Project Completion Notice For Change Of A Water Right Form - Montana Department Of Natural Resources And Conservation Page 4
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4G.
AUTHORIZATION TO CHANGE CONDITIONS OR LIMITATIONS
Explain how each of the conditions of the permit have or have not been met.
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
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H.
MAP AND PHOTOGRAPHS
Attach a copy of aerial photo or USGS Quadrangle showing the following:
Section Corners and Numbers
Place of Use
(old and new)
Township and Range Numbers
Place of Storage
(old and new)
Point of Diversion
(old and new)
Photographs of your changed diversion, place of use, place of storage, or purpose of use will help
document the completion and operation of your project. If photos are submitted, label them with the following
information:
Authorization Number
Name of photographer
Date photo taken
Subject of photo
(point of diversion, etc.)
I.
COMMENTS
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J.
CERTIFICATION
The above information is a true statement of the extent the project was developed.
__________________
_____________________________________________________________
Date
Field Examiner’s Signature
State of Montana
County of ____________________________
Signed or acknowledged before me on
by ____________________________________
Notary's Signature _________________________________________
Notary's Name (Printed) ____________________________________
Notary public for the State of _________________________________
Residing at _______________________________________________
My commission expires _____________________________________
Affix Notarial Seal/Stamp Above
K.
AUTHORIZATION HOLDER
(sign only if the person signing the certification is not the authorization owner)
I have reviewed these findings and submit this Notice of Completion to the Department.
__________________
______________________________________________________________
Date
Signature
SUBMIT THE COMPLETED FORM TO YOUR WATER RESOURCES REGIONAL OFFICE LISTED IN THE INSTRUCTIONS.
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