Project Completion Notice For Change Of A Water Right Form - Montana Department Of Natural Resources And Conservation

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Form No. 618 U12/09
Dept. reviewer ________________________
NOC RCD Coded ______________________
STATE OF MONTANA
DEPARTMENT OF NATURAL RESOURCES AND CONSERVATION
PROJECT COMPLETION NOTICE
FOR CHANGE OF A WATER RIGHT
Field Report
INSTRUCTIONS: Use this form to report the completion of an Authorization to Change a Water Right. This form must be
filed on or before the deadline date on the authorization or authorized extension of time. If the project is not completed, file
an Application for Extension of Time 30 days before the authorization deadline date; otherwise the authorization is void.
For complete instructions, read “Instructions for Project Completion Notice for Change of a Water Right.”
A.
GENERAL INFORMATION
1.
AUTHORIZATION NO. ______________________________
2.
Owner ________________________________________________________________________
Mailing Address _________________________________
Telephone No. ____________________
City ___________________________________________
State _________________ Zip _______
3.
Field Examiner _________________________________
Profession _______________________
Mailing Address _________________________________
Telephone No. ____________________
City ___________________________________________
State _________________ Zip _______
4.
Field Investigation Date ________________________
B.
CHANGE AUTHORIZED
Point of Diversion (Complete Section C)
Purpose of Use (Complete Section E)
Place of Use (Complete Section D)
Place of Storage (Complete Section F)
C.
FOR CHANGE IN POINT OF DIVERSION
The new point of diversion:
replaces OR
is in addition to the old point of diversion.
1.
NEW Point of Diversion
IDENT
GOV’T
LOT
BLK
1/4
1/4
1/4
SEC
TWP N/S
RGE E/W
CNTY
NO
LOT
Subdivision Name _____________________________________________________________________
2.
OLD Point of Diversion if Replaced by the New Point of Diversion
IDENT
GOV’T
LOT
BLK
1/4
1/4
1/4
SEC
TWP N/S
RGE E/W
CNTY
NO
LOT
Subdivision Name ____________________________________________________________________________

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