NeDNR Form COO-1 Notice of Change of Ownership/Water Resources Update Notice - Nebraska

NeDNR Form COO-1 or the "Notice Of Change Of Ownership/water Resources Update Notice" is a form issued by the Nebraska Department of Natural Resources.

Download a PDF version of the NeDNR Form COO-1 down below or find it on the Nebraska Department of Natural Resources Forms website.

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May 8, 2008
DNR Form COO-1
STATE OF NEBRASKA
DEPARTMENT OF NATURAL RESOURCES
NOTICE OF CHANGE OF OWNERSHIP/WATER RESOURCES UPDATE NOTICE
Name, address and telephone number of person to be shown as owner in Department records.
1.
FOR DEPARTMENT USE ONLY
Name(s) must be exactly as described on deed or other document transferring ownership of property.
Owner ID
Surface Water Appropriation(s) Changed:
Zip Code:
Telephone No.:
(
)
E-mail Address:
Alternate Contact Requests: If this box is checked, complete items 6-15 on the second page
Provide legal description of property. The description may be provided by attaching a copy of the deed or
2.
other documentation.
Ground Water Well Registration(s)
Changed:
I have attached a copy of the deed or document transferring ownership
Land is under contract purchase agreement; copy of agreement is enclosed.
3.
Name, address and telephone number of past owner or seller, if applicable.
Name(s) must be exactly as described on deed or other document transferring ownership of property.
This section must be filled out and signed if this form is being used to notify the Department regarding
a transfer of property within 60 days of the transfer in accordance with §76-2,124.
Zip Code:
Telephone No.:
(
)
E-mail Address:
Date
Signature of Past Owner - SELLER
4.
List surface water appropriation numbers, ground water well numbers and dam plan numbers if known. The Department’s records of ownership of surface water appropriations,
ground water wells, and dams may be changed based on the legal description provided in item 2.
a.
List surface water appropriation numbers:
b.
List ground water well registration numbers:
c.
List plan numbers for dams:
5.
The above information is true and accurate to the best of my knowledge.
Signature of Current Owner - BUYER (Or Representative With Proper Documentation)
Date
Return to:
State of Nebraska Department of Natural Resources
301 Centennial Mall South, P.O. Box 94676
Lincoln, Nebraska 68509-4676
Phone: (402) 471-2363
_ _ _ _ _ _ _ _ — _ _ _ _ _ _ — _ _ _ _
permits&registrations/surfacewater/forms 5/8/2008 10:30 AM
May 8, 2008
DNR Form COO-1
STATE OF NEBRASKA
DEPARTMENT OF NATURAL RESOURCES
NOTICE OF CHANGE OF OWNERSHIP/WATER RESOURCES UPDATE NOTICE
Name, address and telephone number of person to be shown as owner in Department records.
1.
FOR DEPARTMENT USE ONLY
Name(s) must be exactly as described on deed or other document transferring ownership of property.
Owner ID
Surface Water Appropriation(s) Changed:
Zip Code:
Telephone No.:
(
)
E-mail Address:
Alternate Contact Requests: If this box is checked, complete items 6-15 on the second page
Provide legal description of property. The description may be provided by attaching a copy of the deed or
2.
other documentation.
Ground Water Well Registration(s)
Changed:
I have attached a copy of the deed or document transferring ownership
Land is under contract purchase agreement; copy of agreement is enclosed.
3.
Name, address and telephone number of past owner or seller, if applicable.
Name(s) must be exactly as described on deed or other document transferring ownership of property.
This section must be filled out and signed if this form is being used to notify the Department regarding
a transfer of property within 60 days of the transfer in accordance with §76-2,124.
Zip Code:
Telephone No.:
(
)
E-mail Address:
Date
Signature of Past Owner - SELLER
4.
List surface water appropriation numbers, ground water well numbers and dam plan numbers if known. The Department’s records of ownership of surface water appropriations,
ground water wells, and dams may be changed based on the legal description provided in item 2.
a.
List surface water appropriation numbers:
b.
List ground water well registration numbers:
c.
List plan numbers for dams:
5.
The above information is true and accurate to the best of my knowledge.
Signature of Current Owner - BUYER (Or Representative With Proper Documentation)
Date
Return to:
State of Nebraska Department of Natural Resources
301 Centennial Mall South, P.O. Box 94676
Lincoln, Nebraska 68509-4676
Phone: (402) 471-2363
_ _ _ _ _ _ _ _ — _ _ _ _ _ _ — _ _ _ _
permits&registrations/surfacewater/forms 5/8/2008 10:30 AM
May 8, 2088
DNR Form COO-1
Page 2
ALTERNATE CONTACT REQUEST (Optional)
Complete information below only if Alternate Contact Request box is checked in item 1.
6.
This is a request to add an alternate contact to the file for:
Surface Water Appropriation Nos.:
Ground Water Well Registration Nos.:
Dam Nos.:
7.
Name, Address and Telephone Number of Alternate Contact:
8.
Alternate Contact is Tenant, Farm Manager,
Attorney, etc. Please explain.
Zip Code:
Telephone No.
(
)
E-mail Address:
9.
Name, Address and Telephone Number of Alternate Contact:
10.
Alternate Contact is Tenant, Farm Manager,
Attorney, etc. Please explain.
Zip Code:
Telephone No.
(
)
E-Mail Address:
11.
Name, Address and Telephone Number of Alternate Contact:
12.
Alternate Contact is Tenant, Farm Manager,
Attorney, etc. Please explain.
Zip Code:
Telephone No.
(
)
E-Mail Address:
13.
Name, Address and Telephone Number of Alternate Contact:
14.
Alternate Contact is Tenant, Farm Manager,
Attorney, etc. Please explain.
Zip Code:
Telephone No.
(
)
E-mail Address:
15.
I/We,
,
give the Department of Natural Resources permission to provide copies of all correspondence, regulation notices, and orders to the
above-mentioned party(ies) for matters concerning this appropriation, registration or dam.
Reminder: Please sign and date on page 1.
Return to: State of Nebraska Department of Natural Resources
301 Centennial Mall South, P.O. Box 94676
Lincoln, Nebraska 68509-4676
Phone: (402) 471-2363

Download NeDNR Form COO-1 Notice of Change of Ownership/Water Resources Update Notice - Nebraska

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