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<br />" <br /> <br />Texas Water rev. Board <br />issued May 13, 1994 <br />page 2 of 2 BANKDEPA <br /> <br />TEXAS WATER BANK <br />APPLICATION FOR DEPOSIT <br /> <br />IF THE WATER OFFERED FOR SALE IS GROUND WATER: <br /> <br />Describe the location of the authorized. pun;lage point or general <br />place of use (attach a page for descriptions of any additional <br />locations) <br />Aquifer County <br />Latitude/Longitude (in decimal degrees) Lat Long <br />In lieu of lat/long, attach County Highway Map, USGS 7.5 I tapa <br />map, or other map with pun;lage pomt (s) or general place (s) of <br />use marked. <br />Name of underground Water COnservation District or Authority <br />with jurisdiction (if applicable) <br />attach a xerox copy of groundwater withdrawal authorization or <br />permit and give pennit number here <br /> <br />Indicate <br />o <br />o <br /> <br />the ~ of Use: <br />Munic~pal/Domestic <br />Irrigation <br /> <br />o <br />o <br /> <br />Industrial <br />Mining <br /> <br />o other <br /> <br />A person who suk:mits a catpleted. application for deposit is considered <br />a de~sitor. The Water Bank will notify a potential depositor if his <br />apphcation for deposit is incatplete. The date of de~sit is the date <br />of receipt of a ccrq;>leted applicati:on for deposit. W~thin 30 calendar <br />days followin<;J rece~pt of a catpleted application for deposit, the Water <br />aank will not~fy the depositor of the acceptance or refusal of de!?"sit <br />(see Sections ~359.5 and ~359.6 of the Water Bank Rules). Depos~tors <br />are participants in the Water Bank, with responsibilities as outlined in <br />the 11andout, "Texas Water Bank Participant Responsibilities". Please <br />indicate understandin.:J and acceptance of these responsibilities and of <br />Water Bank Rules by your signature below. CO-owners of the water right <br />should be in agn:arent and should sign as co-depositors. If signing for <br />depositor (s), so indicate on the signature line and attach documentation <br />showing authorization to represent depositor(s). '!hank you. <br /> <br />I/we, the undersigned, attest to the truth, accuracy and carpleteness of <br />the infonnation I/we have provided on this fom to the best of ITr;{/our <br />knowledge, understand Water Bank Rules and trrf/our role as a partic~pant <br />in the Texas Water Bank. . <br /> <br />Signature <br /> <br />Date <br /> <br />Additional signatures for co-depositors, if applicable <br /> <br />Notary Public signature and seal <br />