NeDNR SW Form API-001 "Application for a Permit to Impound Water" - Nebraska

What Is NeDNR SW Form API-001?

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

Form Details:

  • Released on December 1, 2011;
  • The latest edition provided by the Nebraska Department of Natural Resources (Surface Water);
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of NeDNR SW Form API-001 by clicking the link below or browse more documents and templates provided by the Nebraska Department of Natural Resources (Surface Water).

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Download NeDNR SW Form API-001 "Application for a Permit to Impound Water" - Nebraska

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DNR SW Form API-001
December 2011
Page 1 of 2
STATE OF NEBRASKA
DEPARTMENT OF NATURAL RESOURCES
APPLICATION FOR A PERMIT TO IMPOUND WATER
INSTRUCTIONS
For Department Use Only
Filed in the office of the Department of
Refer to second page of this form for fees, plans and filing requirements.
Complete Items 1 through 11 by typing or printing in ink the appropriate information required.
Natural Resources at
a.m./p.m.
This form must be completed in full.
on
, 20
An incomplete or defective application will be returned with 90 days being allowed for
resubmission. Failure to resubmit a corrected application within this time period shall cause
Application No.
dismissal of the application and consequent loss of priority and fees.
Plan No.
1. Name, address and telephone number of owner of land under proposed project. Names must
Water Division
be exactly as described on the deed or document transferring ownership of property. Application
must be signed by owner.
Receipt No.
Amount
Title 457
Title 458
Zip Code: _______________
Telephone No.: (______) ____________________________
E-mail Address: _______________________________________________________________
2. Name, address and telephone number of applicant if other than landowner.
3. State the purpose for water storage:
(i.e., irrigation, livestock, erosion control)
_________________________________
_________________________________
Zip code
Telephone No.: (
)
E-mail address:
_________________________________
4. Identify the source of water (name of stream):
Name adopted for proposed reservoir or pit:
________________________________________________________
_______________________________________________________
5. State the approximate quantity of water to be impounded: ____________________________________________ acre-feet.
6. Identify the location of the proposed reservoir or pit: County _________________________________________________.
¼
¼
Section
, Township
North, Range
E
W
7. State the approximate date construction will be completed: __________________________________________________________
(Applicant should be aware that failure to begin the construction by date set in Order of Approval will cause cancellation of all rights granted.)
8. State the approximate date water will first be impounded: ___________________________________________________________.
9. If a canal or pipeline is required to convey water to the proposed reservoir or pit, identify the supply canal headgate or pipeline pump
site location: County ________________________________________________________________.
¼
¼
Section
, Township
North, Range
E
West
DNR SW Form API-001
December 2011
Page 1 of 2
STATE OF NEBRASKA
DEPARTMENT OF NATURAL RESOURCES
APPLICATION FOR A PERMIT TO IMPOUND WATER
INSTRUCTIONS
For Department Use Only
Filed in the office of the Department of
Refer to second page of this form for fees, plans and filing requirements.
Complete Items 1 through 11 by typing or printing in ink the appropriate information required.
Natural Resources at
a.m./p.m.
This form must be completed in full.
on
, 20
An incomplete or defective application will be returned with 90 days being allowed for
resubmission. Failure to resubmit a corrected application within this time period shall cause
Application No.
dismissal of the application and consequent loss of priority and fees.
Plan No.
1. Name, address and telephone number of owner of land under proposed project. Names must
Water Division
be exactly as described on the deed or document transferring ownership of property. Application
must be signed by owner.
Receipt No.
Amount
Title 457
Title 458
Zip Code: _______________
Telephone No.: (______) ____________________________
E-mail Address: _______________________________________________________________
2. Name, address and telephone number of applicant if other than landowner.
3. State the purpose for water storage:
(i.e., irrigation, livestock, erosion control)
_________________________________
_________________________________
Zip code
Telephone No.: (
)
E-mail address:
_________________________________
4. Identify the source of water (name of stream):
Name adopted for proposed reservoir or pit:
________________________________________________________
_______________________________________________________
5. State the approximate quantity of water to be impounded: ____________________________________________ acre-feet.
6. Identify the location of the proposed reservoir or pit: County _________________________________________________.
¼
¼
Section
, Township
North, Range
E
W
7. State the approximate date construction will be completed: __________________________________________________________
(Applicant should be aware that failure to begin the construction by date set in Order of Approval will cause cancellation of all rights granted.)
8. State the approximate date water will first be impounded: ___________________________________________________________.
9. If a canal or pipeline is required to convey water to the proposed reservoir or pit, identify the supply canal headgate or pipeline pump
site location: County ________________________________________________________________.
¼
¼
Section
, Township
North, Range
E
West
DNR SW Form API-001
July 2011
Page 2 of 2
10. Will this project be constructed under a federal program, receive federal funding, or have federal planning assistance?
No
Yes
If Yes, explain:
11. I certify that I am familiar with the information contained in this application, and that to the best of my knowledge and belief such
information is true, complete and accurate.
Date
Signature of Owner (Or Owner’s Authorized Agent with Proper Documentation)
FEES FOR APPLICATIONS TO IMPOUND WATER
A non-refundable filing fee payable to DNR must accompany this application.
Quantity of Water Stored ....................................................................... Cost
FORWARD THIS APPLICATION AND APPLICABLE FEES TO:
0-5,000 acre-feet ...................................................................................... $25
State of Nebraska
Each additional 5,000 acre-feet ............................................................... $10
Department of Natural Resources
or fraction thereof
301 Centennial Mall South / P.O. Box 94676
Lincoln, Nebraska 68509
(402) 471-2363
SUMMARY OF FILING REQUIREMENTS
Department of Natural Resources Rules of Surface Water, Title 457, Neb. Admin. Code is abbreviated in the chart below as “Title 457” and is on the website at:
(http://dnr.nebraska.gov/media/SurfaceWaterRights/PDFs/Title_457_0608.pdf)
If project is subject to Title 457 Neb. Admin. Code, submit this application, with applicable fees.
For structures not subject to Title 458 Neb. Admin. Code (see below), but subject to Title 457 Neb. Admin. Code, a project map as described in Title 457 Neb. Admin. Code,
Chapter 11 must be submitted.
Department of Natural Resources Rules of Safety of Dams & Reservoirs , Title 458, Neb. Admin. Code is abbreviated in the chart below as “Title 458” and is on the
website at: (http://dnr.nebraska.gov/media/DamSafety/pdf/Title_458_1008.pdf)
See Dam Safety Approval flow chart (http://dnr.nebraska.gov/media//DamSafety/pdf/StoragePermit.pdf) to see if project is subject to Title 458, Neb. Admin. Code.
Engineering drawings and specifications for proposed projects subject to Title 458 must be submitted within 6 months of the filing of this application and must be submitted
with completed Application of Approval of Plans for Dams (http://dnr.nebraska.gov/Media/DamSafety/pdf/DamApprovalForm0708.pdf).
For projects completed prior to September 4, 2005, and are subject to Title 458 engineering drawings and specifications must be submitted with an Application for Approval
of Plans for Dams (http://dnr.nebraska.gov/media/DamSafety/pdf/PlansforExistingFarmPondDam.pdf) at the time of filing this application.
Filing Requirements for Existing Dam
Category of Dam
Filing Requirements for Proposed Dam
FEES
Built Prior to 09-04-2005
15 AF Normal Storage
Application for a Permit to Impound Water
Application for a Permit to Impound Water
Impound Application Fee
And Subject to Title 458
Plan Review Fee at
(API-001)
(API-001)
Application for Approval of Plans for Dams
Application for Approval of Plans for Dams
time of Plan submittal
Plans & Specifications in accordance with
Plans & Specifications in accordance with
Title 458 must be filed within 6 months of
Title 458, Chapter 5, must be filed
filing Application to Impound
concurrently with Application to Impound
Deed for property
Deed for property
15 AF Normal Storage
Application for a Permit to Impound Water
Application for a Permit to Impound Water
Impound Application Fee
And Not Subject to Title 458
(API-001)
(API-001)
Map in accordance with Title 457
Map in accordance with Title 457
must be filed within 6 months of
must be filed within 6 months of
Approval of Permit to Impound
Approval of Permit to Impound
<
15 AF Normal Storage
Application for a Permit to Impound Water
Application for a Permit to Impound Water
Impound Application Fee
And Not Subject to Title 458 But
(API-001)
(API-001)
Subject to Neb.Rev.Stat. 46-241
Map in accordance with Title 457
Map in accordance with Title 457
must be filed within 6 months of
must be filed within 6 months of
Approval of Permit to Impound
Approval of Permit to Impound
<
15 AF Normal Storage
Plans & specification in accordance with
Plans & Specifications in accordance with
Plan Review Fee at
And Subject to Title 458
Title 458
Title 458
time of Plan submittal
Application for Approval of Plans for Dams
Application for Approval of Plans for Dams
Deed for property
Deed for property
No Impound Form (API-001) required
● No Impound Form (API-001) required
(Neb. Rev. Stat. 46-241)
(Neb. Rev. Stat. 46-241)
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