DETERMINE WHETHER YOU ARE ELIGIBLE FOR AN EXEMPTION Answer the questions below, continuing to the bottom of the form until you are instructed to stop or eligibility is confirmed. If the form indicates that a permit is required, you must complete an application for a permit. If the form indicates that a permit is not required, you do not need a permit or an exemption for your water use. Yes Will you use a surface water source? No Stop! Permit is required Yes Is your desired water use agricultural and less than an Stop! Permit/Exemption not required No annual average of 10,000 gallons per day? You may apply for a voluntary permit Is your designed use for domestic use other than Yes No heating or cooling, and on one individual lot? Stop! Permit/Exemption not required Yes No Is your desired use for extinguishing a fire? Stop! Permit/Exemption not required Is your desired use for dewatering during construction lasting less than 30 days (including days of non- pumping), and using Yes No less than 10,000 gallons per Stop Permit/Exemption not required day? Will your ground water use exceed 5,000 gallons per day as Yes No an annual average? Stop! Permit is required Is your desired water use within a Water Management Yes No Strategy Area target aquifer? Stop! Permit is required Is your desired water use associated with subdividing land Yes No You may be eligible for an exemption into residential lots on individual wells? Is your desired water use for a drinking water system that serves at least 15 service connections used by Yes No year-round residents or regularly at least 25 year- round Stop! Permit is required residents? Yes Did you answer NO to all questions You are eligible to file a Notice of Exemption. Proceed with the form on the first page. To determine whether your location is within a Management Strategy Area, please visit MDE’s website at Please submit a location map and plan of the proposed subdivision for MDE review. MDE will determine whether a permit is required or a Notice of Exemption may be filed and will notify you if a permit application is required. Year-round resident means an individual whose primary residence is served by the water system. The individual need not live at the residence 365 days a year for it to be considered their year-round residence. Note: A confirmation of your approved Notice of Exemption will be provided to your County. Permittee confirmations available by request. If your water use increases above 5,000 gpd, you must apply for a new permit.
DETERMINE WHETHER YOU ARE ELIGIBLE FOR AN EXEMPTION Answer the questions below, continuing to the bottom of the form until you are instructed to stop or eligibility is confirmed. If the form indicates that a permit is required, you must complete an application for a permit. If the form indicates that a permit is not required, you do not need a permit or an exemption for your water use. Will you use a surface water source? Yes Stop! Permit is required No Is your desired water use agricultural and less than an annual average of 10,000 gallons per day? Yes Stop! Permit/Exemption not required You may apply for a voluntary permit No Is your designed use for domestic use other than heating or cooling, and on one individual lot? Yes Stop! Permit/Exemption not required No Is your desired use for extinguishing a fire? Yes Stop! Permit/Exemption not required No Is your desired use for dewatering during construction lasting less than 30 days (including days of non- pumping), and using less than 10,000 gallons per day? Yes Stop Permit/Exemption not required No Will your ground water use exceed 5,000 gallons per day as an annual average? Yes Stop! Permit is required No Is your desired water use within a Water Management Strategy Area target aquifer? Yes Stop! Permit is required No Is your desired water use associated with subdividing land into residential lots on individual wells? Yes You may be eligible for an exemption No Is your desired water use for a drinking water system that serves at least 15 service connections used by year-round residents or regularly at least 25 year- round residents? Yes Stop! Permit is required No Did you answer NO to all questions Yes You are eligible to file a Notice of Exemption. Proceed with the form on the first page. To determine whether your location is within a Management Strategy Area, please visit MDE’s website at Please submit a location map and plan of the proposed subdivision for MDE review. MDE will determine whether a permit is required or a Notice of Exemption may be filed and will notify you if a permit application is required. Year-round resident means an individual whose primary residence is served by the water system. The individual need not live at the residence 365 days a year for it to be considered their year-round residence. Note: A confirmation of your approved Notice of Exemption will be provided to your County. Permittee confirmations available by request. If your water use increases above 5,000 gpd, you must apply for a new permit.
Application_AUWS_Exemption_for_New_Uses.docx