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.