45-521

45-521. Permit application form; filing;
contents

Application for a permit to withdraw groundwater pursuant to this article shall be
made on a form provided by the director which shall include the following information:

1. The name and mailing address of the applicant.

2. The name of the active management area and sub-basin, if any, in which the
applicant proposes to withdraw groundwater.

3. The name and mailing address of the owner of the land from which the applicant
proposes to withdraw groundwater.

4. The legal description of the land on which the applicant proposes to use
groundwater and the name and mailing address of the owner of such land.

5. The category of permit for which application is made.

6. The specific purpose for which the groundwater will be withdrawn.

7. If for a permit other than a permit issued under section 45-519.01, subsection
B, the annual amount of groundwater, in acre-feet, for which application is made.

8. If the applicant proposes to withdraw groundwater from an existing well or
wells, the location of each such well and the depth and diameter of each well and such
other information the director requires.

9. If the applicant proposes to withdraw groundwater from a new well or wells, the
proposed location of each such well and the depth and diameter proposed for each well and
such other information the director requires.

10. If application is made for a dewatering permit pursuant to section 45-513:

(a) The estimated amount of groundwater necessary to meet mineral extraction and
metallurgical processing requirements of the applicant.

(b) The estimated amount of groundwater necessary for municipal and industrial
needs of communities and residential areas directly related to the mineral extraction and
metallurgical processing operation of the applicant.

(c) The legal description of the acres of land owned or controlled by the applicant
entitled to the use of groundwater for irrigation.

11. If application is made for a mineral extraction and metallurgical processing
permit pursuant to section 45-514:

(a) The amount of groundwater available to the applicant under a dewatering permit
previously obtained by the applicant.

(b) The estimated cost the applicant would incur in withdrawing groundwater at a
point where his wellhead or distribution system would otherwise be.

12. Whether the well from which the water will be withdrawn is in a groundwater
replenishment district.

13. If application is made for a general industrial use permit pursuant to section
45-515:

(a) The estimated cost the applicant would incur in withdrawing groundwater at the
point where his wellhead or distribution system would otherwise be.

(b) Proof of denial of service or inaction on a service request by a city, town or
private water company if the location of the applicant's intended use is within three
miles of the exterior boundaries of the service area of such city, town or private water
company. Such evidence is not required for an expanded animal industry use.

(c) Studies satisfactory to the director of the probable hydrologic impact on the
groundwater resources which the applicant proposes to use including evidence of the
availability of an assured water supply for the intended use.

14. If application is made for a temporary dewatering permit pursuant to section
45-518, evidence demonstrating that a temporary dewatering permit is necessary for the
construction or structural integrity of improvements on the land from which the
groundwater is proposed to be withdrawn. If application is made for extension of a
temporary dewatering permit, the application shall include evidence demonstrating that
the criteria prescribed by section 45-518, subsection B exist. If application is made
for an emergency temporary dewatering permit, it must be accompanied by an application
for a temporary dewatering permit and shall include evidence demonstrating that the
criteria prescribed by section 45-518, subsection D exist.

15. If application is made for a drainage water permit pursuant to section 45-519:

(a) Evidence that drainage of irrigated lands is necessary for a reasonable
economic return from agricultural production on such lands.

(b) The legal description of the acres of land entitled to the use of groundwater
for irrigation.

(c) Evidence that the applicant owns or controls the irrigated land to be drained,
if the applicant is other than a groundwater replenishment district.

16. If application is made for a hydrologic testing permit pursuant to section
45-519.01, subsection A:

(a) The purpose of the hydrologic testing.

(b) The proposed duration of the hydrologic testing.

17. If application is made for a hydrologic testing permit pursuant to section
45-519.01, subsection B:

(a) The purpose of the hydrologic testing.

(b) The proposed duration of the hydrologic testing.

(d) If the total amount of groundwater for which application is made exceeds ten
acre-feet or the proposed duration of the hydrologic testing exceeds ninety days, the
testing circumstances that require such withdrawals or such a testing period.

18. A sworn statement that the information contained in the application is true and
correct to the best belief and knowledge of the applicant.

19. Any other information which the director may require.