Form 606 - Application To Change A Water Right

10. FOR QUESTIONS OR CLARIFICATION, WHOM SHOULD THE DNRC CONTACT?

Name ___________________________________________________

Address ___________________________________________________Phone # _____________________

11. AFFIDAVIT

I affirm that statements appearing here are to the best of my knowledge true and correct. I also affirm I have possessory

interest, or the written consent of the person with the possessory interest, in the property where the water is to be put to

beneficial use.

Applicant's Signature

___________________________________________________ Date ______________________

Subscribed and sworn before me this __________ day of ____________________________________________________

Notary's Signature __________________________________________

Notary for the State of _______________________________________

Residing at ________________________________________________

My commission expires ______________________________________

WATER RESOURCES REGIONAL OFFICES

Billings

Havre

Lewistown

1371 Rimtop Drive

210 6th Avenue

613 NE Main Street, Suite E

Billings, MT 59105-1978

P .O. Box 1828

Lewistown, MT 59457-2020

Phone: 406-247-4415

Havre, MT 59501-1828

Phone: 406-538-7459

Fax: 406-245-2064

Phone: 406-265-5516

Fax: 406-538-7089

Serving: Big Horn, Carbon, Carter

Fax: 406-265-2225

Serving: Cascade, Fergus, Golden

Custer, Fallon, Powder River, Prairie,

Serving: Blaine, Chouteau,

Valley, Judith Basin, Meagher,

Rosebud, Stillwater, Sweet Grass,

Glacier, Hill, Liberty, Pondera,

Musselshell, Petroleum, and

Treasure, and Yellowstone Counties

Teton, and Toole Counties

Wheatland Counties

Bozeman

Helena

Missoula

151 Evergreen Drive, Suite C

21 North Last Chance Gulch

Town and Country Shopping Center

Bozeman, MT 59715

P .O. Box 201601

1610 South 3rd Street West, Suite 103

Phone: 406-586-3136

Helena, MT 59620-1601

P .O. Box 5004

Fax: 406-587-9726

Phone: 406-449-0944

Missoula, MT 59806-5004

Serving: Gallatin, Madison, and

Fax: 406-442-9315

Phone: 406-721-4284

Park Counties

Serving: Beaverhead, Broadwater,

Fax: 406-542-1496

Deer Lodge, Jefferson, Lewis and

Serving: Granite, Mineral,

Glasgow

Clark, Powell, and Silver Bow Counties

Missoula, and Ravalli Counties

222 6th Street South

P.O. Box 1269

Kalispell

Glasgow, MT 59230-1269

109 Cooperative Way, Suite 110

Phone: 406-228-2561

Kalispell, MT 59901-2387

For Mailing, Use Post Office Box Number.

Fax: 406-228-8706

Phone: 406-752-2288

Serving: Daniels, Dawson, Garfield,

Fax: 406-752-2843

McCone, Phillips, Richland,

Serving: Flathead, Lake, Lincoln,

Roosevelt, Sheridan, Valley, and

and Sanders Counties

Wibaux Counties

Form 606 - Application To Change A Water Right - 2000 Page 4

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