BEFORE THE FEDERAL ENERGY REGULATORY COMMISSION
NOTICE OF INTENT TO CONSTRUCT QUALIFYING CONDUIT HYDROPOWER FACILITY
[Name of applicant] applies to the Federal Energy Regulatory Commission for a determination that the [facility name] is a qualifying conduit hydropower facility, meeting the requirements of section 30(a) of the Federal Power Act, as amended.
The location of the facility is:
State or Territory: _______________________________
County: _______________________________
Township or nearby town: _______________________________
Water source: _______________________________
The exact name and business address of the applicant(s) are:
Applicant's Name: _______________________________
Address: _______________________________
Telephone Number: _______________________________
Email Address: _______________________________
The exact name and business address of each person authorized to act as an agent for the applicant(s) in this notice of intent are:
Name of Agent: _______________________________
Address: _______________________________
Telephone Number: _______________________________
Email Address: _______________________________
[Name of applicant] is [a citizen of the United States, an association of citizens of the United States, a municipality, State, or a corporation incorporated under the laws of (specify the United States or the state of incorporation), as appropriate].
The [facility name] will use the hydroelectric potential of a non-federally owned conduit.
The [facility name] has not been licensed or exempted from the licensing requirements of Part I of the FPA, on or before August 9, 2013, the date of enactment of the Hydropower Regulatory Efficiency Act.
This (notice of intent to construct, etc.) is executed in the:
State of: _______________________________
County of: _______________________________
by:
(Name) _______________________________
(Address) _______________________________
being duly sworn, depose(s) and say(s) that the contents of this (notice of intent to construct, etc.) are true to the best of (his or her) knowledge or belief. The undersigned applicant(s) has (have) signed the (notice of intent to construct, etc.) this __________day of ____________, 20____.
By: _______________________________
Subscribed and sworn to before me, a ____________ [Notary Public, or title of other official authorized by the state to notarize documents, as appropriate] of the State of ____________this day of ____________, 20____.
/SEAL/[if any]
_______________________________
(Notary Public, or other authorized official)
_______________________________
(Signature)
18 C.F.R. §4.401