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DESCRIPTION OF PROPOSED WORKS * ____ Water t o be d iv e rte d by a d r i l l e d w e ll, empounded In a------------- State manner in which water is to be diverted, whether by aam or other works, whether through pipes, ditches, flumes, or other conduits. I f water ____ r e s e r v o ir o f ?3 »S50 S a le , capacit y and d is t r ib u t e d by a ------- is to be stored in reservoirs, it should be so stated and the location o it h e reservoir should be given with reference to the legal subdivisions. ____ system o f d itc h e r,------------------------------------------------------------------------------- 5. Estimated cost of works $12,000-00------------------- 6. Estimated time required to construct works— 6 Months 7 7. Remarks________________________________________________ F or use o f applicant This sheet inspected. , Engineer. OF STATE ENGINEER This is to certify that I have examined the foregoing application, and do hereby grant the same, subject to the following limitations and conditions: The amount of water to be appropriated shall be limited to the amount which can be applied to beneficial use, and not to exceed--------------- cubic feet per second. Actual construction work shall begin on or before---------------------- — Proof of commencement of work shall be filed before---------------------- Work must be prosecuted with reasonable diligence and be completed on or before_____ ______ )-------- ----------- Proof of completion of work shall be filed before------------------------ Application of water to beneficial use shall be made on or before------- _____________ ________. Proof of the application of water to beneficial use must be filed with State Engineer on or before----------------------- WITNESS MY HAND AND SEAL this_________ day of----------:------ , ------- State Engineer.