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Pumping Details. <br />Point of Taking: <br />County: <br />City: <br />1/4 1/4 1/4, Section ,Township ,Range <br />Estimated Pumping Rate: gallons per minute <br />Estimated Volume of Water to be Appropriated: <br />gallons <br />Start of Pumping (date): End of Pumping (date): <br />Point of discharge: <br />1/4 1/4 1/4, Section ,Township ,Range <br />Receiving Water (name and DNR ID # if applicable): <br />[ ] Stormsewer [ ]Basin [ ]Other (describe) <br />Written approval (if required) has been received from the appropriate authorities for the proposed <br />temporary appropriation: [ ]Watershed Management Organization [ ]County <br />[ ]Municipality [ ] 'T'ownship [ ] CA Authority <br />Applicant Signature <br />Area Hydrologist Authorization <br />[ ]See Attached Additional Conditions <br />Date: <br />Date: <br />FAX or mail this form and a map indicating the pump site anal discharge location to the Area <br />Hydrologist at least five days before the start of pumping. The authorization will be faxed. or mailed <br />within 5 working days of receipt by the Area Hydrologist. <br />c: Watershed Management Organization <br />County Soil and Water Conservation District <br />City <br />Area Conservation Officer <br />Central Waters Data Systems <br />Central Waters Appropriation Unit <br />