Form MO780-1765 "Agricultural Exemption Information Sheet" - Missouri

What Is Form MO780-1765?

This is a legal form that was released by the Missouri Department of Natural Resources - a government authority operating within Missouri. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 1, 2004;
  • The latest edition provided by the Missouri Department of Natural Resources;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form MO780-1765 by clicking the link below or browse more documents and templates provided by the Missouri Department of Natural Resources.

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Download Form MO780-1765 "Agricultural Exemption Information Sheet" - Missouri

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STATE OF MISSOURI
MISSOURI DEPARTMENT OF NATURAL RESOURCES
DAM AND RESERVOIR SAFETY
AGRICULTURAL EXEMPTION INFORMATION SHEET
NAME OF DAM
COUNTY
ID NUMBER
MO
OWNER
ADDRESS
CITY
STATE
ZIP CODE
TELEPHONE NUMBER (REQUIRED)
HEIGHT
RESERVOIR AREA
D/S ENVIRONMENTAL AREA
CLASS:
TYPE OF DAM
EARTH
ROCKFILL
CONCRETE/MASONRY
OTHER__________
USE OF LAKE (CHECK ALL BOXES THAT APPLY)
RECREATION (FISHING, SWIMMING, ETC.)
LIVESTOCK WATERING
WATER SUPPLY
FISH REARING
CROP IRRIGATION
INDUSTRIAL
FLOOD PROTECTION
IRRIGATION
NUMBER OF ACRES IRRIGATED AND TYPES OF CROPS
CORN _______ AC.
SOYBEANS _______ AC.
MILO _______ AC.
HAY _______ AC.
OTHER ________
TYPE OF IRRIGATION
TRAVELING GUN
CENTER PIVOT
STATIONARY SPRINKLER
FLOOR IRRIGATION
PUMPING FROM LAKE
GRAVITY WITHDRAWAL FROM LAKE
LIVESTOCK WATERING
CURRENT NUMBER OF LIVESTOCK ON FARM THAT RECEIVE WATER FROM LAKE
HORSES _______
HOGS _______
CATTLE _______
SHEEP _______
OTHER _______
METHOD OF WATERING LIVESTOCK
DIRECT ACCESS TO LAKE
WATERING TANK
OTHER
COMMERCIAL FISH REARING
NUMBER OF FISH RAISED AND SOLD LAST YEAR
CATFISH __________
TROUT __________
CARP __________
OTHER __________
ARE FISH RAISED IN CONFINEMENT CAGES?
ARE FISH HARVESTED BY SEINING?
YES
NO
YES
NO
NAME OF PERSON FILLING OUT THIS QUESTIONNAIRE
DATE:
COMMENTS
MO 780-1765 (03-04)
STATE OF MISSOURI
MISSOURI DEPARTMENT OF NATURAL RESOURCES
DAM AND RESERVOIR SAFETY
AGRICULTURAL EXEMPTION INFORMATION SHEET
NAME OF DAM
COUNTY
ID NUMBER
MO
OWNER
ADDRESS
CITY
STATE
ZIP CODE
TELEPHONE NUMBER (REQUIRED)
HEIGHT
RESERVOIR AREA
D/S ENVIRONMENTAL AREA
CLASS:
TYPE OF DAM
EARTH
ROCKFILL
CONCRETE/MASONRY
OTHER__________
USE OF LAKE (CHECK ALL BOXES THAT APPLY)
RECREATION (FISHING, SWIMMING, ETC.)
LIVESTOCK WATERING
WATER SUPPLY
FISH REARING
CROP IRRIGATION
INDUSTRIAL
FLOOD PROTECTION
IRRIGATION
NUMBER OF ACRES IRRIGATED AND TYPES OF CROPS
CORN _______ AC.
SOYBEANS _______ AC.
MILO _______ AC.
HAY _______ AC.
OTHER ________
TYPE OF IRRIGATION
TRAVELING GUN
CENTER PIVOT
STATIONARY SPRINKLER
FLOOR IRRIGATION
PUMPING FROM LAKE
GRAVITY WITHDRAWAL FROM LAKE
LIVESTOCK WATERING
CURRENT NUMBER OF LIVESTOCK ON FARM THAT RECEIVE WATER FROM LAKE
HORSES _______
HOGS _______
CATTLE _______
SHEEP _______
OTHER _______
METHOD OF WATERING LIVESTOCK
DIRECT ACCESS TO LAKE
WATERING TANK
OTHER
COMMERCIAL FISH REARING
NUMBER OF FISH RAISED AND SOLD LAST YEAR
CATFISH __________
TROUT __________
CARP __________
OTHER __________
ARE FISH RAISED IN CONFINEMENT CAGES?
ARE FISH HARVESTED BY SEINING?
YES
NO
YES
NO
NAME OF PERSON FILLING OUT THIS QUESTIONNAIRE
DATE:
COMMENTS
MO 780-1765 (03-04)