/, .. (':·:-.-..·Beginning at·a .. point whiqh bears South 06° 18' East 210.30 feet f:i:'om th·e. :'..'H.J' .. ~~r>~{j~~J. J>-.:· <.'·~or~hw.~st cor.·?.e~:o~ ·aa·i,ci':sec.ticiri 33;. and running thence south 89° lB' East ·::\.~::/;;,-;·::.; .. :/~:t'.Jfil:. :!<:<:'..':·: .. 9·~~;.e~.·~ee.t( t~~I!ce South ?9° 3.4~ East 149.44 fee.t; 'thane.a south 14° 38' 42" ·i•.:·: .• ,;-.. "'"'"'-·-''-'·''''ht' .: .. , .. ;,-'::,;;;-.;,:.\East·::1455·;14_,feeti'thence»West.l3l9 .. BB feet; thence North 06°. lB' West 1455.50 :<. :.;.: .~ ... :: .~ ":.::,:·: .~ij'i. ·1. ··.: '. . fei:;t , t~. '.the point o~. beginning: ·
:~~,;:)/\·~::.:·":· .. ~ .::1 _::· · .;6~~THER ·wI~ a non-exclusive easement to.r r.oad and utility purposes over the
:·:..;:;,.;;~ (:~;.. J ~ . ._ 2. . 7he ~asessment roll and the tax roll disclose that the premises herein . .-"··· .:. ~,. · ;J , : · described have. been specially assessed as Farm Use Land. If the land. becomes
!iii., ;;,l:.J~~~t J "! .... ·.::~'. di·s~a~if~ed for_ th.e special .. a·ssessment under the· statute, an additional tax w.,;;;;;,.:l·., .. ,., ... (.. ... ;.~;.. .J :.: .:. ': :: may~be levied· for previous years in which the farm use assessment was in
} : ,.· ~
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: ~ • ' ' • O '• .... ~· o OM •• ,, •...C.Y. o 0 ~ .. •• 0 O
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···. : ..
~,,~&l\l··
~~If ,~;i~&.~~.
,:'.
RECEIVED BY OWRD
SALEM, OR
. . ;-:~. ·. ··'
.... / I
~··
•
~ KECl:tVtU ~ - YAM
STATE OF "OREGON AUG 1 7 tm. WA'fER WELL REPORT PAGE·-
las required by ORS 537.765)
1321 (1) OWNER: SALE~euCIB~~9N Name LAU.RENT-PERRIER CHAMPAGN--E-----Address PO BOX 2 8 0 City DUNDEE - - ··- State (2) TYPE OF WORK: CJCNew Well D Deepen D ReC.ondition (3} DRILL METHOD:
. [jCRotary Air D Rotary Mud 0 Cable
0 Other (4) PROPOSED USE:
OR Zip 97115
·· 0 Abandon - ·
0 Domestic 0 CommunitY 0 Industrial Q9 Irrigation 0 Thermal D Injeetion· o· othcr -·
(5) BORE HOLE CONSTRUCTION: Special Construction approval D Yes~ Depth of Completed Well___E R. Explosives used D Yes !J No Ty~ Arnq11n.__ __ _
HOLE SEAL •. Diameter From To Material From To
Am Dunt sacks or pounds
• •
How was seal placed: Method 0 A 0 B c On DE []Other--------------------~ Backfill placed from__ ft. tp__ ft. . _ ~aterial~,..,,__-....,.-,-c-c:-=-::--Oravcl placed from_ ft. t.o ft. Size of gravel (6) CASING/LINER:
Diameter From To Gauge Casing
6 +2 38 • 21
Liner: q. u '.,: .LOI
Final location of shoe~s)
(7) PERFORATIONS/SCREENS: ~Perforations - ·Method
Steel
D D ox
Plastic _ o
D 0
D D 4§ -~
SAW
Welded Threaded _o· _ ._ o _ 0 :· .. D DX D O ___ .D -~ 0 D D
D Scieens Type . _Materie,l_
Slot Tule/pipe
~5, 2~51 ~ ,.~ er Dl11111eter size Casine
~;:r
I I
_o D p .D D _o _o 0 .D
(8) WELL TESTS: Minimum testing time is 1 hour
0 Pump
Yield gal/min
0 Bailer
Drawdown
OX Air
Drill stem at
235
}'.!owing D Attesian
Time
l hr.
Temperature of Water _5~3___ Depth Artesian Flow Found---Was a water analysis done? D ~s BywJ-10 .. ·• -----------Did any strata contain water not suitable for intended use? 0 Too little 0 Salty 0 Muddy D Odor D Colqred 0 Other --------Depth of strata:
t)bw~S~J33M / 34953 I ....
(START qRD) If-------~---
(9) LOCATION OF WELL by legal description: County YAMHILhti.l:\ld Longitud,.,_ __ ~--Township 3 S .N"or)~-Rl!nge ·. 3 W E_or W. WM. section 3 3 -SE . '-' NW it._. ·- . ·- _ Tax Lo Lo Blqc.._· ____ Subdivisio.~---
Street Address of Well (or nearest address) ______ ...__--,-:=--APPROX 6700 HILLTO~ LN DAYTON, OR
(10) STATIC WATER LE~L: 10 8 ft. bel~w land ~~rtace. Date
Artesian pressure lb. per square inch. Date
(11) WATER BEARING ZONES:
08/13/92
Depth at which water was first fo_u..lld _1_5_8 __________ ~
-From "'fo Estin'rrlted Flow Rate 5WL J. ::> 0 J._!j J. ::> .LU 0
.GJ..U ~~u ..:u. .LUO
(12) WELL LOG: Qround elevation---------
Material From To SWL TOP SOIL ... - .. 0 4
RED CLAY 4 12 DECAYED"- BASALT 12 31 MEDIUM HARD GRAY BASALT 31. 158 LOOSE DECAYED :E}ASALT 158 181 108 MEDIUM GRAY BASALT.-:· 181 206 HARD GRAY BASALT 206 2.10 LOOSE/CAVING BASALT 210 220 108 MEDIUM GRAY BA~ALT _ 220 235 TAN AND BLACK ASH 235 236 c:ni;i'T' R 11 c: Zl T .'T' ?"'.l.h ? .di::;
(unbonded) Water Well Constructor Certification: I certify that the work I performed on the construction, alteration, or abandon
ment of this well is in compliance with Oregon well construction standards. Materials
used and inform;:n/epoil above:re true to my best::!::::: r~~·s
Signed J )J ~ Dqte 0 8 t 13 / 9 2
(bonded) Water Well C struc or Certification: I accept responsibility for the construction, alteration, or abandonment work per·
formed on this well (luring the construction .dates reported above. All work performed dui:fng this time is in ·compliance \Vith Oregon well construction standards. This report is true to the best of my knowledge and belief. ff.?
WWC Number '({':J.... J'-8-Z.~~~ Signed
R:
ORIGINAL & FlRST COPY • WATER RESOURCES DEPARTMENT -. SE_COND COPY • CONSTRUCTOR THIRD COPY • CUSTOMER
State of Oreqon liATF.R WELL REPORT (as required by ORS 537. 765) Paqe 1 of 1
State liell ID 133962 -start card I 125659
'l) CWER: Well Ko. 1907 ' Name FOX GLOVE PROPER'l'IES
Address 14905 23RD AV N. Ci t.f KIHllFJ.POLIS
( 2 ) TYPE OF WORK: Kli WELL
( 3 ) DRILL l!E'mOD: ROTARY AIR
( 4) PROPOSFJl USE: lmSTIC
(5) BORE BOLE COHSTRUcr'IOll:
St 1111 tip 5544 7
(9) IllCATIOH OF WELL by leqal description: Ce/ttffl!'l:J County YMHILL Lat. ' ' • Long. ' ' • c;;, Township 3 s Range 3 11 111. Der Section 33 SE l/' llW 1/4 1 1 199,., Tax Lot 316 Lot Block SUbdiviiHdtn:.R J
street Address of Well (or nearest Address} SALit:_ouAc NYA, HILL'l'OP WE DAY'roll, OR • Ofit:(fcf1,PcPr,
(10) S'l'A'l'IC WA'l'ER LEVEL: 83 ft. below land surface. Date 09/30/99 Artesian pressure_ lb per square in. Date __
Special Construction Approval KO Depth of COlpl. Well 23 7 ft ( 11) liATER BWIHG ZONES: Explosives used HO 'Iype __ AIOunt Depth at which water was first found 141
HOLE SEAL Fron To Est Flow Rate SWL 83 Diu. Prom To Material Frot '1'o Alount 141 241 60
(unbonded) liater Well Constructor Certification: I certify that _ _ _ ___ , the work I perfoned on the construction, alteration, or aband·
-----------------1 orment of this well is in C01pliance with oregon water supply ( 8) WELL '1'FS'l'S: lini1111 testing tine is 1 hour
Test type AIR
Yield GP!! 60 60 60
Drawdim
Drill stem at 300 230 360
Time 1 hr. 4 1/2
Temperature of water 53 Depth Artesian Flow Found _ Was water analysis done? HO By whom ___ _ Reason for water not suitable for use ___ _ Depth of strata _
ORIGINAL ' FIRST COPY • WA'l'ER RBSOURCE.S DEPTAim!ENT
well construction standards. Materials used and infomtion reported above are true to IY best knowledge and belief.
WC KUlber _ Signed Date __
(bonded) Water Well Constructor Certification: I accept responsibility for the construction, alteration, or abando!llent work performed on this well durinq the construction dates reported above. All work perfor1ed durinq this tile is in eo1pliance with Oregon water supply well construction standards. ~s report is true e .· o y edge and belief.
. WC Klllber 1438 Signed V1 Date 09/30/99
9809C 10/91
RECEIVED BY OWRD
MAY 13 2015
SALEM, OR
state of oreqon iiATER liELL REPORT (.as required by ORS 537.765)
(1) OWIIBR: l!an.e
1 Address
Well Ho. 2345 DOKAI!IE SERENE VDIBYARD & WINERY 6701 EVENSTAD DR.
Page 1 of
City MAPLE GROVE St MN Zip 5.?.)'~?
( 2 ) TYPE OF llOBK: lIBW llELL
( 3 ) DRILL JIE'll!OD: ROO'ARY AIR
( 4) PROPOSED USE: DOKESTIC
( 5) BORE HOLE COl!STROCTION:
YAMH 54 028
State Well ID 172048 -start Card # 170098
( 9) LOCATION OF liELL by legal description: County YAlll!ILL rat. · ' • Long. ' 1 n Tolinshi p 3 s Range 3 W WM. Section 33 HE 1/4 !!Ii 1/4 Tax wt 316 lot Block SUbdivision Street Address of Well (or nearest Address)
6555 NE HILLTOP LW DAYTON, OR
( 10) STATIC WATER LEVEL: BB ft. below land surface. Date 01/28/05 Artesian pressure_ lb per square in. Date
Special Construction Approval HO Depth Of Co1pl. Well 302 ft (11) WATER BEARIKG ZONES: Explosives used NO Type__ Amount___ Depth at which water was first found 210
HOLE SEAL Fron To Est Flow Rate SWL BB Dian.. From To Material Fr011 To Allount 210 279 6+
(unbonded) Water Well constructor Certification: I certify that _ _ _ ___
1 the work I perfoned on the construction, alteration, or aband-
-------------------< onnent of this well is in compliance with Dreqon water supply well construction standards. Materials used and information reported above are true to my.best knowledge and belief.
( 8) llELL TESTS: Kinimun testing tile is l hour Test type hIR
Yield GPM 6 6
Drawdown
Drill stem at Time 300 1 hr. 280 2. 5
Te1perature of water 53F Depth Artesian FlO'i Found _ Was water analysis done? YES By whon BLOE Reason for water not suitable for use ___ _ Depth of strata _
ORIGINAL t FIRST COPY - llATER RESOURCES DEPTARTMRNT
WWC HUllber Signed Date __
(bonded) Water Well Constructor Certification: I accept resp:msibili ty for the construction, alteration, or abandonaent work perforned on this well during the construction dates rep:irted above. All work perfoned during this ti.lie is in conpliance with Oregon water ppl y we co stru 'on standards. This rep:irt is true e bes f ge and belief.
~c Hunber 1438 signed L~~u~~~~-tate 02102/05
9809C 10/91
~ "T'I :0 cnm
> ::0 m m l1i ::0 OJ (') ;: rn N> -og CJI m -::Q ::n "" < mo c:::>
~m c::> m U1
~ 0
RECEIVED BY OWRD ~-~--~--------~~-~----------------~
MAY 13 2015
SALEM. oi:r
YAMH 54029 State of Oregon State Well ID L72049
start card I 170099 WATER WELL REPORT (as required by ORS 537. 765) ilage 1 of 1
( 1 ) tlil!ER: Well Ho. 2346 ( 9) LOCATION OF WELL by legal description: DOOINE SERENE VINEYARD & WI!IERY County YA!IHILL Lat. ' I • Long. ' I n 6701 EVE!!STAD DR. Township 3 s Range 3 w Ill!.
Hane Address City MAPLE GROVE St KN Zip 553ftf, Section 33 HE 1/4 RW 1/4
Tax Lot 316 Lot Block Subdivision ~ .,, d.....-( 2) TYPE OF WORK: NEW WELL
(10) STATIC WATER LEVEL: 89 ft. below land surface. Date 02/03/05
( 5) BORE HOLE CONSTRUCTION: Artesian pressure __ lb per square in. Date
Special Construction Approval NO Depth of Cou.pl. Well 229 ft ( 11) WATER BF.ARillG ZONES: Explosives used HO Type__ Amount___ Depth at which water was first found 195
HOLE SFAL Fron To Est Flow Rate SliL Dian. From To Material Fron To AD.aunt 195 231 21 89 10 C 44 BEXTOHITE CHIP 0 41 30 SAX 8 44 158 CDT Ii/GEL 41 158 38 SAX 6 158 260
Seal placeaent nethod A AHO POURED - -Backfill: frou. 231 ft to 260 ft Material CAVING SLOUGH Gravel: frou. ft to ft Size
(unbonded) Water llell Constructor Certification: I certify that the work I perfomd on the construction, alteration, or aband
----------------~ olllent of this well is in cou.pliance with Oregon water supply well construction standards. Materials used and info:mtion reported above are true to llY. best knowledge and belief.
( B) WELL TESTS: Ki.niD.uu. testing tine is 1 hour Test type AIR
Yield GPM 21 21
Drawdolin
Drill steu. at Tine 260 1 hr. 225 2
we Hunber Signed Date __
Tenperature of water 53F Depth Artesian Flow Found _ Was water analysis done? YES By who11 BUIB Reason for water not suitable for use ___ _ Depth of strata _
ORIGINAL & FIRST COPY - liATER RESOURCES DEPTAR'l'KE!IT SECOND COPY • CONSTRUC'roR 9809C 10/91
I nt
~:7.1 ,... ::D mm -~~ Oc: ::.0 ::0 mo G:>m
~~ m ~
,, ::u m m c::c
(") l\.: m Ql -~ < c::i
c:3 m C.l"I
0
RECEIVED BY OWRD
MAY 13 2015
SALEM, OR
YAMH 56417 state of-Oregon
WA'l'ER mL REPORT (as required by ORS 537, 765) Page 1 of 1 state Well ID Ll09555 Start card I 1017943
(1) <Im: llell lo. 2768 lue P'OXGUIVE .PROPERmS LLP Address 6555 n BIW'OP Im City DAYml St (II Zip 97114
(2) nPE or m: m mL
(JJ liILL Dal: TelARY AIR
(9) UQTI(I OP mt by leqal description: camty fUllIIJ, Lat, • I I IDng, ' I I
bnship 3 s l!anqe 3 ' •• section 34 Sii 1/4 n 1/4 Tm: I.ot 320 I.ot Blook SUbli vision street Address of lell (or nearest Mklress J
17350 IE TIMS LI llml, Ii
(10) SmIC mER LIYIL: ( 4) PROPOSED USE: IRRIGATial
(5) BOU BOLE aJIS'lWC\'ICll:
212 ft. belor lm:I surface. Date 10/15/12 Artesian pressure _ lb per square in. Date __
Special Construction~ 10 Depth of Cmpl. lell 501 ft (11) IUD !!WIG m: lxplosi ves used 10 !YJle Alount Depth at Illich vater vas first found 318
!OL! SEAL PrOI To Est Plor Rate Diu. Prol To laterial Pr01 To Anlnt 318 461 50 10 0 301 BPMm!I!! CSIP 0 '7 29 SAX 6 lOl 501 CD1R'l' '7 JOl 98 SAX
Seal placmnt 1ttha! C AID PCXlRI) - -
Backfill: frOI _ft to_ ft latarial Gravel: frca _ ft to _ ft Size
(12) mt~: GrCWld elevation_
laterial Prol Ta
SIL 212
SIL
( 6) CASIIG,tr.Im~ 'roP SOIL 0 5 RECEIVED BY OWRD CUY, Rm/mll 5 68
Pinal I.ocati111 of Bboe(s)101 // SPLIIE·UX: LIIER
(7) PEP.PORmtlS/SCREEIS: (I] Perf. lethod cncuw SAN [_J SCreens Type llaterial ___ _
Slot Prca Ta Size lulber Dia. m 480 .m• 38 490 500 1116 I 20
Yield GP! 5-0 50
Drav· down
!ele/pipe Size Casinq/liner
LillR LIKER
Teaperature of nter 53F Depth Artesian Flor Found _ las vatar analysis done? 10 By llhoa ___ _ laason for nter not suitable for use ___ _ Depth of strata _
ORIGillAL ' nm COPY • IATER wornm Dl?l'lRmltT
cw, mm f/DD'.'.AYED B.w.L'f 68 92 WALT, QIAY 92 178 NOV 1 5 2012 BWLT I QIAY I/DE ODY 178 193 BASALT, GRAY VIRY DRD 193 227 &\SALT I GRAT 1/$00 DDY 227 264 SALEM, OR llWLT I GRAY V!RY Wll 264 318 BWLT, llDIIDI GBAY lij!'RA(.'1t!W 318 361 212 BWLT I Q.\Y VIRY lWD liflRACl'llW 361 379 212 BWLT, II..\CI ~ GRAY SOm.R 379 313 212 WAL! I VBRY BARI> GRAY I~ 383 461 212 BWLT, f/S(llB GRl/BW CUYS'D! 461 489 WALT I I/DB GRl/BUI! CUYml 489 501
Total primary yield for Winery Hill Vineyard = Total acres this applic. = 30.9
Total primary yield per OWRD 1/80/ac =
Deficiency in Rate = Deficiency in Rate =
Well yield (cfs)
0.058
0.149 0.013 0.047
0.27 cfs
0.39 cfs
0.12 cfs 53.9 gpm
RECEIVED BY OWRD
MAY 13 2015
SALEM, OR
1: ~ ~
Domaine Serene Winery Hill Well #7 areas of new irrigation by 1I4-1I4
Cert. 87843 QuaryPond New irrigation Cert. 88371 Permit S-54831
NW/NW p 12.4 acres 5.0 acres s 6.0 acres
SW/NW p 0.3 acres 20.3 acres s 20.3 acres
SE/NW p 5.2 acres 5.6 acres 6.9 acres s 5.6 acres
NE/NE p 16.3 acres s
Total 34.2 acres 30.9 acres 37.8 acres
Subtotal primary acres for deficiency in rate = 30.9 Subtotal primary irrigation new for future planting = 34.2
Total primary irrigation acres for Well #7 application= 65.l
Total supplemental irrigation acres, primary is S-54831 = 6.9
Total primary and supplemental irrigation acres for Well #7 application= 72.0
RECEIVED BY OWRD
MAY 13 2015
SALEM, OR
Total Application primary supplemental
17.4
20.6
10.8 6.9
16.3
65.l 6.9
Pump Capacity Calculation Sheet using Department designed formula:
(hp)(efficiency) I (lift+ psi head) =capacity in cfs
Efficiency:
Centrifugal = 6.61 Turbine= 7.04
Data Entry (fill in underlined blanks)
HP= 4 ----Efficiency= 7.04 ----
Lift= 150 ----PSI= 5 ----
Results Calculated
(hp)( efficiency) = Head based on psi = Total dynamic head = (head + lift)
Pump Capacity = Pump Capacity =
28.16 12.7 162.7
Domaine Serene Well #7 Theoretical pump sizing
0.17 cubic feet per second 77.68 gallons per minute
RECEIVED BY OWRD
MAY I 3 2015
SALEM, OR
OWRD Fee Calculator
()REGON
Water Resources Department
Apply for a Permit to Appropriate Ground Water and/ or Store Ground Water
Today's Date: Wednesday, April 22, 2015
Base Application Fee for use of Ground, Surface and optionally Stored Water.
Number of proposed cubic feet per second (cfs) to be appropriated. (1 cfs = 448.83 gallons per minute)
I I
Number of proposed Use's for the appropriated water. I (i.e. Irrigation, Supplemental Irrigation, Pond Maintenance, Industrial, Commercial, etc) *:
Number of proposed Ground Water points of appropriation. (I.e. number of wells) I (include all injection wells, If applicable) **
Number of Acre Feet to be stored in a reservoir/pond from Ground water. I Number of Acre Feet to be appropriated from reservoir/pond
I (Only Applies to reservoir/pond constructed under Ground Water Application)
!Number of reservoirs. II !Permit Recording Fee. ***
II * the 1st Water Use is Included in the base cost. ** the 1st Ground Water point of appropriation is included in the base cost. ***the Permit Recording Fee is not required when the application is submitted but, must be paid before a permit will be issued. It is fully refundable if a permit is not issued. If the recording fee is not paid prior to issuance of the Final Order, permit issuance will be delayed.
SUBJECT: Application for groundwater water right, Foxglove Properties, LLC I Domaine Serene Vineyards & Winery, Inc.
To whom it may concern:
Please find enclosed our map, application, supplemental forms, supporting information and the fee to drill a well and use the water for irrigation and commercial use.
Evan Karp is the CFO for both Foxglove Properties, LLP. and Domaine Serene Vineyards and Winery Inc ..
INDEX
Minimum Requirements Checklist. Application for new well, groundwater right. Paper map for reference Paper map of nearest surface water
Attachment Information Land use information form. Deeds. Tax map for reference. Reduced scale rep lat of Breyman Orchards Well logs for wells 1-5 Calculations for deficiency in rate . Areas by quarter quarter and water right. Theoretical pump capacity calculation spreadsheet OWRD Fee calculation printout
P. 2 P. 3 P. 11 P. 12
P. 1 P. 3 P. 11 P. 12 P. 14 P. 19 P.__2Q_ P. 21 P._n_
Please call if you have any questions or need any further information. I am available on my cell phone at most any time, 503-939-8381.
Sincerely, Stuntzner Engineering & Forestry, LLC
u-5~t . -~~ /1 ' 1iit Bill Flatz, PE, W RECEIVED BY OWRD
MAY 13 2015
SALEM, OR
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REPLA T OF PORTIONS OF BREYMAN ORCHARDS FOR:
llra~f E. r;Hr/KOI(~ r;u.~t Location: Sections 33 and 34 T. 3 s .. R 3 W., WM ..
Yamhill County, OR
Tax Lot 3333-300 Dale: 18 May, 2004
Docket R--01-04
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LEGEND
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VEDBYOWRD
MAY 13 2015
SALEM, OR
- ....,,.._ ..... DANYA G OCH9NER
llOTAR'I' PUlltc · Oll[COlf COMMISSION NO 151903 ll'l~llMIM•.'"5
