TYPES OF APPLICATIONS - Edwards Aquifer Authority

APPLICATION TO TRANSFER CIBOLO LEASE900 East Quincy, San Antonio, Texas 78215Telephone (210) 222-2204Fax (210) 222-9869www.edwardsaquifer.orgT_________________Check # ___________A. Transferor Information:PART I - TRANSFEROR AND TRANSFEREE INFORMATIONName of Permit Holder:________________________________________________________________________________________________Mailing Address:_____________________________________________________________________________________________________(Street or PO Box) (City) (State) (Zip)Physical Address:____________________________________________________________________________________________________(Street) (City) (State) (Zip)Telephone: _______________________________________E-mail Address:_____________________________________________________Authorized Representative: ____________________________________________________________________________________________(Name) (Relationship) (Telephone)Mailing Address:_________________________________________________________________________________________(Street or PO Box) (City) (State) (Zip)Has any of the above information recently changed? Yes NoB. Transferee Information:Name of Transferee:__________________________________________________________________________________________________Mailing Address:_____________________________________________________________________________________________________(Street or PO Box) (City) (State) (Zip)Physical Address:____________________________________________________________________________________________________(Street) (City) (State) (Zip)Telephone: _______________________________________E-mail Address:_____________________________________________________Authorized Representative: ____________________________________________________________________________________________(Name) (Relationship) (Telephone)Mailing Address: ________________________________________________________________________________________(Street or PO Box) (City) (State) (Zip)Has any of the above information recently changed? Yes NoPART II – WATER USE INFORMATIONA. Groundwater Use Information for Transferor (Lessor): Initial Regular Permit (IRP)/Regular Permit (RP) No: P_____________________Current purpose of use: Municipal Use Industrial Use Irrigation UseAmount of groundwater used to date: _________________________________ acre-feetMeter Serial Number:_____________________ Reading: ________________________________ Date: ___________________B. Groundwater Use Information for Transferee (Lessee): If applicable, Initial Regular Permit (IRP)/Regular Permit (RP) No: P_________________Proposed purpose of use: Municipal Use Industrial Use Irrigation UseDo you intend to withdraw this water? Yes No At what rate? ____________________ gallons per minuteIf YES, please describe what this water will be used for? ______________________________________________________________________Meter readings (Note: readings must be taken within one week of submission of application):Not Applicable (no well)Meter Serial Number:_____________________ Reading: ________________________________ Date: ___________________Meter Serial Number:_____________________ Reading: ________________________________ Date: ___________________(attach additional sheets if needed)