Applications and Forms
Board of Control
Consumptive Use Worksheet - Please note that this worksheet is only to be used to calculate consumptive use values and may be attached to a consumptive use report. However, it does not replace an actual consumptive use report.
**To Edit, go to File > Save as Google Sheets.**
Petition Sample Forms
Amended Certificate - Blanket Petition
Change of POD and MOC pre 1965 Petition
Change of Well Location Petition
Voluntary Abandonment (GW) Petition
Voluntary Abandonment (SW) Petition
Board of Control Sample Petitions and Forms (pdf)
Field Administration Forms
Authorization to Detach Water Rights
Temporary Change in POD (Point of Diversion)
Application For Permit To Appropriate Ground Water: Form U.W. 5
Instructions for Completing U.W. 5
Filing an Enlargement of and Existing Water Right
Registering Existing Domestic and Stock Wells
Registering All Other Existing Wells
Change in Location of Well Without Loss of Priority When Ground Water Rights Have Been Adjudicated or Will Be Adjudicated
Statement of Completion and Description of Well or Spring: Form U.W. 6
Instructions for Completing Form U.W. 6
Licensed Water Well Drilling Contractors Required to Submit Form U.W. 6
Memorandum Requiring Necessary Reports From Licensed Water Well Drilling Contractors
Addendum to Statement of Completion Form
**Required 1) when a pump is replaced in a well, or 2) when a well is relocated or deepened, and the U.W. 6 Form is submitted prior to installation of the pump (i.e., the pump information must then be provided on the Addendum to Statement of Completion Form)
Proof of Appropriation and Beneficial Use of Ground Water: Form U.W. 8
Proof of Appropriation and Beneficial Use of Ground Water Pump Only: Form U.W. 8-P (Pump Information Only)
**Complete and submit this Form when the U.W. 6 Form was submitted without the pump information
Instructions for Completing Forms U.W. 8 and U.W. 8-P
Application To Relocate or Deepen an Existing Well: Form R&D-1
**Note: When a well is relocated or deepened a new U.W. 6 Form must be submitted. If a pump has not been installed in the well when the U.W. 6 Form is submitted, pump information must then be provided on an Addendum to Statement of Completion Form
Instructions for Relocating and/or Deepening a Domestic or Stock Well Only
Application to Deepen an Existing Well: Form U.W. 6-69
**This from may be used for all types of wells, but only when the quantity of water to be developed will not exceed the appropriative right and the use of water will not be increased or otherwise changed. This form is not to be used if the well is to be relocated. A Form U.W. 6, Statement of Completion and Description of Well or Spring, must be submitted to the State Engineer's Office within 30 days after completion of the well.
Temporary Water User Agreement - Ground Water Source: Water Use Agreement
**Request to allow a temporary change of use of a water right to occur for a maximum of two years.
Ground Water Monitoring Well Requirements
SW-1 Ditches, Pipelines, Waterhauls - This form is for permitting a new diversion from streams, including ditches, pipelines, and Temporary Water Hauls. ($50 filing fee) This form is also used for special application stock or domestic diversions from a stream not exceeding 25 gallons per minute. ($25 filing fee) Use Item 10 continuation to make item 10 tabulations prior to entering them on the SW-1 form. Instructions for Completing the SW1 application
SW-2 Enlargement of Ditches, Pipelines - This is the application used to enlarge an existing SW-1 facility. The enlargement may physically enlarge the facility to allow the diversion of more water by adding points of use (more lands) or it could just add uses to the existing facility. ($50 filing fee) Instructions for Completing the SW2 Application
SW-3 Reservoirs - (**download form before printing**) this form is used to permit new reservoirs or enlarge existing reservoirs. Reservoirs that qualify as Special Applications can use the 3A (see below) with the SW-3 form. Reservoirs that meet or exceed the minimum height and capacity requirements are subject to jurisdiction under the Safety of Dams law. See fee schedule Instructions for Completing the SW3 application
SW-3A Special Application Reservoirs -(**download form before printing**) This form can be used for all Special Application reservoirs in lieu of the general mapping requirements necessary for most SW-3 reservoirs. Special Application reservoirs include all facilities with a dam less than 20 feet high and a capacity of less than 20 acre-feet($25 filing fee) Instructions for Completing the SW3A application
SW-4 Stock Reservoirs - (**download form before printing**) This form is to be used with facilities having a dam less than 20 feet high and a capacity of less than 20 acre-feet for stock use only. ($25 filing fee) Instruction for Completing the SW4 application
SW-4A Stock Reservoir Multiple Points of Storage - This form is to accompany a SW-4 in cases where a pipeline extends from the stock reservoir to a stock tank or series of stock tanks.
Authorization To Correct The Record (no fee for filing)
ACR-1 (Petition for Authorization for Change of Location) -used to change the legal land description of a special application reservoir or stock reservoir
ACR-2 (Petition for Authorization to Correct Record) - used to change physical characteristics of a special application reservoir or stock reservoir
ACR-3 (Petition for Authorization to Change the Place of Storage) - used when the initial facility has completely silted in and the appropriator would like to transfer the storage immediately downstream to a new facility equal to or smaller in size.
Temporary Water Use Agreement - Surface Water Source - Request to allow a temporary change of use of a water right to occur for a max of two years.
Elimination Request - used to eliminate unadjudicated lands from a permit.
Consent to Enlarge Ditch - formal request for consent from co-appropriators of a ditch being enlarged.
Notice of Completion of Construction - use to inform that all the construction work has been completed.
Notice of Beneficial Use of Water - use to infom that the water has been put to the beneficial use outlined in the permit.
Reinstatement of Notice of Beneficial Use -Notarized - use this form when the expiration date has past, but Beneficial Use was completed before the expiration date.
Reinstatement of Notice of Completion - Notarized - use this form when the expiration date has past, but the facility was completed before the expiration date.
Allocation of Interest and Capacity of Reservoir - used in conjunction with a secondary Application to allocate a reservoir's capacity to specific acreages listed under that secondary.
Affidavit of Reservoir Ownership
Affidavit for Reservoir Reinstatement
Affidavit for Platte River Reservoir Exemptions