Purpose: This form is used in conjunction with an Application for Permit to Drill and Produce Water for applicants requesting greater than 500 acre-feet per year from well(s) that are in the District. Information provided on this form is intended to aid in the evaluation of the effects of the quantity and quality of groundwater in the District resulting from such a withdrawal. All wells produced by the applicant should be identified on this form.

Please fill out the form below and submit: