HomeMy WebLinkAbout009-DNRC Predetermination Submittal Form-signed December 2022
DNRC WATER RIGHT PREDETERMINATION REQUEST
ARM 17.36.103(s)
Complete this form if you have a proposed project which will be subject to DEQ or county sanitation or subdivision
review. All information described in the instructions below must be submitted. Use of this specific form for submittal
of the information to DNRC is required. See page 3 for additional guidance about this process.
Narne(s)/Business Name Summit Properties, LLC
Mailing Address/City/St/Zip 135 Hutton Ranch Road, Suite 103
Preferred Phone 406-570-8859 E-Mail donnle@donnieolsson.com
• Proiect and Location Information
Identify the type of project:
❑ Release of Sanitary Restrictions/Rewrite ❑ Family Transfer
❑ Boundary Line Adjustment ❑ Subdivision of Property E]Other
Provide a brief description of the proposed project:
utilities, and landscanina The Owner intends to drill a n _w ansite mie l for irrigation ni�rnnses_
Domestic water suTy will be from the City of Bozeman public wate[ supplysystem.
Geocode of Existing Property: 06-0904-22-4-06-01-0000
Legal Land Description of Project Area:
1/4 SE 1/4 Section 22 TWP IS RGE 5E County Gallatin
1/4 1/4 Section TWP RGE County
• Subdivision Plat Information
Subdivision/Plat Name: Nelson Meadows SuWiyislon(Plat J-680)
Total number of proposed lots: 1 Lot sizes: 2.59 acres
Current landowner: Summit Properties, LLC
Is this a rewrite? 0 Yes W No If yes, briefly explain the details of the rewrite below.
• Existing Water Use
Describe all existing water uses within the footprint of the project area.
Before DNRC can make a predetermination, all existing water uses within the project area must have a water
right. If existing uses do not have a water right, you cannot file this Predetermination request at this time. If you
have questions, please contact your local Regional Office for assistance. See Page 4 for contact information.
Identify water right numbers of the existing water uses. none
Explain how the existing water uses will operate with the proposed project and new uses of water,
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• Proiect Information
Purpose — Identify all new water uses proposed for the subdivided property. Be sure to adhere to applicable
CC&Rs. Refer to DNRC Form 615 for information on general water requirements.
Type of Use Details of Use Volume Required AF
Domestic Number of new households proposed:
Lawn & Garden o.90 Acres/Lot x i Lots = 0.90 Total Acres
1 .8
Commercial or Type:
Industrial
Stock Type and number of animal units proposed:
Other Describe:
If more than one lot is involved in your project and you intend to meet the exception to the permitting
process, how will the maximum volume of 10 AF/year allowed under the permit exception be divided
between the lots, parcels or tracts being reviewed:
Diversion Means
W New Well ❑ Existing Well: GWIC ID Water Right Number
❑ Developed Spring ❑ Pit
Flow rate: 35 GPM
Total number of wells:
If multiple wells are being proposed, explain the use for each well.
• Attach the Followin Re uired Documents
0 Proposed Plat Map/Lot Layout Map
General Location Map
W Copy of recorded documents (COS, Final Plat) that created parcels under 20 acres in this review.
W Well log(s). if well has been drilled
Attach any additional information that may be helpful to DNRC on a separate sheet.
• Signatures of Property Owners
This proposal must be reviewed by owners of all parcels involved in the proposed project; signatures from all
property owners are required. Use additional sheets if necessary.
Parcel Owner ature
2