BEFORE THE STATE ENGINEER OF THE STATE OF NEVADA
APPLICATION FOR EXTENSION OF TIME FOR FILING PROOF OF COMPLETION OF WORK
Name of person signing this form
4. Current owner(s) of record in the Nevada Division of Water Resources (NDWR):
If "Yes", when was the Report of Conveyance filed with NDWR?
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a. If the permit has multiple owners, on whose behalf is this application being filed?
Name(s) of owners for which this application is filed
8. If requesting more than one year for extension of time, please state the reason for requesting multiple years.
If "Yes", please describe the diversion works.
If "Yes", please describe the totalizing meter or measuring device.
15. Describe what work must be completed before water can be diverted under the terms of the permit.
16. Describe the progress made during the previous year(s) and explain why this request for an extension of time is needed.
17. Describe your plans for the next year(s) towards completing your Proof of Completion of Work.
YOU WILL BE PROMPTED FOR A $120 FILING FEE PER YEAR REQUESTED IN THIS APPLICATION FOR EXTENSION OF TIME.
A SEPARATE APPLICATION MUST BE FILED FOR EACH PERMIT.