a. CERTIFICATE OF ENGINEER OR SURVEYOR - All maps filed in the office of the State Engineer must bear a certificate signed by a professional engineer or land surveyor who is licensed to practice in Wyoming. The following formats may be used as guides for such certificates: - - - - CERTIFICATE OF ENGINEER OR SURVEYOR STATE OF WYOMING ) ) SS. COUNTY OF ________________ ) I, _______________________________________________of_____________________________________ hereby certify that this map was made from notes taken during an actual survey made by me on________________, 19 ___, (or made on ______________ , 19____, under my direction by____________ ___________, for whose work I stand personally responsible); and that it correctly represents the proposed facility, the location and area of the lands proposed to be irrigated (or point of use) in each subdivision, and the location of streams, as described in the accompanying application. (Signed)___________________________ (Engineer or Surveyor) Wyoming Registration No.____________ (Indicate -- PE and/or LS) NOTE: The certificate should also credit the use of information obtained from other sources where other sources are used. Care should be taken that certification indicates the source of all information shown on the map. CERTIFICATE. OF ENGINEER OR SURVEYOR STATE OF WYOMING ) ) SS. COUNTY OF _____________ ) I,_____________________________________________________________ of________________________________________________________hereby certify that this map was made from notes taken during an actual Survey made by me on _____________________, 19_____, (or made on __ ___________, 19_____, under my direction by________________ ____________, for whose work I stand personally responsible); and that it correctly represents the proposed reservoir dam location, contours, spillway, outlet, and capacity, as described In the accompanying application. (Signed)_____________________________ (Engineer or Surveyor) Wyoming Registration No.____________, ---- (Indicate -- PE and/or LS) NOTE: The certificate should also credit the use of information obtained from other sources where other sources are used. Care should be taken that certification indicates the source of all information shown on the map.
b. ASSIGNMENT OF PERMIT -- When a permit or an interest therein is transferred or assigned, the assignment should be recorded in the office of the State Engineer. The following format, when modified to meet the particular conditions, may be used:
ASSIGNMENT OF PERMIT
STATE OF WYOMING )
) SS.
COUNTY OF ____________ )
I/We, __________________________________________________________ of the City of_____________________, County of___________________, State of__________________, being the owner(s) (if not the sole owner, state interest in permit) of the Ditch/Reservoir/Enlargement under Permit No.______________________ to divert and appropriate (to construct and store) the waters of the State of Wyoming, recorded in Book No. ______of Applications/Reservoirs/Enlargements on Page No,_______in the office of the State Engineer of the State of Wyoming, for and in consideration of the sum of One Dollar (SI.00) and other valuable considerations, the receipt of which is hereby acknowledged, do by these presents hereby transfer and assign all my/our right, title and interest of whatsoever nature in and to said permit, and all irrigation works pertaining thereto, to _____________________, of ___________________________________________________, City of _____
(Street address, P.O. Box No., etc.)
____________________, County of________________________, State of
_____________._______., his/their heirs, successors or assigns, forever.
(Signed)________________________________
STATE OF WYOMING )
) SS.
COUNTY OF ________________ )
On this____________day of _______________, 19_____, before me personally appeared __________i________________________________, to me known to be the person(s) described in and who executed the foregoing instrument, and acknowledged that he/she/they executed the same as his/her/their free act and deed.
(Signed)________________________________
Notary Public
My commission expires: 19____.
c. CONSENT TO EStARGE -- When there are two or more appropriators using a facility, and one desires to enlarge that facility, he should acquire the consent of the other appropriators. The following formats may be used as guides: ---- CONSENT TO ENLARGE STATE OF WYOMING ) ) SS. COUNTY OF _______________ ) 1/We,___________________________________, the sole owner(s) of the_______________________________________taking water from _ ___________ under Permit No._________________, for and in consideration of_______________do hereby give my/our free and voluntary consent to the enlargement or extension of, and to the use of water through the said facility, for the irrigation of ________ acres, by____________________________________, according to the terms of this application for enlargement. Dated this ________, day of________________________, 19___. (Signed)____________________________________ (Signed)____________________________________ ---- ---- CONSENT TO ENLARGE STATE OF WYOMING ) ) SS. COUNTY OF ______________ ) 1/We,_____________________________________., the sole owner(s) of the_______________________________Reservoir divorcing water from ___________________________under Permit No. _________ for and in consideration of_____________ ° hereby give my/our tree and voluntary consent to the enlargement of said reservoir according to the terms of this application for enlargement. Dated this ___ day of____________________, 19____. (Signed)________________________________, (Signed)________________________________ ---- (Pecition for Change of Point of Diversion and Means of Conveyance) EXAMPLE - The following individuals are all of the owners of record of Chose appropriations under the Highline Ditch, diverting from Deer Creek. Each of the following individuals has read, understands, and gives his consent to the petition of John W. Doe for a petition for change of poinc of diversion and means of conveyance for the Silas Smith appropriation, Permit No. f32, to be changed from the Leaky Ditch to the Highline Ditch. (Signed)___________________________________ (Signed)___________________________________ (Signed)___________________________________ (Signed)___________________________________ I hereby state, to the best of my knowledge and belief, that the above listed individuals are all of the owners of record for appropriations of water under the Highline Ditch, diverting from Deer Creek. (Date)_________________________ (Signed_____________________ Petitioner
037-11 Wyo. Code R. § 11-1