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HomeMy WebLinkAboutRequest to Withdraw Water Right REQUEST TO WITHDRAW A WATER RIGHT / EXEMPT NOTICE For Provisional Permits, Groundwater Certificates, or Exempt Notices ALL WATER RIGHT / EXEMPT NOTICE OWNERS MUST SIGN THIS FORM. /we, William Thompson (Zoey Development LLC) hereby request the withdrawal of water right / exempt notice no. 41H 86484-00 The reason for this request is: ❑ This water right was never completed or put to use. ❑ This water right has not been used for years. ❑ This filing is an exempt notice and I no longer want to be notified by DNRC of any water right applications in the area -or- I am filing a Statement of Claim which duplicates this notice. *If marking this box, you do NOT need to notarize this form. ❑ Other Well abandoned. As legal owners of this water right, I/we request this right / exempt notice be terminated. If withdrawing an exempt notice, you do not need to notarize this form. All other withdrawals must be notarized. rL - -� 19 Signature Date Signature Date Signature Date State of Montana County of �au4 jtK. Signed or acknowledged before me on ?00,7_ by CHRIS BUDESKI Notary's Signature .1..••''•.S - Notary Public 0:ooUfti .' for the State of Montana Notary's Name (Printed) C,4 (3�Y/ 1 —•— Residing at: /�f r/ SEAL.-*m= Bozeman, Montana Notary public for the State of "lOGt tG�G ? cP=' My Commission Expires: OF MO November 26, 2023 Residing at �O,P � h'« / My commission expires Ijo F 2-a23 Return form to your local DNRC Water Resources Office or mail to:DNRC/PO Box 201601/Helena MT 59620 Note: If you withdraw your water right it will not be a valid water right. It means you have no legal right to use or enforce the water right against other water users. REQUEST TO WITHDRAW A WATER RIGHT / EXEMPT NOTICE For Provisional Permits, Groundwater Certificates, or Exempt Notices ALL WATER RIGHT / EXEMPT NOTICE OWNERS MUST SIGN THIS FORM. I/we, William Thompson (Zoey Development LLC) hereby request the withdrawal of water right / exempt notice no. 41 H 84063-00 The reason for this request is: ❑ This water right was never completed or put to use. ❑ This water right has not been used for years. ❑ This filing is an exempt notice and I no longer want to be notified by DNRC of any water right applications in the area -or- I am filing a Statement of Claim which duplicates this notice. If marking this box,you do NOT need to notarize this form. Other Well abandoned. As legal owners of this water right, I/we request this right / exempt notice be terminated. /f withdrawing an exempt notice, you do not need to notarize this form. All other withdrawals must be notarized. Signature Date Signature Date Signature Date State of Montana County of C j4 c..c_,4 T & Signed or acknowledged before me on N V Y. t-O22 by W/L l 4 '51?i r/c_ Notary's Signature CHRIS BUDESKI Notary's Name Printed Notary Public y 0zae1 -for the State of Montana q� Residing at: Notary public for the State of N .SEAL. a Bozeman, Montana /U/C 9 Residing•pit My Commission Expires: at 0y °FMO '` November 26,2023 My commission expires / OO .zfo, 2013 Return form to your local DNRC Water Resources Office or mail to:DNRC/PO Box 201601/Helena MT 59620 Note: If you withdraw your water right it will not be a valid water right. It means you have no legal right to use or enforce the water right against other water users.