Lake Michigan Water Allocation - Application for Permit - Illinois

This Illinois-specific "Lake Michigan Water Allocation - Application for Permit" is a document released by the Illinois Department of Natural Resources.

Download the fillable PDF by clicking the link below and use it according to the applicable legal guidelines.

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LAKE MICHIGAN WATER ALLOCATION – APPLICATION FOR PERMIT
Office of Water Resources, Michael A. Bilandic Building, 160 N. LaSalle Street, Suite S-700, Chicago, Illinois 60601
Office: 312/793-3123
Fax: 312/793-5968
Completing this Application for Permit for a Lake Michigan Water allocation is required under Illinois law (615
ILCS 50/5) and is the first step in the Department’s Lake Michigan water allocation process. All water
demand/usage amounts should be shown in units of million gallons per day (mgd). Our water year begins
October 1 and ends on September 30. Do not include any water which is sold or transferred to any other water
distribution system unless expressly indicated otherwise in this application. Please complete/answer all of the
questions in this application form. The completed application can be submitted to the Illinois Department of
Natural Resources, Office of Water Resources, Michael A. Bilandic Building, 160 N. LaSalle Street, Suite S-
700, Chicago, Illinois 60601.
SECTION I – GENERAL INFORMATION
Name, address, phone number and email of applicant:
Names, address, phone number and email of the contact person for the applicant:
Authorized Official
Name:
Title:
Date
Subscribed and sworn to before me this
day of
, 20
Notary Public
(Seal)
LAKE MICHIGAN WATER ALLOCATION – APPLICATION FOR PERMIT
Office of Water Resources, Michael A. Bilandic Building, 160 N. LaSalle Street, Suite S-700, Chicago, Illinois 60601
Office: 312/793-3123
Fax: 312/793-5968
Completing this Application for Permit for a Lake Michigan Water allocation is required under Illinois law (615
ILCS 50/5) and is the first step in the Department’s Lake Michigan water allocation process. All water
demand/usage amounts should be shown in units of million gallons per day (mgd). Our water year begins
October 1 and ends on September 30. Do not include any water which is sold or transferred to any other water
distribution system unless expressly indicated otherwise in this application. Please complete/answer all of the
questions in this application form. The completed application can be submitted to the Illinois Department of
Natural Resources, Office of Water Resources, Michael A. Bilandic Building, 160 N. LaSalle Street, Suite S-
700, Chicago, Illinois 60601.
SECTION I – GENERAL INFORMATION
Name, address, phone number and email of applicant:
Names, address, phone number and email of the contact person for the applicant:
Authorized Official
Name:
Title:
Date
Subscribed and sworn to before me this
day of
, 20
Notary Public
(Seal)
SECTION II – REQUESTED LAKE MICHIGAN WATER ALLOCATION
The applicant applies for a permit to use Lake Michigan Water in the following amounts for the years listed
below (all requests should extend out to the year 2030):
Water
Amount
Water
Amount
Year
(mgd)
Year
(mgd)
SECTION III – HISTORIC WATER USE
A. HISTORIC WATER USE BREAKDOWN
List the total historic water usage (mgd) for at least 10 consecutive prior years (if available) from the
date of the application and the contribution of each water source to that total. All amounts should be in
million gallons per day (mgd).
Water
Total
Lake
Deep
Shallow
Year
Water Use
Michigan
Aquifer
Aquifer
Other
B. TYPE OF HISTORIC WATER USE
Based on Total Historic Water Usage figures tabulated in Section III A, indicate the type of historic
water usage (mgd) as shown below. If the data is estimated, indicate with an asterisk (*). Population
should reflect census figures when applicable. Data should be shown for a minimum of 10 years prior
to the date of the application.
Water
Residential
Commercial
Manufacturing
Year
Water Use
Water Use
Water Use
Population
SECTION IV – PROJECTED WATER DEMAND
A. PROJECTED TOTAL WATER DEMAND BREAKDOWN
List the projected water demand (mgd) and projected contribution (mgd) of each water source to the
total water demand out to the year 2030.
Water
Total
Lake
Deep
Shallow
Other
Year
Demand
Michigan
Aquifer
Aquifer
Source

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