HomeMy WebLinkAbout(26) Notice of Completion of Grndwtr develop 04-25-2016 RECEIVED
Form No.602 R 01/2015 APR 2 5 2016
NOTICE OF COMPLETION OF V
GROUNDWATER DEVELOPMENT DNRC Bozeman Water
Use this form for completed groundwater FO 08MAR7MEMSONTY
developments where the water has been put to use
for the purposes identified with a maximum use of Notice N Basin
Priority Date
te Time 9' 3 y �-PM
35 GPM not to exceed 10 Acre-Feet per year. Rec'd By t50-L
Fee Rec'd$ IaS - Check No. 118�
Incomplete forms will be returned. Deposit Receipt#
Payor(if different from name(s)listed in item 1 below)
Filing Fee $125.00
Refund$ to
Make checks payable to DNRC. Deficiency Letter Sent
Your priority is determined by the date of filing. If it is determined this form was improperly filed, your priority
date may be changed.
[ If your development is within a Controlled Ground Water Area, the regional office will contact you to explain
the correct filing requirements.
1. NAME(S) (3fZ �1) ER C Fi!-J'T L L.C
MAILING ADDRESS 1 y,5-o C_H M(U1 lve
CITY 15t-Z& t A J STATE MT ZIP 5q 7 i
PHONE 'Ao(, SaS 14c1 EMAIL tlUni"rArjN WlrVO -
C9 14,srmftll ,COI`
2. HAS THIS WATER BEEN PUT TO USE FOR THE PURPOSES ON WHICH YOU ARE FILING?
Yes ❑ No (1F YOU ANSWER NO, YOU CANNOT FILE THIS FORMAT THIS TIME.)
3. DIVERSION USED TO OBTAIN GROUNDWATER
t!l Well -Attach well log, if available Water Well Contractor Name: �l�l�
❑ Developed Spring (Excavation performed at the spring location.)
❑ Pit/Pond - Surface Area Acres Depth
4. FLOW RATE USED GPM (Cannot Exceed 35 GPM)
5. COMBINATION OR SHARED DEVELOPMENT
a. Are there other groundwater developments on your property? ❑ Yes RNo
If yes, how far away are the existing groundwater developments from this new groundwater
development? Provide a DNRC water right number for each.
b. Is this development shared with other users? ❑ Yes QNo
If yes, please explain how and provide a DNRC water right number for each.
6. PURPOSE AND PERIOD OF USE: Check those that apply and answer applicable questions
❑ Domestic: Number of homes supplied: 2-
Year round use? CRYes ❑ No If no, from to inclusive of each year.
'] Lawn & Garden: i
Total size of lawn & garden - length x width -OR- Number of Acres
April 1 - October 31 R'Yes ❑ No If no, from to inclusive of each year.
I