HomeMy WebLinkAboutAppendix V.1 - Bozeman Haus Req to Withdraw Interest in Claims BOZEMAN HAUS TWO, LLC
MANAGER FILED
15267 Rivershore Drive
Vancouver, WA 98683 MAY 18 2022
Montana Water Court
May 5, 2022
Montana Water Court
1123 Research Drive
Bozeman, MT 59718
Dear Montana Water Court:
Please find the enclosed forms requesting to withdraw statement of claim or interest in statement of claim for
water rights:41H 103732-00, 41H 103733-00, and 41H 30151619. 1 have included copies of these forms along
with a self-addressed, stamped envelope to receive conformed copies of the requested. If you have any
questions please contact Carl Sanders at 503-559-4782.
Sincerely,
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Bozeman Haus Two, LLC
Manager
REQUEST TO WITHDRAW STATEMENT OF CLAIM OR INTEREST IN STATEMENT OF CLAIM
I/We, Bozeman Haus Two, LLC hereby request the withdrawal or withdrawal of interest of
Statement of Claim Number 41 H 30151619
The reason for this request is:
I/We have an existing right which is exempt from filing.
This claim was for a use of water after July 1, 1973.
I/We have no existing water right to claim.
I/We have no interest in said Statement of Claim
X Other/Comments:
We no longer have any need of the water and do not want the water to be discharged on to our property
Statement Signed by Owner:
I declare under penalty of perjury (§ 45-7-201, MCA) under the laws of the state of Montana that
the foregoing content of this form is true and correct. I further declare that I have the authority to
sign this document for myself as an individual or in representational capacity as an officer of a
corporation, member of a limited liability company, general partner of a limited partnership, trustee
for a trust or other official capacity for an entity as defined under "person" in §85-2-102, MCA. (All
current owners of the right as listed in the DNRC centralized record system are required to
sign. Please attach DNRC's Withdrawal Agreement form if additional owner signatures are
needed.)
(Date Signed) (Sign ure of Claimant) (Office or Title)
(Date Signed) (Signature of Claimant) (Office or Title)
(Date Signed) (Signature of Claimant) (Office or Title)
(Date Signed) (Signature of Claimant) (Office or Title)
Request to Withdraw Statement of Claim
Page 1 of 1 Revised April 30,2014
REQUEST TO WITHDRAW STATEMENT OF CLAIM OR INTEREST IN STATEMENT OF CLAIM
I/We, Bozeman Haus Two, LLC hereby request the withdrawal or withdrawal of interest of
Statement of Claim Number 41 H 103732-00
The reason for this request is:
I/We have an existing right which is exempt from filing.
This claim was for a use of water after July 1, 1971
I/We have no existing water right to claim.
I/We have no interest in said Statement of Claim
X Other/Comments:
We no longer have any need of the water and do not want the water to be discharged on to our property
Statement Signed by Owner:
I declare under penalty of perjury (§ 45-7-201, MCA) under the laws of the state of Montana that
the foregoing content of this form is true and correct. I further declare that I have the authority to
sign this document for myself as an individual or in representational capacity as an officer of a
corporation, member of a limited liability company, general partner of a limited partnership, trustee
for a trust or other official capacity for an entity as defined under "person" in §85-2-102, MCA. (All
current owners of the right as listed in the DNRC centralized record system are required to
sign. Please attach DNRC's Withdrawal Agreement form if additional owner signatures are
needed.)
S , 9- 2 2 ��� Ru/-\CL
(Date Signed) (Signature of Claimant) (Office or Title)
(Date Signed) (Signature of Claimant) (Office or Title)
(Date Signed) (Signature of Claimant) (Office or Title)
(Date Signed) (Signature of Claimant) (Office or Title)
Request to Withdraw Statement of Claim
Page 1 of 1 Revised April 30,2014
REQUEST TO WITHDRAW STATEMENT OF CLAIM OR INTEREST IN STATEMENT OF CLAIM
I/We, Bozeman Haus Two LLC hereby request the withdrawal or withdrawal of interest of
Statement of Claim Number 41 H 103733-00
The reason for this request is:
I/We have an existing right which is exempt from filing.
This claim was for a use of water after July 1, 1973.
i/We have no existing water right to claim.
I/We have no interest in said Statement of Claim
X Other/Comments:
We no longer have any need of the water and do not want the water to be discharged on to our property.
Statement Signed by Owner:
I declare under penalty of perjury (§ 45-7-201, MCA) under the laws of the state of Montana that
the foregoing content of this form is true and correct. I further declare that I have the authority to
sign this document for myself as an individual or in representational capacity as an officer of a
corporation, member of a limited liability company, general partner of a limited partnership, trustee
for a trust or other official capacity for an entity as defined under"person" in §85-2-102, MCA. (All
current owners of the right as listed in the DNRC centralized record system are required to
sign. Please attach DNRC's Withdrawal Agreement form if additional owner signatures are
needed.)
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(Date Signed) (Signat re of Claimant) (Office or TI e)
(Date Signed) (Signature of Claimant) (Office or Title)
(Date Signed) (Signature of Claimant) (Office or Title)
(Date Signed) (Signature of Claimant) (Office or Title)
Request to Withdraw Statement of Claim
Page 1 of 1 Revised April 30,2014