Form 600 Sp - Application For Beneficial Water Use Permit - 2016

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Applicant Name_______________________________________________
Form 600 SP– U02-2016
Water Right Number ___________________________________________
APPLICATION FOR BENEFICIAL WATER USE PERMIT
SOUTH PINE CONTROLLED GROUNDWATER AREA ADDENDUM
Section 85-2-311(1), MCA, provides the Department shall approve a water use permit for an
appropriation of water if the applicant proves by a preponderance of evidence the criteria listed below
are met. It is the applicant’s responsibility to provide credible, relevant and factual information upon which the Department
may rely to support the issuance of a provisional permit.
AFTER THE WELL IS DRILLED, COMPLETE THIS FORM AND SUBMIT A COPY OF THE WELL LOG.
Attach additional sheets if necessary.
1. What substantial, credible information or data do you have to prove there is water physically available at the proposed
point of diversion in the amount you seek to appropriate?
The well was tested for ______ hour(s) at ______ gpm.
We intend to use ________ gpm.
______ gpm would produce _________ acre-feet (AF) per year.
We request to use __________ AF per year.
2. What substantial, credible information or data do you have to prove water is legally available during the period and in
the amount you requested?
I have reviewed the DNRC water right listing of wells within a ½ mile radius of my well.
The total volume used within this radius is _______ AF per year.
3. Provide a comparison of the physical availability and existing legal demands by subtracting the total volume used
within the ½ mile radius from the aquifer flux of 27.5 AF*. ______________________________________________
____________________________________________________________________________________________________________________
4. What substantial, credible information do you have to prove the proposed use of water will not adversely affect a prior
appropriator using an existing water right, certificate, permit, or a state water reservation? How do you plan to regulate
your use during times of shortage and control your diversion to ensure prior appropriators will be satisfied?
____________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________
5. Describe the proposed means of diversion, constructions and operation of the diversion works you intend to use and
provide substantial, credible information to prove the means of diversion, construction and operation are adequate.
The well was drilled on _________________ by ____________________________________________________
(a licensed well driller). The well has a _______________ diameter casing to a depth of ___________ feet and is
grouted with bentonite. A ________ horsepower pump is installed and the static water level is ________ feet.
6. Provide substantial, credible information and data to prove the proposed use is a beneficial use of water and the flow
rate and volume requested in reasonable for the proposed use.
The water will be used for _____________________________________________________________________.
The requested flow rate is __________________. This amount is requested because ______________________
__________________________________________________________________________________________
The requested volume is __________________.
Volume was calculated based on the DNRC standards, as shown by the calculations below:
Domestic: number of homes supplied______ x 1 AF/year = _____________AF/yr
Lawn & Garden: total size of lawn & garden _________acres x 2.5 AF/yr = ____________AF/yr
Irrigation: Type of Crop ______________________
Climatic Area _______________
____________ Acres Irrigated x ________________AF/acre** = __________________ AF/yr
Stock: the number of animal units ____________ x 0.017 = _____________ AF/yr.
*************************************************************************************************
Printed Name
_________________________________________
Applicant Signature
_____________________________________________
Date: __________________
Printed Name
_________________________________________
Applicant Signature
_____________________________________________
Date: __________________
*This figure is only valid for proposed uses that are less than 35 GPM up to 10 AF/yr from the Fox Hills – lower Hell Creek Aquifer.
Aquifer flux = transmissivity x hydraulic gradient x width of zone of influence
2
Transmissivity = 178 ft
/day (1,330 gallons per day per foot)
Hydraulic gradient = 0.0035
Width = 5,280 feet
** Use the table found in ARM 36.12.115(e) to determine the AF/acre based on your climatic area.**

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