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BEFORE THE STATE ENGINEER OF THE STATE OF NEVADA In t h b M a t t e r o f A p p l i c a t i o n N o ......................................................................... Fil e d b y ............... ;............................................................................................................ - A p p r o p r ia t e t h e W a t e r s o f ....................................................................................... (Source) APPLICATION FOR EXTENSION OF TIME V St a t e o f .................... C o u n t y o f ................. Comes now........... under Application No. That due to..........i...... SS. ., the___________ _________________ (Permittee or Agent) , who, after being first duly sworn, deposes and says: (Give reasons why extension o f time is necessary) I have been unable to comply with provisions of said permit. Wherefore permittee requests an extension of time of.....................— -—.................................... within which to file proof * (Not to exceed one year) 0f...................................................................| and comply with the provisions of said permit. (Include map if required) Signed.............................................................................................................. Address........................................................................——........ -.................. — Subscribed and sworn to before me this .................day of...................................... . 19----- - Notary Public in and for the County of ...................................State of.---------------- My Commission expires................................ $5 FILING FEE MUST ACCOMPANY THIS APPLICATION FOR EXTENSION OF TIME. AN APPLICATION SHOULD BE FILED FOR EACH SEPARATE PERMIT TO APPROPRIATE WATER