BEFORE THE STATE ENGINEER OF THE STATE OF NEVADA
APPLICATION FOR EXTENSION OF TIME TO PREVENT A FORFEITURE FOR IRRIGATION
Name of person signing this form
who after being first duly sworn and answering to the best of his/her knowledge the following questions in compliance with the requirements as set forth in the Certificate of Claim:
3. Nevada Division of Water Resource's (NDWR) Owner(s) of Record on file in the office of the State Engineer:
b. If "No" on Question 4a is checked, on whose behalf is this extension being filed?
6. Give date when the last full beneficial use occurred?
8. Explain in detail the reason for non-use:est for an extension of time is needed.
9. Describe the progress made during the past year as compared to previous years to resume beneficial use.
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 CERTIFICATE OR CLAIM.