1413STATE OF CALIFORNIA
STATE WATER RIGHTS BOARD
P. O. BOX 1592
SACRAMENTO 7, CALIFORNIA
Receipt
N? 12886
Received- ($
❑ Cash ❑ Money Order ®. Check (Receipt contingent upon collection) DEC 1 1960
E
Were *Ater Go.
Via 220d Street
oments 1b ,Califitxraa
Re UATE-p$-1$0
❑ Deposit ❑
Recordation Fee $___—________
Verification—Fee
Expense
❑ Uncleared Collections
❑ Application
❑ Proof of Claim
❑ Adjudication Apportionment
p Verification Advance
❑ Other
FORM 300
47168 11-86 2OM QUIN 0 SPO
Balance D Full
Application No $ _
Permit Fee
Permit Extension Fee �
Petition Fee' $_______
Additional Fee on Charges
Copying—Comparing
Proof of Claim Fee $-------
Adjudication Apportionment
Refund—Verification
Other
Certification Fee.
STATE WATER RIGHTS BOARD
LESLIE C. JOPSON, Chief Engineer
By
Title
41, 411
PETITION FOR CHANGE IN PLACE OF USE'
Attach $10.00 filing fee with petitions for changes
Application 18038 Permit License
State Water Rights Board
1401 - 21st Street
Sacramento, California
Gentlemen:
We
Xt hereby request permission to change the place of use as described in the
above -numbered filing to a place described as follows and as shown on the map here-
with submitted:
For description of new place of use see attachment.
(Give acreage to be irrigated within each 40 -acre tract
GIVE REASON FOR PROPOSED CHANGE: Area planned to be subdivided and served
.has been enlarged.
WILL THE OLD PLACE OF USE BE ABANDONED? Included in new lace of use
Answer Yes or No
WATER WILL BE USED FOR Domestic PURPOSES.
control the place of use proposed by virtue of It is wj:thin the
existing oryroposed public utility service area.
(Ownership, lease, agreement)
This change does not involve the introduction of any new source or any in-
crease in the amount of the appropriation.
The persons affected by or interested in the proposed change are as follows:
None
(Name) •
/1- 21- 6 d
(Date)
(Address
c t Ver trulyy yours
N, WATER COMP
By r �Yresidentl ,(signature)
Chapter 254, Statutes of 1955 requires a $10.00 filing fee with petition for changes
Form 105 r _
8-11-60
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