Form 611 - Objection To Application 2008
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2Form No. 611 R10/08
OBJECTION TO APPLICATION
Use this form when objecting to an application for a water use permit,
change authorization or reservation of water. Use one form for each
application to which you are objecting. Individual water right owners
FOR DEPARTMENT USE ONLY
must file separate objections.
Postmarked Date
______________________
Date Received
______________________
THIS FORM MUST BE RECEIVED OR POSTMARKED ON OR BEFORE THE
Rec'd By
______________________
DEADLINE SPECIFIED IN THE PUBLIC NOTICE.
Fee Rec'd
______________________
Check No.
______________________
Refund
______________________
FILING FEE: $25.00
Submit form and filing fee to:
Permit
Change
Montana Department of Natural Resources and Conservation
Obj #
__________________________
Reviewed by
__________________________
1424 9th Avenue, PO Box 201601, Helena, MT 59620-1601
Date
__________________________
406-444-9754 or 406-444-9755
1. NAME OF OBJECTOR ________________________________________________________________________
Mailing Address
________________________________________________________________________
City
_____________________________________________ State ___________
Zip
______________
Home Phone
_______________________________________Other Phone
___________________________
2. WHAT APPLICATION ARE YOU OBJECTING TO?
Number________________________________________
Applicant Name _______________________________________________________________________________
3. HOW DO YOU HAVE STANDING TO FILE THIS OBJECTION? - A person has standing if his or her property,
water rights, or interests would be adversely affected by the proposed appropriation. Explain your interest and how it
would be adversely affected.
_____________________________________________________________________________________________
_____________________________________________________________________________________________
4. WILL YOUR WATER RIGHT BE AFFECTED? If so, provide the water right number.
(W)
Statement of Claim No. ________________________________________________________________
(P)
Permit to Appropriate Water No. __________________________________________________________
(C)
Certificate of Water Right No.
__________________________________________________________
(D)
Powder River Final Decree No. __________________________________________________________
(M/R) Reservation of Water No.
__________________________________________________________
(E)
Exempt Water Right No. ________________________________________________________________
(F)
Non-recorded Water Right (For a filing not on record with the DNRC, complete the information below).
ype of Use
Stock
Domestic
Date of First Use
___________________
T
Groundwater (For example, well or developed spring)
Instream Surface water Source
___________________________________________________
Amount Used
Flow Rate___________Gallons Per Minute
Volume__________Acre-Feet
Point of Diversion ______1/4 ______1/4 ______1/4 Section____ , Twp______ N/S, Rge______ E/W
County ________________________________________________
Lot___________ Block__________ Tract No._________ Subdivision Name_______________________
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