File Number:_________
(For OSE Use Only)
NEW MEXICO OFFICE OF THE STATE ENGINEER
APPLICATION FOR PERMIT FOR LIVESTOCK WATER IMPOUNDMENT
IN ACCORDANCE WITH SECTION 72-9-3 NEW MEXICO STATUTES
1. APPLICANT
Name:__________________________________ Work Phone:_______________
Contact:__________________________________ Home Phone:_______________
Mailing
Address:__________________________________
__________________________________
City:__________________________________ State:_______ Zip:________
2. LOCATION OF LIVESTOCK WATER IMPOUNDMENT (B, E and F optional)
A: ____¼ ____¼ ____¼ Section:______ Township:____ Range:____ N.M.P.M.
in ______________________ County
B. X = __________ feet, Y = __________ feet, N.M. Coordinate System
C. Latitude: _____________________ Longitude: _____________________
D. On land owned by: ______________________________________________
E. Tract No. __________ Map No. _______ of the ____________________
F. Other __________________________________________________________
3. DESCRIPTION OF LIVESTOCK WATER IMPOUNDMENT
A. Name of impoundment:____________________________________________
B. Name of watercourse:____________________________________________
Tributary of:___________________________________________________
C. State engineer administrative basin name:_______________________
D. Height of dam = __________feet, maximum depth = ____________feet,
surface area = ________acres, storage capacity = _______acre-feet
Height of spillway = ___________ feet
E. Other sources of water:__________________________________________
F. Type of stock:________________, amount of stock:_________________
Trn Desc:_________________________
File Number:__________________
Completion Due Date:______________
Trn Number:___________________
page: 1 of 4
File Number:_________
(For OSE Use Only)
NEW MEXICO OFFICE OF THE STATE ENGINEER
APPLICATION FOR PERMIT FOR LIVESTOCK WATER IMPOUNDMENT
IN ACCORDANCE WITH SECTION 72-9-3 NEW MEXICO STATUTES
4.
INFORMATION
______ Construct new livestock water impoundment
______ Increase capacity of existing livestock water impoundment
5. ADDITIONAL STATEMENTS OR EXPLANATIONS
ACKNOWLEDGEMENT FOR NATURAL PERSONS
I, _______________________ affirm that the foregoing statements are true to
(Please Print)
the best of my knowledge and belief, By:___________________________________
_____________________________________
Signature
___________________________________
Signature
Trn Desc:________________________
File Number:________________
Completion Due Date:_____________
Trn Number:_________________
page: 2 of 4
File Number:_________
(For OSE Use Only)
NEW MEXICO OFFICE OF THE STATE ENGINEER
APPLICATION FOR PERMIT FOR LIVESTOCK WATER IMPOUNDMENT
IN ACCORDANCE WITH SECTION 72-9-3 NEW MEXICO STATUTES
GENERAL CONDITIONS OF APPROVAL
1) The permittee shall utilize the highest and best technology available
to ensure conservation of water to the maximum extent practical.
2) No works may be constructed, modified or used except in accordance
with this permit.
SPECIFIC CONDITIONS OF APPROVAL
ACTION OF THE STATE ENGINEER
This application is approved for the use indicated, subject to all general
conditions and to the specific conditions listed above.
Witness my hand and seal this ______ day of _______ A.D., _________
John R. D’Antonio, Jr. P.E., State Engineer
By: _______________________________________
Trn Desc:________________________
File Number:________________
Completion Due Date:_____________
Trn Number:_________________
page: 3 of 4
File Number:_________
(For OSE Use Only)
NEW MEXICO OFFICE OF THE STATE ENGINEER
APPLICATION FOR PERMIT FOR LIVESTOCK WATER IMPOUNDMENT
IN ACCORDANCE WITH SECTION 72-9-3 NEW MEXICO STATUTES
INSTRUCTIONS
1.
The application shall be made in the name of the actual user of the livestock water
impoundment for the purpose specified in the application.
2.
The application shall be forwarded with a $10.00 filing fee to the New Mexico Office
of the State Engineer.
3.
A separate application must be filed for each livestock water impoundment to be
constructed or used.
4.
If the livestock water impoundment is located on state or federal land, proof of the
following must be included as part of the application: (a) applicant is legally
entitled to place his or her livestock on the land where the livestock water
impoundment is to be located, (b) applicant has been granted access to the
impoundment site and has permission to occupy the portion of the land as is
necessary to construct and use the livestock water impoundment.
5.
Application for livestock water impoundment, statement of completion and requests
for information in the following basins should be addressed to the New Mexico Office
of the State Engineer at the location indicated.
Bluewater, Estancia, Middle Rio Grande, Sandia, and Gallup underground
water basins and basin surface rights
District 1 – 5550 San Antonio Dr., NE,
Albuquerque, NM 87109-4127, Phone # 505-383-4000
Capitan, Carlsbad, Causey Lingo, Curry County, Fort Sumner, Hagerman Canal, Hondo,
Jal, Lea County, Peñasco, Portales, and Roswell Artesian, underground water basins
and basin surface rights
District 2 - 1900 West Second Street,
Roswell, NM 88201-1712, Phone # 575-622-6521
Animas, Cloverdale, Gila-San Francisco, Hatchita, Lordsburg, Mimbres, Mount Riley,
Nutt-Hockett, Playas, San Simon, Virden Valley and Yaqui underground water basins
and basin surface rights
District 3 - 301 South Tin, P.O. Box 844,
Deming, NM 88031-0844, Phone # 575-546-2851
Lower Rio Grande, Mount Riley, Tularosa, Hueco, Las Animas Creek, Hot Springs and
Salt underground water basins and basin surface rights
District 4 – 1680 Hickory Loop, Suite J
Las Cruces, NM 88005-6598, Phone # 575-524-6161
San Juan Underground Water Basin and San Juan Basin surface rights for San Juan,
Animas, and La Plata Rivers
District 5 - 100 Gossett Drive, Suite A
Aztec, NM 87410, Phone # 505-334-4571
Northern Rio Grande and Upper Pecos underground water basins and basin surface
rights
District 6 - Room 102, Bataan Memorial Building, P.O. Box 25102,
Santa Fe, NM 87504-5102, Phone # 505-827-6120
Clayton, Tucumcari and Canadian River underground water basins and basin surface
rights
District 7 – 301 East 9th Street
Cimarron, NM 87714, Phone # 575-376-2918
Trn Desc:_________________________
File Number:__________________
Completion Due Date:______________
Trn Number:___________________
page: 4 of 4