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2. 
3. Coachella Valley Water District
   
   Application for Canal Water Service Outside of Improvement District No. 1 (ID1) - (CVWD106)
   
   
   
5. CVWD District Code Article V. Water Use Outside Improvement District No. 1
   Article V. Water Use Outside Improvement District No. 1
9. Property Owner Information
11. Property Owner First Name*
12. Property Owner Last Name*
14. Property Owner Mailing Address *
16. City*
17. State or Province*
18. Zip or Postal Code*
20. Property Owner
    Email Address*
21. Property Owner Telephone Number*
22. Property Owner Telephone Number Type*

    1. Cell phone
    2. Work
    3. Home
24. Canal Water Service Proposed Use
26. Proposed Use*

    1. Agriculture
    2. Construction
    3. Golf Course / Lakes

    1. Urban / Non-Potable Water
    2. Other
27. Proposed Use - Other*
29. Acreage to be Irrigated*
30. Quantity of Canal Water Requested (cfs)*
32. Water will be used for: (check all that apply)*

    1. Bell Peppers
    2. Carrots
    3. Citrus
    4. Dates

    1. Grapes
    2. Nursery - Trees
    3. Okra
    4. Oriental Vegetables

    1. Strawberries
    2. Construction
    3. Duck Farm

    1. Fish Farm
    2. Golf Courses / Lakes
    3. Industrial Hemp
34. Industrial Hemp Certification*

    I hereby certify that I will comply with all federal, state and local requirements as it pertains to the production of industrial hemp, including any federal requirements of the United States Bureau of Reclamation, which owns a portion of the facilities used to provide agricultural water service. CVWD makes no representation or warranty regarding what, if any, federal, state or local requirements may apply to hemp production. Water service may be subject to interruption or termination if CVWD determines, in its reasonable discretion, that USBR, the California Department of Food and Agriculture, or County Agricultural Commissioner has denied, revoked, or changed any of its authorizations, which result in a prohibition against Applicant’s hemp production. Further, it shall be the responsibility of the applicant to provide CVWD proof of valid registration with the County Agricultural Commissioner on an annual basis. Applicant hereby waives and releases CVWD from any and all liabilities, which may arise from Applicant’s use of water service for hemp production.

    1. I acknowledge and agree to comply with all District Regulations, Ordinances, Policies and Rules, or amendments thereto.
36. By typing or signing my name, I certify that I understand the terms and conditions outlined above and that to the best of my knowledge the information I provided is true and correct.*
38. Title*
39. Date*
    Date
41. Industrial Hemp Registrant Name*
43. Industrial Hemp Registration Number*
44. Industrial Hemp Registration Expiration Date*
    Industrial Hemp Registration Expiration Date
46. Attach Copy of Industrial Hemp Registration Here*
48. Canal Water Service Parcel Data
50. Parcel Number*
51. Section*
52. Township (S)*
53. Range (E)*
55. Acres
    Inside ID1*
56. + Acres
    Outside ID1*
57. + Acres Outside Area of Benefit*
58. = Total
    Number of Acres*
60. Existing Well within Area of Benefit?*

    1. Yes
    2. No
61. If agricultural use, has this Parcel been previously farmed?*

    1. Yes
    2. No
63. Is this Parcel within a CVWD Assessment District?*

    1. Yes
    2. No
64. Is groundwater currently being used for farming?*

    1. Yes
    2. No
66. Assessment District No.*
68. 1. Check here to add another parcel
70. Parcel Number*
71. Section*
72. Township (S)*
73. Range (E)*
75. Acres
    Inside ID1*
76. + Acres
    Outside ID1*
77. + Acres Outside Area of Benefit*
78. = Total
    Number of Acres*
80. Existing Well within Area of Benefit?*

    1. Yes
    2. No
81. If agricultural use, has this Parcel been previously farmed?*

    1. Yes
    2. No
83. Is this Parcel within a CVWD Assessment District?*

    1. Yes
    2. No
84. Is groundwater currently being used for farming?*

    1. Yes
    2. No
86. Assessment District No.*
88. 1. Check here to add another parcel
90. Parcel Number*
91. Section*
92. Township (S)*
93. Range (E)*
95. Acres
    Inside ID1*
96. + Acres
    Outside ID1*
97. + Acres Outside Area of Benefit*
98. = Total
    Number of Acres*
100. Existing Well within Area of Benefit?*

     1. Yes
     2. No
101. If agricultural use, has this Parcel been previously farmed?*

     1. Yes
     2. No
103. Is this Parcel within a CVWD Assessment District?*

     1. Yes
     2. No
104. Is groundwater currently being used for farming?*

     1. Yes
     2. No
106. Assessment District No.*
108. List additional parcel information on a separate page and upload here.
110. Preliminary Engineering Report
112. The Preliminary Engineering Report provided by the Applicant is to include the following items at a minimum:
     • Map(s) that identifies the Property location and area relative to the ID1 boundary and Area of Benefit
     • Proposed infrastructure
     • Cost estimate
     • Hydraulic analysis
     • Project schedule. 
       The project must be in service within 3 years from the Effective Date.
     • Well production data. 
       Applicant shall submit the previous 12 months recorded well production data with the Application. *
     • Projected canal water demand

     * For wells within the Area of Benefit, existing groundwater quantity use must be a minimum of 67% of the proposed quantity of requested canal water.

     * For wells outside the Area of Benefit, groundwater quantity use must be a minimum of 100% of the proposed quantity of requested canal water.

114. Upload Preliminary Engineering Report *
120. By typing my name or signing this document, I certify I am the legal property owner for the parcels identified within this application; all information is true and correct. I acknowledge and agree to comply with CVWD Regulations Governing Canal Water and Drainage Service, and amendments thereto, as well as applicable laws and regulations of the U.S., state and local governmental bodies (collectively, “Rules and Regulations”).
     
     Pursuant to certain rights, CVWD imports water from the Colorado River to provide service to eligible lands within Improvement District No. 1 (“ID1”). CVWD has developed Guidelines for Colorado River Water Service Agreements For Use Outside Improvement District No. 1 Boundary (Outside ID1 Guidelines). The Guidelines provide, in part, that CVWD may utilize Colorado River water outside ID1 upon the satisfaction of certain conditions. This Agreement provides for service outside ID1 and therefore, the Guidelines are incorporated herein by reference. *
122. Date Signed:*
     Date Signed:
126. CVWD Office Use Only:
128. Notes:
130. Customer Billing

     Processed by:

     Date:

132. Zanjeros

     Processed by:

     Date:

134. Customer Billing

     Processed by:

     Date:

138. 
     

     
     

     
     

     COACHELLA VALLEY WATER DISTRICT
     Post Office Box 1058
     Coachella, California 92236
     (760) 391-9600
     (760) 398-3190 - fax
     CustomerService@cvwd.org

     rev 11/2023

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140. 1. Receive an email copy of this form.
141. Email address

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142. Submit

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