Form Wr-21-Mrg - Declaration Of Ownership Of Water Right - New Mexico Office Of The State Engineer

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Fee: _____ Receipt No. HC 1-___________
File Number: _______________
NEW MEXICO OFFICE OF THE STATE ENGINEER
DECLARATION OF OWNERSHIP OF WATER RIGHT OF SURFACE WATERS
PERFECTED PRIOR TO MARCH 19, 1907 IN THE MIDDLE RIO GRANDE CONSERVANCY DISTRICT
1. OWNER OF DECLARED WATER RIGHT
Name: _____________________________________
Day Tel: ____________________
Contact: _____________________________________
Evening Tel: ________________
Address: _____________________________________
Email: ______________________
_____________________________________
City: __________________________ State: _____ Zip: ____________
2. LOCATION OF WATER POINT OF DIVERSION
MRGCD Diversion Dam
WATERS Name
MRGCD Maps
Check which
applies
Cochiti
SP-1690-1
1 through 4
Angostura
SP-1690-2
5 through 60
Isleta
SP-1690-3
61 through 146
San Acacia
SP-1690-4
147 through 189
Name of ditch or acequia: ___________________________________
3. PLACE OF USE
__________ total acres of land described as follows:
Tract/Lot number(s) and
Acres in
MRGCD Map #
Section
Township
Range
Description (e.g. Lands of)
each tract
Place of use is on land owned by:_____________________________________________
Are there other sources of water for these lands? Yes ____ / No ____
If yes, describe by OSE file number: ______________
4. QUANTITY
Diversion Amount:
__________ acre-feet per year (Acres x 3.0)
Consumptive Use Amount:
__________ acre-feet per year (Acres x 2.1)
File Number: _______________
Trn Number: _______________
(Revised April 2016)
Form: wr-21-mrg

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