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<br />lJJ ;;: il'7 l <br /> <br />. <br /> <br />. <br /> <br />7 <br /> <br />. <br /> <br /> <br />Notification of Proposed Water Use <br />in Conjunction with <br />Application for Right-of-Way Permit <br /> <br />R/W Application No. H <br /> <br />Date of Filing: <br /> <br />-. <br /> <br />1. Name of applicant(s) <br />Post Office address <br />County of <br /> <br />State of <br /> <br />Zip <br /> <br />2. If applicant is a corporation: (a) Date and place of incorporation <br /> <br />(b) Number of licensed stock <br />(d) Authorized agent name <br /> <br />(c) Allotment No. <br />(e) Address <br /> <br />3. Quantity of water requested <br /> <br />(g.tl.d.) (c.f.s.) (ac. ft. vr.) <br />(Circle one of above) <br /> <br />. <br /> <br />4. Season of use <br /> <br />to <br /> <br />S. Location of water requested: <br /> <br />(a) Source name <br /> <br />Stream/Well/Stlrine/1<aterhole <br />(Circle one of above) <br /> <br />which is <br />which is <br />Township <br />total volume of <br /> <br />a tributary of <br />located in <br /> <br />1/4 <br />Range <br />of this source <br /> <br />1/4 Sec. <br />County <br />(g.p.d.) (c.f.s.) (ac. ft. vr.) <br />(Circle one of above) <br /> <br />flow <br /> <br /> Source of data <br />(b) Diversion is located in 1/4 1/:', Sec. <br /> Township Range County <br />(c) Use(s) occur(s) in 1/4 1/4, Sec. <br /> Township Range County <br /> <br />Indicate the location of source, diversion, and developcent(s) on <br />the filing cap accompanying the R/W application. <br /> <br />. <br /> <br />Attachment 1 - 1 <br />