Form 606/634-Nfwpa - Non-Filed Water Project Addendum
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1Form 606/634-NFWPA Revised 6/17/2009
Applicant Name ____________________________________
NON-FILED WATER PROJECT ADDENDUM
This addendum must be completed and the required information attached to a change application (Form 606 or
634) if you do not have a DNRC water right number, and the following information applies:
Water rights for stock and domestic uses from groundwater sources (wells or developed springs) were exempt
from the general adjudication filing requirements for claims of existing water rights if they met either of the
following criteria:
A. The water was put to use prior to January 1, 1962, or
B. The water was put to use between January 1, 1962 and July 1, 1973, and a notice was recorded in the
courthouse records.
Water rights for instream stock and domestic from surface water was also exempt from the general adjudication
filing requirements if put to use prior to July 1, 1973.
NFWPA.1
DATE THE WATER WAS FIRST USED: ___________________________________
(month, day, year)
NFWPA.2
COURTHOUSE FILING: Attach a copy of the recorded document filed in the courthouse, if applicable.
NFWPA.3
PURPOSE AND PERIOD OF USE
Domestic
(cannot be
Year round use?
Yes
No
If no, from _______ to ________, inclusive of each year.
more than one
household)
Lawn & Garden
Total Size of lawn and/or garden - length x width
_____________________
(cannot exceed
April 1 – October 31
Yes
No
If no, from _______ to ________, inclusive of each year.
5 acres)
Stock
Number and type _____________________________________________________________________________________
(Example: 100
Year round use?
Yes
No
If no, from _______ to ________, inclusive of each year.
Cows & 1 Horse)
NFWPA.4
POINT OF DIVERSION: (describe the location of the old well)
_____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
____________________________________________________________________________________________________________
Source of Water: _____________________________________________________________________________________________
Means of Diversion: __________________________________________________________________________________________
NFWPA.5
PLACE OF USE: (describe the location where the water is used)
Enter the 17 digit geocode(s) applicable to the place of use legal land description.
___________________________________________________
______________________________________________________
If there are multiple places of use, attach additional sheets and list the geocode for each legal land description. The geocodes can be
found in county records.
Is the place where water is used the same as the point of diversion?
Yes
No
If no, enter the place of use land description below. Attach additional sheets if necessary.
Domestic
Lawn & Garden
Stock
_____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
____________________________________________________________________________________________________________
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