Looking for a Oregon Legal Forms And Templates? Download it for free!

Application For District Temporary Water Right Form - Oregon Water Resources Department

Application for District

Oregon Water Resources Department

725 Summer Street NE, Suite A

Temporary Water Right

Salem Oregon 97301-1266

(503) 986-0900

Transfer

Please type or print legibly in dark ink. If your application is incomplete or inaccurate, we will return it to you. If any

requested information does not apply to your application, insert “N/A” to indicate “Not Applicable.” As you complete

this form, please refer to notes and guidance included on the application. A summary of review criteria and procedures

that are generally applicable to these applications is available at /OWRD/PUBS/forms.shtml.

Application for the

irrigation season.

year

1. APPLICANT INFORMATION

District: ______________________________________________________________________

Address:______________________________________________________________________

City: ___________________________________ State: ____________ Zip: ______________

Phone: ________________ Fax: _________________ E-Mail address: ____________________

2. PROPOSED CHANGE(S) TO WATER RIGHT(S)

 List all water rights to be affected by this transfer. Indicate the certificate, permit, decree or

other identifying number(s) in the table below: If a certificate has been issued and reflects

the current status of the water right, you need only list the certificate number.

(Attach additional pages as necessary.)

Application / Decree

Permit / Previous Transfer

Certificate

 Check all proposed change(s) included in this transfer application:

Place of Use

Point of Diversion or Point of Appropriation

Surface Water source to Ground Water source

Character or Type of Use

Last Revised March 2015

District Temporary Transfer Application

Page 1 of 3

Application For District Temporary Water Right Form - Oregon Water Resources Department