037-5 Wyo. Code R. § 5-21
Authorization for this type of petition is found in W.S. 41-3-917. Petitions affecting adjudicated ground water rights or unadjudicated ground water rights where beneficial use has been received will follow the sample format as those for surface water rights with some exceptions based on what is requested by the petitioner. When a petition is submitted to the Board to change a well location, it must be accompanied by copies of all water production records for at least 5 years past to the extent available. A change may be allowed for the amount of water the well is actually capable of producing, but not in excess of the adjudicated right. A condition of approval on any change of location of a well shall be that no injury will occur to any other appropriator. The new well location must be indicated in the records of the Board by a new survey tie certified to by a licensed professional engineer or professional land surveyor. A new map is not required except as may be necessary to show the new location. A new well located within 100 feet of the original adjudicated well may be described by non-certified distance and bearing from the original well. This information will be provided by the petitioner to the Board on the required Statement of Completion Form (U.W. 6) for the new relocated well. The old well shall be properly abandoned and re-sealed unless it's re-permitted for beneficial use. The following information is required:
a. HEADING -- Sufficiently identify the appropriation to be changed.
b. OPENING STATEMENT - Identify the petitioner and their mailing address and give a general introduction.
c. BODY -
ITEM 1 -- Show that the petitioner is the present owner of the ground water appropriation involved in the petition, and identify the proof of ownership being furnished with the petition.
ITEM 2 -- Describe the appropriation listing the name of the well, permit number (or statement of claim or well registration number), proof number, Order Record Book and page number, Certificate Record Book and page, and priority date. If the appropriation is for irrigation, the irrigated acreage must be described.
ITEM 3 -- Set forth the change that is desired by describing in detail both the location of the original well and the proposed new location of the well.
ITEM 4 -- Describe the reason for the proposed change.
ITEM 5 -- Indicate that the new well will be in the same ground water basin and the same aquifer. The original well depth and the proposed depth of the new relocated well must be provided. If the well is in a ground water control area, note that the recommendation of the Control Area Advisory Board will be provided.
ITEM 6 -- Maps are required in most instances. However, a letter certificate from a licensed professional engineer or professional land surveyor is sufficient, provided that the letter certificate indicates a tie, by distance and direction, has been made to the new site. A new well location within 100 feet of the original adjudicated well may be described by non-certified distance and bearing from the original well. This information will be provided by the petitioner to the Board on the required Statement of Completion Form (U.W. 6) for the relocated well. A correction can then be added to the proof of beneficial use of ground water map in the Board's records.
ITEM 7 -- No fees are required for a petition for change of location of a well.
ITEM 8 -- Unless re-permitted for another use, state that the old well will be properly abandoned and sealed in accordance with the State Engineer's Regulations and Instructions. Abandonment and sealing of the old well will be completed within one year of the completion of the relocated new well and a Statement of Completion Form (U.W. 6) will be filed with the Board providing the details of abandonment and sealing.
ITEM 9 - A Statement of Completion Form (U.W. 6) will be submitted to the Board within thirty days after completion of the new well.
d. PRAYER -- State specifically what is desired to be accomplished by the petition (see sample petition in Appendix A accompanying these Regulations and Instructions).
037-5 Wyo. Code R. § 5-21