Title: Review of Draft Copy for new Consumptive Use Permit Application
CITATION PAGE IMAGE
Full Citation
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Permanent Link: http://ufdc.ufl.edu/UF00051311/00001
 Material Information
Title: Review of Draft Copy for new Consumptive Use Permit Application
Alternate Title: Memorandum re: Review of Draft Copy for new Consumptive Use Permit Application, three different copies of which are attached
Physical Description: Memorandum, 34p.
Language: English
Publication Date: Nov. 26, 1975
 Subjects
Spatial Coverage: North America -- United States of America -- Florida
 Notes
General Note: Box 3, Folder 1 ( SWF CONSUMPTIVE USE PERMIT APPLICATION (CUP) FORM ), Item 22
Funding: Digitized by the Legal Technology Institute in the Levin College of Law at the University of Florida.
 Record Information
Bibliographic ID: UF00051311
Volume ID: VID00001
Source Institution: University of Florida
Holding Location: Levin College of Law, University of Florida
Rights Management: All rights reserved by the source institution and holding location.

Full Text


.' uth west Flc ida
E Water Management District
1 96P. O. BOX 457 BROOKSVILLE. FLORIDA 33512

DERRILL McATEER, Chairman, Brooksville THOMAS VAN der VEER, Secretary, Yankeetown JOE E. HILL, Leesburg
"GE ROBERT E. VAUGHN, Vice Chairman, Brandon JOHN A. ANDERSON, St. Petersburg N. BROOKS JOHNS, Lakeland
J. R. GRAW, Treasurer, Ocala S. C BEXLEY, JR., Land O'Lakes RONALD B. LAMBERT, Wauchula
Donald R. Feaster, Executive Director
November 26, 1975














Re: Review of Draft Copy for new Consumptive Use Permit Application

Dear Sir:

Enclosed for your review and comments is a draft copy of a new consumptive
use permit application form for use within our District. This new draft has
been shortened considerably, however, all the required data from the present
form has been maintained in a more simplified format. This draft form will be
presented to our Governing Board for their consideration and comments at their
December 10, 1975 meeting. A public hearing will be scheduled in January 1976
to allow public comment on the revised draft form.

We are scheduling a meeting here at our Brooksville office to consider comments
from those who have expressed an interest in this new draft form. The meeting
will be at 1:30 P.M. on Wednesday, December 3, 1975 in our Governing Board room.
If for some reason you cannot attend at this time, we would appreciate your
written comments by December 8, 1975.

Thanking you in advance for your time and interest.

Very truly yours,



JAMES A. MANN
Di rector
Regulatory Division

JAM:hh






i Sauth'west Flo da
SWatei MWanagemezit District
E S T,: P. O. BOX 457 BROOKSVILLE. FLORIDA 33512
1961jW IQU

S DERRILL McATEER. Chairman, Brookville THOMAS VAN der VEER, Secretary, Yankeetown JOE E. HILL, Leesbur
"GGEHM ROBERT E. VAUGHN, Vice Chairman, Brandon JOHN A. ANDERSON. St Petnwbrg N. BROOKS JOHNS. Lakeland
J R. GRAW. Treaurer, Ocala. & C. BEXLEY, JR., Land O'Lakes RONALD B. LAMBERT, Wauchula
DoaId R. Feater, Executive Director



November 26, 1975





MEMORANDUM




TO: GOVERNING BOARD MEMBERS

FROM: DONALD R. FEASTER, Executive Director A

RE: Proposed Revised Consumptive-Use Form


Attached is a revised Consumptive-Use Permit application form with instructions.
We would appreciate your reviewing this form and note any corrections or sugges-
tions you may have and return same to me prior to the December 10th Governing
Board meeting.

DRF:rls

Attachment: As stated above.








SOUTHWEST FLORIDA WATER MANAGEMENT DISTRICT

INSTRUCTIONS AND FORMS FOR COMPLETING THE CONSUMPTIVE USE PERMIT (CUP) APPLICATION


INSTRUCTIONS:

THIS APPLICATION IS FOR ONLY THOSE WATERS WHICH ARE WITHDRAWN FROM THE PROPERTY COVERED
BY THIS APPLICATION. DO NOT INCLUDE ANY WATERS FROM OTHER SOURCES. PLEASE TYPE OR PRINT

IN INK ALL ANSWERS FOR THE CONSUMPTIVE USE PERMIT (CUP) APPLICATION. A WORK SHEET COPY

OF ALL FORMS AND SKETCHES SHOULD BE COMPLETED FIRST IN PENCIL AND RETAINED FOR YOUR RECORDS.




1. Name and mailing address of applicant. The applicant is the individual or the corpo-

ration who owns, leases or otherwise controls the property. "Local contact" is the

individual who has knowledge of the property, facilities, etc., who may be contacted

for additional information about the application, and who may assist with tagging

the facilities.


2. Property covered by this application. Property "owned" or "leased" are self explan-

atory. "Otherwise controlled" includes any contractual right, rental agreement,

license, or permission from an owner which gives the applicant authority over certain

property, especially insofar as it relates to the water resources of same. County is

that County in which a majority of said property lies.


3. Complete the spaces provided.


4. Complete the spaces provided. If the answer is both, C, be sure to indicate in #9

which are existing and which are proposed facilities.


5. Indicate in the appropriate spaces, the number of points from which water will be

withdrawn. Example: wells 2 ; streams 1 ; lakes or ponds 0 ; other (specify)

0 Total 3 .


6. Indicate by percentage amounts, the proposed uses of the water to be withdrawn; the

total should add to one hundred percent (100%). Individual domestic supply: include
here the total percent which is used for individual personal needs or for household

purposes, such as, drinking, bathing, heating, cooking, or sanitation and for lawns
of less than five (5) acres.




-1-









7. Provide breakdown of water uses shown in #6 by inserting the percent of usage in the

appropriate spaces. Complete parts #7a. Public supply; and '#7b. Industrial, if appli-
cable.


Complete part #7c. Irrigation, per the following instructions:

/1/ CROP: list each separately. If more than one crop will be raised per year

from the same acreage, indicate the number of crop harvests by placing that

number in parenthesis behind the crop name. Example: strawberries (2).

Pasture, golf courses, and lawns of more than five (5) acres in size should be

listed here as "grass". Fish farming should be listed as "fish".

/2/ PERCENT of total withdrawal is that percentage of the total water withdrawn which

will be applied to the crop on an average yearly basis.

/3/ ACREAGE is the amount of acres used each year for the crop. In most cases,

this will only be a portion of the total lands on the application, unless the

total acreage is under cultivation.

/4/ Irrigation METHOD should be indicated by a letter. Example: "s" for sprinkling;

"f" for flood (ditch) and "d" for drip or trickle.

/5/ Annual hours of OPERATION is the total hours that this crop will be irrigated

during an average year, broken down into day and night time operation. Time re-

quired for moving portable equipment should not be included if the system is not

in operation at that time.

8. The amount of water disposed off site for public supply has been shown in #7.

Industrial uses should indicate water disposed off site if the final disposition of

water is into a city sewer or by runoff into a stream or other body of water which

leaves the property. There are some instances in irrigation where water is disposed

off site from ditches. The percent of water so disposed should be reported here.


9. Indicate all withdrawal points on the property whether or not they are in use at the

present time. Standby, fire protection, and any other facility not presently in use
should show the withdrawal as "zero". Proposed facilities should be treated as work-

ing facilities but should be shown as "proposed" by notation of the letter "P" beside
the number. Complete parts #9a and #9b per the following instructions:


The number assigned, column /I/, to either the well, or the intake (drop) pipe, should

agree with the number shown on the location sheet. The diameter, column /2/, is the

diameter of the well casing or the intake (drop) pipe, in inches. The depth of the


-2-








well, column a/3/, is to be given in feet measured from the ground surface to the bot-
tom of the hole. The name of the stream, column b/3/, is that formal or common name

associated with the body of water from which water is being withdrawn. If more than

one name i.s associated with such water, it should be so noted.


The average daily withdrawal, column /4/, is the estimated amount of water to be used

for the year divided by 365. For example: To compute the average daily withdrawal

for irrigation, take the total number of inches of water anticipated to be applied on

an average annual basis; multiply by the number of acres to be irrigated, and multiply

again by 27,154. Finally, divide the entire amount by 365.

Example: 12" average annual to be applied; 40 acres of crop:

1) 12x40 = 480

2) 480x27,154 = 13,033,920

3). 13,033,920-365 = 35,710 gallons/day


The maximum daily withdrawal, column /5/, is that amount of water which could be

pumped during 24 hours of pumping, in accordance with pump capacity.

Example: Pump capacity is 550 gallons/minute:

1) 550 gallons/minute x 60 minutes/hour x 24 hours/day =

550x60x24 = 792,000 gallons/day maximum.


10. Affidavit of Ownership: The Rules and Regulations of the Southwest Florida Water

Management District require that adjacent property owners be listed by the applicant
for notification concerning any large withdrawal of water in their immediate area.

In special instances when the permit is for a continuing use of water and when there
is an inordinately large number of persons to be notified, it is possible to get a

waiver of affidavit by making application to the Board for such a waiver. Forms

for waiver of affidavit will be furnished upon request. The application for waiver

will be presented to the Board at its regular monthly meeting. If approved, the

waiver may be used in place of the Affidavit of Ownership, and should be submitted
with this application. The applicant is required to complete an Affidavit of Owner-

ship form along with this application~or submit a waiver.

Complete the form as per instruction thereon.

11..Complete the Withdrawals Location Sketch as indicated.
12. Complete the Property Location Map as indicated if required.





-3-













SOUTHWEST FLORIDA WATER MANAGEMENT DISTRICT
CONSUMPTIVE USE PERMIT APPLICATION


Please TYPE OR PRINT IN INK.

1. APPLICANT:
(name) (address)
(city & state) (zip) (telephone) (area code)
LOCAL CONTACT:
(name) (telephone) (area code)
2. Describe PROPERTY covered by this application : Location
.(section) (township)


(range) (county)

Indicate amount of acreage to nearest 1/10 of an acre: owned ; Leased ;
.otherwise controlled Total


3. Is this application for (check one) renewal? yes no ; or modification of a
current Consumptive Use Permit (CUP)? yes no If yes, give the CUP

number


4. The withdrawal of all water covered by this application:
a. Existed prior to January 1, 1975: yes no
b. Withdrawal began or will begin
c. Both of the above: yes no


5. Indicate the number of withdrawal points for this application:
wells streams lakes ponds __, other (specify)


6. What percent (%) of water withdrawn will be used for the following purposes?:

(If "Zero", so indicate)

a. public supply ; b. industrial ; c. irrigation ; d. individual domes-
tic supply ; e. other (specify) Total (should equal 100%).



(1)
















7. Provide breakdown of uses as listed in #6; enter percent of total for:

a. Public supply by disposal method: individual septic tank %, on site perco-

lation and ponding %; on site spray irrigation %; off site
disposal of treated sewage %; other (specify) %. Sub-total
#7a % (should agree with #6a above).
b. Industrial: Mining; phosphate %; limerock %; sand/gravel %;,
other (specify %.
Processing/refining: phosphate %; limerock %; sand/gravel

%; other (specify) %.
Perishable food processing %;
Power companies (make up) %; other (specify) %.
Sub-total #7b % (should agree with #6b above).
c. Irrigation:

/1/ /2/ /3/ /4/ /5/
CROP (list each separately) PERCENT (total ACREAGE METHOD* OPERATION hours)
(see instruction #7) withdrawal) s,f, or d day night total









Sub-total #7c (should agree with #6C above).
*METHOD: "s" for sprinkling; "f" for flood (ditch): and "d" for drip or trickle.


8. Will any part of the water withdrawn, for use other than public supply, as shown in #6
above, be disposed off site? yes no ___ Indicate the total percent so disposed:








(2)






S... ll-lll|















9. Indicate all withdrawal points on the property whether or not they are in use at the
present time. Standby, fire protection, and any other facility not presently in use should
show the withdrawal as "zero". Proposed facilities should be treated the same as work-

ing facilities but should be shown as "proposed" by notation of the letter "P".


a. Withdrawal from WELLS: assign a number in column /1/ to each well and enter data
for each well in columns /2/ through /5/. The number assigned to each well must
agree with the number on withdrawal sheet (#11).

Do not write in this space /I/ /2/ /3/ Withdrawal-gallons/day
(for office use only) No. Diam. Depth Average Maximum
/4/ /5/


~ i i








b. withdrawal from LAKES, STREAMS, IMPOUNDMENTS, or other SURFACE WATER: Assign a


(for I iAverage Maximumm












If additional space is needed, add a separate sheet.















(3) : ,_ __,_____






AFFIDAVIT OF OWNERSHIP FORM

10. List below, as per the following tables, the name and address of each property owner
within the prescribed distance. Encircle the distance as used. The District assumes

the responsibility of noticing the list of adjacent property owners as provided by
the applicant.


If water greater then 100,000 gallons per day is to be withdrawn from a well or
combination of wells, all property owners within the following indicated distances

from the well, or (at the option of the applicant) from the property boundary on

all sides, must be listed:


Withdrawal amounts Distance Distance from
average gallons/day from Well property boundary

under 100,000 Notice not required, however, the Affidavit of Ownership form must
be marked NA (not applicable) and returned with the CUP application.
100,000 to 500,000 660 feet 100 feet
500,000 to 1,000,000 1,320 feet 200 feet
1,000,000 and above 2,640 feet 400 feet


If water is to be withdrawn from a body of SURFACE WATER list adjacent owners according
to the following schedule:


Withdrawal amounts Distance Distance from
average gallons/day upstream downstream property boundary

any amount from any
impoundment of less all property owners along the shoreline
than 80 acres within 660 feet in each direction

5,000,000 or less 660 1,320 same
over 5,000,000 1,320 2,640 same
















If additional space is needed, add a separate sheet. Failure to list all property
owners and their correct addresses may result in the delayed processing of your
application.


Signature of Applicant

,.. ,( 4 )









11. WITHDRAWALS) LOCATION SKETCH
Below is a map of one section of a township divided into 1/4 1/4. Please
complete a sketch for every section of property covered by this application
which has one or more withdrawal points (well or intake pipe), showing the
exact location of the points as accurately as possible. Locate all withdrawal
points whether or not they are in use if they are covered by this application.
Numbers assigned to these withdrawal points must agree with the numbers shown
in item #9 on the CUP application form.

If all of the property covered by this application is in one section, sketch the
outline of said property on this sheet.
If the property covered by the application is in more than one section of property,
complete the enclosed PROPERTY LOCATION MAP (item #12).

Section Township South Range East





NW 1/4 of NW 1/4 NE 1/4 of NW 1/4 MW 1/4 of NE 1/4 NE 1/4 of NE 1/4
















i
NW 1/4 NE 1/4

SW 1/4 of NW 1/4 SE 1/4 of NW 1/4 SW 1/4 of NE 1/4 S 1/4 of NE 1/4









NW 1/4 of SW 1/4 NE 1/4 of SW 1/4 NW 1/4 of SE 1/4 NE 1/4 of SE 1/4|







_______SW 1/4_____________SE 1/4________

SW 1/4 of SW 1/4 iSE 1/4 of SW 1/4 SW 1/4 of SE 1/4 SE 1/4 of SE 1/4


10a
n i80 acres
160 acres ^ ^ -
540 acres 20a










12. PROPERTY LOCATION MAP

Each block in the illustration below represents a section of a township. If the
property covered by this application covers more than one section, please draw a
sketch of the property boundaries on this sheet.
One section has been divided to show the proportionate size of a plot.
Number the sections to agree with your property.
If you need more sections than the sixteen(16) available here, add a separate sheet
with the appropriate illustration thereon.

















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j 620a Acres
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r ... 0I NOVL;.Rt O, 1975
r INSTRUCTIONS FOR COMPLETING THE CONSUMPTIVE USE PERMIT APPLICATION

THIS APPLICATION SHOULD BE ... ONLY THOSE WATERS WHICH ARE W. DRAWNN FROM THE PROPERTY
COVERED BY THIS APPLICATION. DO NOT INCLUDE ANY WATERS FROM OTHER SOURCES. PLEASE
TYPE OR PRINT IN INK ALL ANSWERS FOR THE CONSUMPTIVE USE PERMIT (CUP) APPLICATION.
INDEX NUMBERS AND LETTERS ON THE INSTRUCTIONS CORRESPOND TO THOSE ON THE APPLICATION FORM.

1. Name and mailing address of applicant. This should be the individual or the

corporation who has legal ownership or control of the -property. Local contact is

an individual who has knowledge of the property, facilities, etc. who may be con-

tacted for additional information about the application, and who may assist with

tagging the facilities.

2. Property covered by this application. Property "owned" or "leased" are self

explanatory. "Otherwise controlled" includes any contractual right, rental agree-

ment, license, or permission from an owner which gives the applicant authority

over certain property, especially insofar as it relates to the water resources

of same.

3. If this permit application is for a renewal or modification give permit number.

If for a previous or existing permit agreement entered into with the District,

list parties to the agreement and date of execution.

4. Indicate by filling the necessary spaces. If the answer is both /C/ be sure to

indicate in 9 and 10 which are new or proposed facilities.

5. Indicate by placing a number in the appropriate spaces the numbers m ints

which water will be withdrawn. (Example well(s) 2 ).

6. Indicate by check the appropriate use(s) of water. NOV 1'> 1975

7. Include all uses of water as shown in #6. The total should add to one hundred (100)

percent.
A. Public Supply; and B, Industrial; uses may be completed by inserting the

percent of usage in the appropriate spaces. C. Irrigation; /I/ Crop, list each

separately. Pasture, also .golf courses and lawns of more than five (5) acres in
size should be listed here with the crop as grass. Fish farming also with the

crop as fish. If more than one crop will be raisedcper year from the same acreage,
indicate the number of crop harvests by placing that number in parenthesis behind

the crop name. Example: strawberries (2) /2/ Percent of total withdrawals is that

percentage of the total water withdrawn that will be used by that crop on an average

yearly basis. /3/ Acreage is the amount of acres used each year for that crop. In
most cases this will only be a portion of the total lands on the application unless

the total acreage is in grove then it would be 100%. /4/ Irrigation method should

be indicated by a letter: s for sprinkling; d for ditch (flood) and c for drip

(covered). /5/ Annual hours of operation is the total hours that you will irrigate
this crop during an average year broken into day and night time operation. Time

used for moving portable equipment should not be included as the system is not in

operation at that time. (As much irrigation as possible should be done during

night time hours as the loss by evapotranspiration is much lower at night.)







INSTRUCTIONS Continued

D. Individual domestic supply: include here the percent of total withdrawal from the

facility which is used for individual personal needs or for household purposes such as

drinking, bathing, heating, cooking or sanitation and for lawns of less than five (5)

acres. E. Other signify.

8. The amount of water disposed off site for public supply has been shown in number 7.

Industrial uses may have water disposed off site if the final disposition of water

is into a city sewer or by runoff into a stream or other body of water which leaves

the property. There are some instances in irrigation where water is disposed off

site from ditches. The percent of water so disposed should be reported here.

INCLUDE UNDER 9 AND 10 ALL WITHDRAWAL POINTS ON THE PROPERTY WHETHER THEY ARE IN USE AT
THE PRESENT TIME. STANDBY, FIRE PROTECTION AND ANY OTHER FACILITY NOT IN USE SHOULD
SHOW THE WITHDRAWAL AS ZERO. PROPOSED FACILITIES SHOULD BE TREATED THE SAME AS WORKING
FACILITIES BUT SHOULD BE SHOWN AS PROPOSED BY NOTATION OF THE LETTER P BESIDE THE NUMBER.

9. and 10. The instructions for filling out these two parts are the same except that

the depth of the well 9/3/ is to be given in feet measured from the ground surface

to the bottom of the hole. The name of the stream 10/3/ is that formal or common

name associated with the body of water from which water is being withdrawn. If

more than one name is associated with such water it should be so noted. The number

assigned to either the well 9/1/ or the intake pipe 10/1/ should agree with the

number shown on the location sheet. Diameter is the diameter of the well casing

9/2/ or the intake or drop pipe 10/2/ in inches. Average daily withdrawal is the

estimated amount of water to be used for the year divided into daily average. To

figure the daily average take the total number of inches of water anticipated to be

needed to complement the rainfall, multiply this number by 27,154(acre/in) gallons

and multiply this number by the number of acres to be irrigateddivide the entire

amount by 365 and you have the average daily withdrawal.

Example: 12" additional water antttipated

40 acres of grove

12X27154X40 = 35710 gallons/day average withdrawal
365

Maximum daily /5/ is that amount of water which would be pumped during a full day

of pumping.

Example: 550 gallons per minute pumped X 60 minutes X 24 hours
550 X 60 X 24 = 792,000 gallons/day. This would be maximum daily.












)_Draft.', #3, novet, ler 10, 1O'(5






COSUMPTIVE USE PERMIT APPLICATIONS

PLEASE TYPE OR PRINT IN INK.

1. NAME AND MAILING ADDRESS OF APPLICANT


NAME AND TELEPHONE NUMBER OF LOCAL CONTACT IF OTHER THAN ABOVE


2. PROPERTY COVERED BY THIS APPLICATION: Location
section, township, range, county
to nearest 1/10 of an acre
total
Acreage owned Leased Otherwise controlled

3. Is this application for (check one) renewal, yes__ no ; or modification of a

current Consumptive Use Permit (CUP), yes no__. If yes, give CUP number

4. Use of all water covered by this application: A. existed prior to January 1, 1975_

B..will be a new use withdrawal is anticipated to begin

C. both of the above

5. Number of withdrawal points on this application; (indicate number for each) wells

streams, lakes, ponds other(signify) Total

6. Water will be used for: A. public supply ; B. industrial ; C. irrigation

D. individual domestic supply ; E. other (signify)

7. Fill out for appropriate usage(s) as listed above: Show percent (%) of total for

A. each Public supply w/ disposal method; individual septic tank__ ; on site percola-

tion and ponding ; on site spray irrigation ; off site disposal of treated

sewage ; other (signify)
Sub total A: %

B. Industrial: mining; phosphate ; limerock ; sand/gravel ; other (signify


Processing/refining: Phosphate ; limerock ; sand/gravel ; other
signify
Perishable food processing ; Power companies (make up) ;

Other (signify) ____________.

Sub total B: %

C. Irrigation: Method s, sprinkling; d, ditch (flood); and c, covered (drip).


/I/ /2/ /3/ /4/ ; /5/
CROP(list each separately) Percent total Acreage Method OPERATION (annual hours)
show # if more than 1/yr. withdrawal s,d,or c day nig__t total








Sub total C; %. .- i

NOV 12 1975


_-_ ____________._~__~____ i__________






CONSUMPTIVE USE PERMIT APPLIC'7ON Continued 0"

D. Individual Domestic Supply %

E. Other %

Total: A+B+C+D+E = (Should equal and not exceed 100%)

8. Will any part of the water withdrawn for use other than public supply be disposed

off site: yes no___. Indicate percent so disposed

INCLUDE ALL WITHDRAWAL POINTS ON THE PROPERTY WHETHER OR NOT THEY ARE IN USE AT THE PRESENT
TIME. STANDBY, FIRE PROTECTION AND ANY OTHER FACILITY NOT PRESENTLY IN USE SHOULD SHOW THE
WITHDRAWAL AS ZERO. PROPOSED FACILITIES SHOULD BE TREATED AS WORKING FACILITIES BUT SHOULD
BE SHOWN AS PROPOSED Bi NOTATION BOTH HERE AND ON THE LOCATION SHEET.

9. Withdrawal from wells. Number assigned to each well must agree with number on sketch.

Do not write in this space /1/ /2/ /3/ Withdrawal-gallons per day
for office use only No. Diam. Depth Average maximum
/4/ /5/



-------,._ .___.-----___1








Si i


--^ -,.-- ., .. .u,, .- ... .. C i_ _. L
If additional space is needed add a separate sheet.

10. Withdrawal from lakes, streams, impoundments or other surface water. Number assigned

to each intake pipe must agree with number on sketch.
Do not written this spac // /2/ /3/ Withdrawa-galons per day_
for office use only No Diam. Name average maximum
/4/ /5/













If additional space is needed add a separate sheet.













] __'ai't:. //3, Novc,,in,-:r. ]0, 19y)'(l"








LAYOUT SHEET

EACH BLOCK IN THE ILLUSTRATION BELOW REPRESENTS A SECTION OF A TOWNSHIP. WHEN THE

PROPERTY COVERED BY AN APPLICATION COVERS MORE THAN ONE SECTION A LAYOUT OF THE

PROPERTY BOUNDARIES SHOULD BE DRAWN ON THIS SHEET UNLESS YOU HAVE ANOTHER SKETCH

OF THE PROPERTY THAT SHOWS THE ENTIRE PROPERTY.

ONE SECTION HAS BEEN DIVIDED TO SHOW THE PROPORTIONATE SIZE OF A PLOT.

NUMBER THE SECTIONS TO AGREE WITH YOUR PROPERTY.

IF YOU NEED MORE SECTIONS THAN THE SIXTEEN (16) AVAILABLE HERE ATTACH A SEPARATE

SHEET WITH THE APPROPRIATE ILLUSTRATION THEREON.




























160 acres



40a
80s _




I i
:-;^ ^ 10



















)Dr;ift //3 Nov. 10, 1975






IcIDRAWAL(S) LOCATION SHEET
Below is a land section map divided into 1/4-1/4. Every section of property covered by
this application which has one or more withdrawal points (well or intake pipe) must have
a sheet completed showing the exact location of the points) as accurately as possible.
List all withdrawal facilities whether or not they are being used or whether they are
covered by this application and so indicate on each point. If the application also
covers proposed facilities indicate these as proposed on the diagram. Numbers assigned
to these withdrawal points must agree with the numbers shown in numbers 9 and/or 10 on
the application form.

If all of the property covered by this application is in one section sketch the outline
of said property on this sheet also and indicate the point on your boundary nearest to
the points) of withdrawal.

If the property covered by the application is in more than one section of property
complete the enclosed layout sheet.

Section Township__ Range East County_





Nw 1/1 of NW 1/4 NE 1/4 of Nw 1/4 NW 1/4 of NE 1/4 NE 1/4 of NE 1/4
1 i









NW 1/4 of NW 1/4 NE 1/4 of SW 1/4 NW 1/4 of NE 1/4 NE 1/4 of NE 1/4 i
E I

























SW 1/4 of SW 1/4 SE 1/4 of SW 1/ S 1/4 of SE 1/4 SE 1/4 of SE 1/4
f i
I






















nnB~~_jj ______ __ __________ i.wlu of_______ swzli +4 s/-l. orsz4swl.RsTl ~ lko ~l






AFFIDAVIT FORM .

INSTRUCTIONS FOR PROPERLY COMPLETING THE AFFIDAVIT FORM


The regulations require that adjacent property owners be notified concerning the with-

drawal of water in their immediate area. The amounts withdrawn govern the distances

from either the withdrawal facilities or the boundary of the property that must be

covered. In special instances when the permit is for a continuing use of water and

when there are a large number of persons to be notified it is possible to get a waiver

of affidavit by making application to the Board for such a waiver. Forms will be

furnished and the application for waiver will be presented to the Board at its regular

monthly meeting. If approved the waiver may be used in place of the affidavit.
When the average daily withdrawal does not exceed

100,000 gallons/day it is not necessary to list anyone. However, the affidavit form

must be returned to make a complete application. It should be marked N/A.

If the water requested is to be withdrawn from a well or combination of wells, all

property owners within the distance from the well, or, at the option of the applicant

all owners of property within the distance from the property boundary on all sides

may be used.

Withdrawal amounts Distance Distance from
average gallons/day from well property boundary

under 100,000 not necessary to notify anyone. Form must be marked NA and returned

with application

100,000 to 500,000 660 feet 100 feet

500,000 to 1,000,000 1320 feet 200 feet

1,000,000 and above 2640 feet 400 feet

If water is to be withdrawn from a body of surface water.

Withdrawal amounts Distance Distance from
average gallons/day upstream downstream property boundary

any impoundment of less all property owners along the shoreline
than 80 acres within 660 feet in-each direction

5,000,000 gallons or less 660 320 same

over 5,000,000 1320 2640 same

List below the name and address of each property owner as required by the above.

If additional space is needed attach a separate sheet. Failure to list all property

owners and their correct addresses may result in the delayed processing of your

application.










DRAFT #3 NOVEMBER 10, 1975






ir"'IDRAWAL(S) LOCATION SIEET A
Below is a land section map divided into 1/4-1/4. Every section of property covered by
this application which has one or more withdrawal points (well or intake pipe) must have
a sheet completed showing the exact location of the points) as accurately as possble.
List all withdrawal facilities whether or not they are being used or whether they are
covered by this application and so indicate on each point. If the application also
covers proposed facilities indicate these as proposed on the diagram. Numbers assigned
to these withdrawal points must agree with the numbers shown in numbers 9 and/or 10 on
the appl ication form.
If all of the property covered by this application is in one section sketch the outline
of said property on this sheet also and indicate the point on your boundary nearest to
the points) of withdrawal.
If the property covered by the application is in more than one section of property
complete the enclosed layout sheet.
Section Township Range East County



"V 0
Nw 1/4 of Nw-1/4 I NE 1/4 of m. 1/4 NW 1/4 of NE 1/4 NE 1/4 of NE....








sw 1/4 of NW 1/4 SE 1/4 of NW 1/4 sW 1/4 of NE 1/4 SE 1/4 of NE
iI I
t
I i

i :





. 1/4 of sw ./4 NE 1/4 of SW 1/4 .. NW 1/4 of SE 1/4 NE 1/4 of SE 1/
j SW 1/4 of NW 1/4 SE 1/4 of KW 1/4 Sw 1/4 of NE 1/4 SE 1/4 of NE 1/4










I I
I SW 1/4 of SW 1/4 NE 1/4 of SW 1/4 SNW 1/4 of SE 1/4 I NE 1/4 of SE 1/4













160 acres 80 acres !s ..20a 13...



r^.' AF



_____________Dr~i f '>i~ i- -










PROPOSED PROCEDURAL STEPS ON
APPLICATIONS FOR PERMITS



1. The application is filed with the District.

2. It is signed to Hydrologist to reviev.S ent to Data Processing
Depa tment for printout. /94/p -HL. 7

3. A Hydrologist reviews application and determines whether additional
data is required.

(a) Hydrologist request applicant to forward the additional
data; or

(b) Hydrologist reviews application as completed.
P.C- pInVI/6"N
4. If application is complete, the H"ydros giet- prepares notice to publish
application and date for receipt of objections which shall be three
weeks before hearing date.

5. The Hydrologist reviews objections and prepares written recommendation
on whether permit be granted by District Governing Board. The recom-
m-ndation should set forth the agreed set of facts, the issue to be
decided and whether the applicant meets the conditions for the particular
requested permit. Where a permit fails one or more conditions set forth
in the Rules, the staff should indicate the extent of the failure and
whether a waiver of the condition by the Governing Board will cause
significant hydrologic damage or if not, what damage will be caused by
granting the waiver.

6. The recommendation is sent to the Board or Hearing Officer, and applicant t .
at least two weeks before scheduled hearing date.

7. At the hearing, the Officer or Board calls the hearing to order. The c
Opening Statement is read by the Chairman or an opening remark is made LeO
by the Hearing Officer setting forth the guidelines as to time permitted
per person to present a position on the application. The original
application or a xerox copy is introduced into the record.' Also, the
Proof of Publication of the notice of the application and scheduled
hearing is introduced into the record and any other documents agreed to
by the interested parties.

8. The applicant and the consultant proceeds to explain the activity for
which a permit is being sought from the District and shows whether the
application meets the conditions for the particular permit.

9. Applicant is cross-examined by District representative and those who
have signed a slip indicating a position on opposing or in favor of the
application.










10. The staff presents its recommendation to the Board or Hearing Officer
on whether the applicant has shown sufficient data indicating ccmpli-
ance with the conditions for a permit. Also, when new evidence has been
presented not formerly considered by the staff, he staff reo
an opportunity to review._ -VL -o / 4y7 '

11. The staff is then cross-examined by those who had priorly registered
as appearing as a party in interest on the application. The cross-
examination is kept to a reasonable time period without denying the
parties in interest due process.

12. At conclusion of all the testimony, the Board or Hearing Officer
requests additional evidence or information to be presented at a
continued hearing date. This would enable the parties to review
and evaluate any testimony presented at the hearing and present a
position on it at a later date. Also, the Board or Hearing Officer
could determine the hearing be concluded and a decision be made on the
application where there is no need for additional testimony or
presentation of facts.




































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