NeDNR SW Form 100-E "Application to Renew a Temporary Change of Location of Use and Purpose of Appropriation to Augment the Flow in a Specific Stream Reach for a Privately Held Water Appropriation" - Nebraska

What Is NeDNR SW Form 100-E?

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 August 1, 2016;
  • 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;
  • Fill out the form in our online filing application.

Download a fillable version of NeDNR SW Form 100-E 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 100-E "Application to Renew a Temporary Change of Location of Use and Purpose of Appropriation to Augment the Flow in a Specific Stream Reach for a Privately Held Water Appropriation" - Nebraska

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August 2016
DNR SW Form #100-E
Page 1
STATE OF NEBRASKA
DEPARTMENT OF NATURAL RESOURCES
APPLICATION TO RENEW A TEMPORARY CHANGE OF LOCATION OF USE AND
PURPOSE OF APPROPRIATION TO AUGMENT THE FLOW IN A SPECIFIC STREAM REACH
FOR A PRIVATELY HELD WATER APPROPRIATION
FOR DEPARTMENT USE ONLY
Filed in the office of the Department of Natural Resources
1.
Name and Address of Appropriator of Record:
at
a.m. / p.m.
on
,
20
Mod. No. TRL-
App No.
Zip Code:
Telephone No.: (
)
Original Transfer Mod No.
Cell Phone No.: (
)
Water Division
e-mail address:
Receipt No.
Amount
2.
Name and Address of each mortgage holder or deed of trust holder for land now under permit.
(If more than one, please use DNR form 962-4)
Zip Code:
Telephone Number:
(
)
Cell Phone Number:
(
)
e-mail address:
3.
List the water appropriation number that this application is proposed to modify:
4.
List the current water use contracts (CREP, EQIP, etc.):
5.
List the original transfer number (if known):
6.
a)
Date original transfer began: ___________________________________
b)
Date original transfer ends: ___________________________________
c)
Length of original transfer (years): _____________________________
7.
a)
Date requested for transfer renewal end: _________________________
b)
Requested length of transfer renewal (years): _____________________
8.
If Lease is involved, attach a copy of lease agreement or document that lists all parties involved and the intent of the lease.
Acknowledgement by Landowner
9.
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. I have initialed and dated all addendums and attachments to this transfer. I certify that all conditions of the original
transfer remain in effect and only seek to extend the length of the transfer. I agree to pay for the cost that may be incurred in the processing and
approval of this application:
Date
Signature of Appropriator of Record (Or Representative with Proper Documentation)
Submit this application with a $10.00 filing fee to:
Nebraska Department of Natural Resources
P.O. Box 94676
Lincoln, Nebraska 68509
(402) 471-2363
August 2016
DNR SW Form #100-E
Page 1
STATE OF NEBRASKA
DEPARTMENT OF NATURAL RESOURCES
APPLICATION TO RENEW A TEMPORARY CHANGE OF LOCATION OF USE AND
PURPOSE OF APPROPRIATION TO AUGMENT THE FLOW IN A SPECIFIC STREAM REACH
FOR A PRIVATELY HELD WATER APPROPRIATION
FOR DEPARTMENT USE ONLY
Filed in the office of the Department of Natural Resources
1.
Name and Address of Appropriator of Record:
at
a.m. / p.m.
on
,
20
Mod. No. TRL-
App No.
Zip Code:
Telephone No.: (
)
Original Transfer Mod No.
Cell Phone No.: (
)
Water Division
e-mail address:
Receipt No.
Amount
2.
Name and Address of each mortgage holder or deed of trust holder for land now under permit.
(If more than one, please use DNR form 962-4)
Zip Code:
Telephone Number:
(
)
Cell Phone Number:
(
)
e-mail address:
3.
List the water appropriation number that this application is proposed to modify:
4.
List the current water use contracts (CREP, EQIP, etc.):
5.
List the original transfer number (if known):
6.
a)
Date original transfer began: ___________________________________
b)
Date original transfer ends: ___________________________________
c)
Length of original transfer (years): _____________________________
7.
a)
Date requested for transfer renewal end: _________________________
b)
Requested length of transfer renewal (years): _____________________
8.
If Lease is involved, attach a copy of lease agreement or document that lists all parties involved and the intent of the lease.
Acknowledgement by Landowner
9.
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. I have initialed and dated all addendums and attachments to this transfer. I certify that all conditions of the original
transfer remain in effect and only seek to extend the length of the transfer. I agree to pay for the cost that may be incurred in the processing and
approval of this application:
Date
Signature of Appropriator of Record (Or Representative with Proper Documentation)
Submit this application with a $10.00 filing fee to:
Nebraska Department of Natural Resources
P.O. Box 94676
Lincoln, Nebraska 68509
(402) 471-2363