Form 606 - Application To Change A Water Right Page 2
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7TYPE OF PROPOSED CHANGE – Complete only the section for the type of change being proposed.
5.A.
Change in Point of Diversion
5.B.
Yes
No
Will the existing point of diversion still be used?
5.C.
Yes
No
Is there a source change? If yes, new source
___________________________________
5.D.
Yes
No
Is there a means of diversion change? If yes, new diversion means
________________
5.E.
Yes
No
Is this is a change for a replacement well? Old well depth _______ New well depth ______
The new well is located approximately ________ (feet) _________(direction) of the new well.
5.F. Location of the proposed point of diversion.
5.F.1
_____1/4 _____1/4 _____1/4
Section _____
Twp _____N / S Rge _____E /W County _____________________________
Lot _______
Block_______
Tract No. ______________
Subdivision Name _____________________________________________
Government Lot No. _____________________________
COS No. _____________________________________________________
Street or Road Address, including City, State & Zip Code of the Development
_____________________________________________
5.F.2
_____1/4 _____1/4 _____1/4
Section _____
Twp _____N / S Rge _____E /W County _____________________________
Lot _______
Block_______
Tract No. ______________
Subdivision Name _____________________________________________
Government Lot No. _____________________________
COS No. _____________________________________________________
Street or Road Address, including City, State & Zip Code of the Development
_____________________________________________
6.A.
Change in Place of Use
If there are multiple places of use, list the geocode for each parcel. The
Geocode: The geocode is a 17 digit number.
geocodes can be found at the County Clerk and Recorders Office or by visiting
6.B. Describe the proposed place of use. For irrigation, identify those acres below.
_____ Acres _____1/4 _____1/4 _____1/4
Section _____ Twp _____N / S
Rge _____E /W
Geocode_____________________________
Lot _______
Block_______
Tract No. ______________
Subdivision Name ____________________________________________
_____ Acres _____1/4 _____1/4 _____1/4
Section _____ Twp _____N / S
Rge _____E /W
Geocode_____________________________
Lot _______
Block_______
Tract No. ______________
Subdivision Name ____________________________________________
_____Acres
_____1/4 _____1/4 _____1/4
Section _____ Twp _____N / S
Rge _____E /W
Geocode_____________________________
Lot _______
Block_______
Tract No. ______________
Subdivision Name ____________________________________________
6.C.
Yes
No
Will acres be taken out of irrigation? If yes, identify those acres below.
_____Acres
_____1/4 _____1/4 _____1/4
Section _____ Twp _____N / S
Rge _____E /W
Geocode_____________________________
_____Acres
_____1/4 _____1/4 _____1/4
Section _____ Twp _____N / S
Rge _____E /W
Geocode_____________________________
_____Acres
_____1/4 _____1/4 _____1/4
Section _____ Twp _____N / S
Rge _____E /W
Geocode_____________________________
_____Acres
_____1/4 _____1/4 _____1/4
Section _____ Twp _____N / S
Rge _____E /W
Geocode_____________________________
7.A.
Change in Purpose of Use
omplete and attach the Temporary Change
7.B.
Yes
No
Is this a temporary change? If yes, c
Addendum
7.C. Proposed New Purpose
Commercial/Industrial/Institutional Flow Rate ______GPM/CFS
Volume _____
Period of Use ________________
Domestic/Multiple Domestic
Flow Rate ______GPM/CFS
Volume _____
Period of Use ________________
Fishery
Flow Rate ______GPM/CFS
Volume _____
Period of Use ________________
Geothermal
Flow Rate ______GPM/CFS
Volume _____
Period of Use ________________
Instream Fishery
Flow Rate ______GPM/CFS
Volume _____
Period of Use ________________
Irrigation
Flow Rate ______GPM/CFS
Volume _____
Period of Use ________________
Mitigation
Flow Rate ______GPM/CFS
Volume _____
Period of Use ________________
Wetland
Flow Rate ______GPM/CFS
Volume _____
Period of Use ________________
Wildlife Habitat
Flow Rate ______GPM/CFS
Volume _____
Period of Use ________________
Other ____________________
Flow Rate ______GPM/CFS
Volume _____
Period of Use ________________
8.A.
Change in Place of Storage
8.B.
Yes
No
Is this change to add a storage reservoir? If yes, identify the reservoir location.
8.B.1
_____1/4 _____1/4 _____1/4
Section _____
Twp _____N / S Rge _____E /W County _____________________________
8.C. Identify the capacity
DAM: surface area
acres X maximum depth
feet X 0.4 =
capacity in ac-ft
PIT: surface area
acres X maximum depth
feet X 0.5 =
capacity in ac-ft
Page 2 of 7
Application to Change a Water Right, Form 606 ~ R06/10
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