Fillable Request Form To Reduce A Groundwater Certificate printable pdf download

New (03-2015)

REQUEST TO REDUCE A GROUNDWATER CERTIFICATE

This form may be used to reduce the flow rate, volume, place of use, period of use, and/or purposes of use for

a Groundwater Certificate. Once processed, a new Certificate will be issued for the reduced amount. Once a

new Certificate with the reduced elements is issued, the elements listed on the original Certificate may not be

reinstated. Any right to the use of water under the original Certificate will be permanently relinquished and/or

abandoned in an amount equal to the reduction.

Water Right Owner Names: ________________________________________________________________

Address/City/St/Zip: ______________________________________________________________________

Phone: _____________________

E-mail Address: _____________________________________________

Groundwater Certificate Number: ___________________________________

The reason for this request is: (check one and describe below)



This water right was filed for more water than was actually being used.



A portion of the original right is no longer being used and has been abandoned because:



A shared well user drilled another well and is no longer using this well / water right



The pump was changed to one that pumps at a lower flow rate



Irrigated acreage was reduced



A purpose has been discontinued/reduced (stock removed, pond filled-in (fully or partially), etc.)



Other (explain) _______________________________________________________________

 Yes

 No

Is the flow rate less than identified on the original Groundwater Certificate?

If yes, what is the actual flow rate? _____________ gallons per minute

 Yes

 No

Is the purpose of use less than what is identified in the DNRC water right record?

If yes, please explain—be very specific (i.e. past and current number of irrigated acres, stock, dwellings, etc.).

________________________________________________________________________________________

Provide any additional details that will help DNRC assess this reduction. Note that DNRC will use standard

volumes by purpose (found in ARM 36.12.115) when quantifying the new use. If you are requesting a

departure from those standards, explain that here.

________________________________________________________________________________________

I declare under penalty of perjury and under the laws of the State of Montana that the foregoing is true and correct.

__________________________________________

Signature

Date

Signature

Date

State of _________ 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

Return form to your local DNRC Water Resources Office or mail to: DNRC / PO Box 201601 / Helena MT 59620

Request Form To Reduce A Groundwater Certificate

Related Articles

Related forms

Related Categories