In the said rules after FORM 16, the new forms 17, 18, 19, 20 and 21 shall be inserted namely:- FORM 17 (see rule 17-D) Application for permission by new user to extract and use groundwater within five hundred meters from the centre of the lift irrigation scheme and irrigation canal or channel and for No Objection Certificate to Obtain Power Connection Application Number:
To, The Irrigation Officer, ………………….
………………….
(1) I,……………, am a resident of………………….. village…………… Taluk……………District……………, Karnataka make this application for permission to extract and use groundwater within five hundred meters from the centre of the lift irrigation scheme and irrigation canal or channel and to obtain No Objection Certificate for Power Connection, for the purpose of irrigation of the land herein after described, subject to the provisions of the Karnataka Irrigation Act, 1965, and any other law for the time being in force, relating to irrigation and the provisions contained in the instructions and the conditions specified at the end of this application, to which I agree.-
(2) I am the owner/lease holder of the lands for the irrigation of which it is necessary to use water and for which permission is sought for.
(3) The name and address of the applicant to whom the orders on the application should be communicated are……………………… Date:
Signature or left-hand thumb Impression of the applicant [All the details of the application have to be filled up by the applicant.]
Forwarded for sanction as follows:
[………………………………] 5 INSTRUCTIONS:
(1) The application should be submitted in duplicate to the Irrigation Officer or to any officer authorized by him (Not below the rank of AEE) to receive such applications presented personally, or sent by speed post.
(2) Until the permission is granted, the applicant shall not proceed with any activity connected with drilling or digging of a well or creation of an artificial pond.
(3) When an order is passed, the duplicate form will be returned to the applicant endorsed with the Irrigation Officers’ orders.
(4) No sanction will ordinarily be given for the irrigation of any land to any person other than (a) the sole occupant or all joint occupants, (b) the sole superior holders or all joint superior holders, (c) a person having the right to carry on irrigated cultivation of the land for the period of the sanction.
(5) The grant of permission for the extraction and use of ground water is restricted to irrigation and domestic purposes and such other purposes as directed by the Government.
(6) Permission may be refused for the extraction and use of ground water for the irrigation in the following cases:
(i) if it is likely to adversely affect water availability of any drinking water sources in the vicinity.
(ii) there are requirements to conserve the ground water, if the water table is found to be extremely low in the opinion of ground water Directorate.
(iii) other conditions as prescribed in the Act under Section-28A (6).
(7) The application is liable to be rejected, if, full particulars are not given in the application as detailed above, and in the event of failure to furnish any information which the Irrigation Officer requires in this connection.
(8) Permission granted will be for a period of 5 years and renewal for further period subject to satisfactory fulfillment of conditions prescribed for grant of permission.
+++ 6 FORM 18 (see rule 17-E) Application for registration of borewell by beneficiary of Ganga Kalyan Scheme.- Application Number:
To, The Irrigation Officer, ………………….
………………….
(1) I,……………, am a resident of………………….. village…………… Taluk …………… District……………, Karnataka make this application for registration of borewell, subject to the provisions of the Karnataka Irrigation Act, 1965, and any other law for the time being in force, relating to irrigation and the provisions contained in the instructions and the conditions specified at the end of this application, to which I agree.-
(2) I am a beneficiary of the Ganga Kalyan Scheme.
(3) I am the Owner / Lease Holder of the lands for the irrigation of which, I have installed a borewell under the aforementioned Scheme.
(4) The name and address of the applicant to whom the orders on the application should be communicated are……………………… Date:
Signature or left-hand thumb Impression of the applicant [All the details of the application have to be filled up by the applicant.]
Forwarded for sanction as follows:
[………………………………] INSTRUCTIONS:
(1) The application should be submitted in duplicate to the Irrigation Officer or to any officer authorized by him (Not below the rank of AEE) to receive such applications presented personally, or sent by speed post.
(2) When an order is passed, the duplicate form will be returned to the applicant endorsed with the Irrigation Officers’ orders.
(3) Incomplete application without required documents are liable to be rejected.
(4) Where the Irrigation Officer approves the registration of borewell, an order in this regard, shall be passed by him within a period of sixty days from the date of receipt of the application.
+++ 7 FORM 19 (see rule 17-F) Permission/No Objection Certificate to extract and use groundwater within five hundred meters from the centre of the lift irrigation scheme and irrigation canal or channel for new user.- To, The Irrigation Officer, ………………….
………………….
Application Number:
Permission/NOC No: Date:
Upon processing the application submitted by …………………[Name of the Applicant], dated…………..[date of the application] bearing Application Number……….[number of the application], permission has been granted to the applicant in accordance with the provisions of Section 28A of the Karnataka Irrigation Act, 1965 read with Rule 17-D of the Karnataka Irrigation Rules, 1965.
Name and Address of the Applicant:
Purpose of extraction and use of groundwater:
[Agricultural/Domestic/Industrial etc.]
Permission granted for: Drilling of Borewell or Digging of a open well [Purpose to be specified] ……………………… ……………………… Office Stamp Issuing Authority Name:
Signature:
Designation:
+++ 8 FORM 20 (see rule 17-G) Application for registration/renewal of existing ground water users within five hundred meters from the centre of the lift irrigation scheme and irrigation canal or channel.- Application Number:
Permission/NOC No. (for renewal):
To, The Irrigation Officer, ………………….
………………….
(1) I,……………, am a resident of………………….. village…………… Taluk……………District……………, Karnataka make this application seeking registration/renewal as an existing ground water user within five hundred meters from the centre of the lift irrigation scheme and irrigation canal or channel for the purpose of irrigation of the land herein after described, subject to the provisions of the Karnataka Irrigation Act, 1965, and any other law for the time being in force, relating to irrigation and the provisions contained in the instructions and the conditions specified at the end of this application, to which I agree.- Source of the ground water Lifting device used Quantity of groundwater withdrawal (mcft) and hours of operation in a day Total period of use in each year each year Purpose of extraction of groundwater [The description of the source of ground water and exact location to be specified by the Applicant] [Number of days to be specified] Whether for drinking water or for irrigation or others (to be specified).
(2) The applicant is using the extracted water for the purpose of …………….. [Purpose of extraction of groundwater to be specified] and : [Fill whichever is applicable]
(a) The location and extent of the irrigated area is ………………………………………………………………………[the location of the irrigated land and the extent is to be specified] and the crops grown in this land is………………………………[description of the crops cultivated is to be specified]
(b) The approximate population served with drinking water by the applicant is ……. [Number of people to be specified, numerically] (if applicable).
9
(c) This application has been preferred after the expiry of six months from the date of commencement of the Karnataka Irrigation (Amendment) Act, 2024, due to the reason of ……………………………………………………………………….
(d) The name and address of the applicant to whom the orders on the application should be communicated are……………………… Date:
Signature or left-hand thumb Impression of the applicant [All the details of the application have to be filled up by the applicant.]
Forwarded for sanction as follows:
[………………………………] INSTRUCTIONS:
(1) The application should be submitted in duplicate to the Irrigation Officer or to any officer authorized by him (Not below the rank of AEE) to receive such applications presented personally, or sent by speed post.
(2) When an order for registration/renewal is passed, the duplicate form will be returned to the applicant endorsed with the Irrigation Officers’ orders.
(3) The applicant shall specify the reason for delay in preferring the application in Clause 3 of the application form.
(4) Certificate of registration/renewal for the extraction and use of ground water is restricted to irrigation (including sprinkler and drip irrigation system) and domestic purposes and such other purposes as directed by the Government as long as it does not adversely affect the ground water table and/or drinking water sources in the vicinity.
(5) A certificate of registration/renewal may be refused for the extraction and use of ground water for the irrigation in the following cases:
(i) if it is likely to adversely affect water availability of any drinking water sources in the vicinity.
(ii) there are requirements to conserve the ground water, if the water table is found to be extremely low in the opinion of Ground Water Directorate.
(iii) other conditions as prescribed in the Act under Section-28B (5) of the act.
+++ 10 FORM 21 (see rule 17-H) Issuance of certificate of registration/renewal to existing ground water users within five hundred meters from the centre of the lift irrigation scheme and irrigation canal or channel.- The Irrigation Officer, ………………….
………………….
Application Number:
Certificate No: Date:
CERTIFICATE OF REGISTRATION/RENEWAL Upon processing the application submitted by …………………[Name of the Applicant], dated…………..[date of the application] bearing Application Number……….[number of the application], PERMISSION has been GRANTED IN ACCORDANCE WITH Section 28B of the Karnataka Irrigation Act, 1965 read with Rule 17-G of the Karnataka Irrigation Rules, 1965 as under.
(1) Name and Address of the Applicant:
(2) Location (Sy. No and Village) and extent of land Source of the ground water Lifting device and its capacity Quantity of groundwater Withdrawal (mcft) and hours of operation in a day Total period of use in each year Purpose of extraction of groundwater The description of the source of ground water and exact location [Number of days to be specified] Whether for drinking water or for irrigation or others (to be specified.
……………………… Office Stamp Issuing Authority Name:
Signature:
Designation:
By order and in the name of the Governor of Karnataka, ( MANOHAR V. ROTTE ) Officer on Special Duty Water Resources Department ಮುದÎಕರು ²ಾಗೂ ಪÎ�ಾಶಕರು:- ಸಂಕಲ£ಾĩ�ಾĸಗಳ�, ಕ£ಾ�ಟಕ ªಾಜÍಪತÎ, ಸ�ಾ�ĸ �ೇಂದÎ ಮುದÎ�ಾಲಯ, ¦ೆಂಗಳ�ರು R.N.I. No. KARBIL/2001/47147 POSTAL REGN. No. RNP/KA/BGS/2202/2017-19 Licensed to post without prepayment WPP No. 297 2025-12-17T17:56:36+0530 THAMMAIAH