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CARD ' <br /> ,.,,,..., ,., . . START ~ ,., <br /> NOTICE OF BEGINN~G OF WELL CONSTRU~ION, · <br /> (as ~qu~d by ORS 5~7.762) <br /> <br />~i~ ~ ~b~d~ ~k ~i~. A $7~ fee sh~ll ac~mpany ~11 notic~ fer ~w w~JJ ~enstru~tJOn'or ~on~e~$Jon - <br />m~lin~ ~s ~m~i buJ ~ei*ed wi$~m Se ~ui~ f~ will ~ot ~ aec~t~d <br />f~B~ ~ ~bmti ~ ~ ~ ~g~$ ~ ~. ~t~ii~. ~v~Jon ~ ~b~d~t work. <br /> <br />Owner's name and mailing address <br /> <br />Chec. k type of work: <br /> <br /> ira <br />R~ui~A [] Conversion <br /> <br />Proposed Commcnc~memt Date <br />Check Use: [-'] Domestic <br /> <br />Proposed Well Location:. Count~, <br /> <br />Townsh p , <br /> <br />Required Deepening <br /> <br /> ..... Existing or Proposed Well Depth <br />7qCommunity [~I~usu~.:: [~']Irfigation <br />["] Injection F'I Other <br /> - Owner's Well Id; No <br /> <br />" ':0VorS) Range <br /> <br />[] Recondition <br />[] Abandonment <br /> <br /> . (E or W) Sectign: .. <br />1/4~f' "" ' l/4'of <br /> <br />4, Attach map with location identified.. , <br /> (See revet~ of th,~ form for approved maps)" · <br /> <br />5. Show well location within 1/4, !/4 of section gad at lei3C ~ . <br /> <br /> We bemby ceallfy that we have mad. the back of this form, and that to the best of our knowledg6 the information ~! ' <br /> provided herein is accurate and the well is being properly located from septic tanks, septic?raj~ field~ and other, i · ~ ,' ' <br /> hazards. ( See g2 on back) <br /> <br /> ; . .., · ..... "'.' ' <br /> . e_~. ,~...,-~,~ ,~ ?/., z/,, ,,a ...... ., ..... , <br /> <br /> ti~ ~ woe~ p~ Company .... <br /> <br />NOT£: This is not u water right application. The owner is responsible for obtaining a water right through the Water <br />Resources Department, if required. <br /> <br /> · '"I ,. ' ",";%,. ,, ,,,, .'."I .... · . <br /> <br /> <br />