Form 600 - Application For Beneficial Water Use Permit Page 3
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79a. PLACE OF USE
(a) Geocode of the place of use (17 digits)
If there are multiple places of use, list the geocode for each parcel on an attached sheet. The geocodes can be found at the
County Clerk and Recorders Office or by visiting
(b) Irrigation / Lawn & Garden
County
Subdivision Name
Acres
Lot
Block
1/4
1/4
1/4 Sec
Twp
N/S
Rge
E/W
Acres
Lot
Block
1/4
1/4
1/4 Sec
Twp
N/S
Rge
E/W
Acres
Lot
Block
1/4
1/4
1/4 Sec
Twp
N/S
Rge
E/W
Acres
Lot
Block
1/4
1/4
1/4 Sec
Twp
N/S
Rge
E/W
Acres
Lot
Block
1/4
1/4
1/4 Sec
Twp
N/S
Rge
E/W
Total Acres
9b. PLACE OF USE
(c) Non-Irrigation
(i) Purpose of Use
Place of use same as Point of Diversion, CHECK
1/4
1/4
1/4 Sec
Twp
N/S Rge
E/W County
Lot
Block
Tract #
Government Lot
(ii) Purpose of Use
Place of use same as Point of Diversion, CHECK
1/4
1/4
1/4 Sec
Twp
N/S Rge
E/W County
Lot
Block
Tract #
Government Lot
10. FLOW RATE, VOLUME, PURPOSE OF USE, AND PERIOD OF USE
(cfs/gpm) up to
acre-feet for
purpose (month/day)
to (month/day)
(cfs/gpm) up to
acre-feet for
purpose (month/day)
to (month/day)
(cfs/gpm) up to
acre-feet for
purpose (month/day)
to (month/day)
Total Amount Requested
(cfs/gpm) up to
acre-feet per year
11. GENERAL PROJECT PLAN & PROPOSED COMPLETION PERIOD
What year will the project completed and all of the water put to beneficial use? __________
Explain why this amount of time is requested. Include information about the cost, magnitude, complexity, or any other reason
for the time period requested. ____________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
Generally identify what will be completed and how much water will be put to use during each year until the project is completed.
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
Application For Beneficial Use Permit, Form 600 ~ R8/2010
Page 3 of 7
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