Merced County, CA · Merced County
Well Construction, Destruction, Mining, and Export Application/Permit
Property owners and licensed water well contractors use this application to request a Merced County permit for well construction, destruction, mining, or export.
At a glance
- Issued by
- City of Merced County · Merced County, Merced County, California
- Notarization
- Not required: file this form without a notary.
- Official source
- countyofmerced.com
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
This application requests a permit for well construction, destruction, mining, or export in Merced County. It collects property owner and contractor details, the well’s location and proposed construction information, and (when applicable) existing well and destruction details. The form also includes exemption classifications, signatures, and statements about the project and property.
Who needs it
Property owners and licensed C-57 water well contractors applying for a well construction, destruction, mining, or export permit in Merced County need this form.
How to submit it
Submit the application to Merced County Community and Economic Development Department, Division of Environmental Health, 2222 M St., Merced, CA 95340.
About notarization
This document is signed without a notary; it includes a contractor’s statement under penalty of perjury and a property owner’s sworn statement, but no notary block.
How to submit this form
- 1
Download the Application
Download the Well Construction, Destruction, Mining, and Export Application/Permit PDF.
- 2
Complete the Application
Enter the property owner and contractor information, intended use, location, and applicable well details.
- 3
Gather Required Attachments
Include a plot plan displaying existing and proposed wells. The form also calls for a Letter of Intent for each well where required.
- 4
Sign the Application
Complete the applicable contractor and property owner statements and signature fields.
- 5
Submit to the County
Submit the application to the Division of Environmental Health at 2222 M St., Merced, CA 95340.
Frequently asked questions
- Do I need a notary for the well permit application?
- No. The form has no notary block. It includes a contractor’s statement under penalty of perjury and a property owner’s sworn statement, but neither is presented with a notary section.
- Who completes this well permit application?
- The form requests information and signatures from the property owner and the licensed C-57 water well contractor.
- How do I submit the well permit application?
- Submit it to Merced County Community and Economic Development Department, Division of Environmental Health, 2222 M St., Merced, CA 95340.
- What project information does the application request?
- It asks for the intended use, well location, proposed construction details, and, for destruction or out-of-service wells, existing well and destruction information.