Riverbank, CA · Stanislaus County
Well Destruction Permit Application
Property owners and contractors use this application to request a Riverbank permit to destroy a well and provide details about the work.
What this form is
The application requests a permit to destroy a well and asks for the job address, work description, property owner and contractor information, and proposed destruction details. It also includes a well destruction supplement, a plot plan, and a requirement to submit a copy of the well completion report or equivalent for each well. The form states that a $75 survey and inspection fee is payable to the city.
Who needs it
Property owners seeking a well destruction permit and the contractors performing the work need to complete the application and its supplement.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details. The form identifies the Development Services Department and states that the $75 survey and inspection fee is payable to the city.
About notarization
This document is signed and dated without a notary; the application includes a signed certification, but does not require a notarized or sworn attachment.
How to submit this form
- 1
Download the Application
Download the Well Destruction Permit Application and its included supplement and plot plan.
- 2
Complete the Application
Enter the job, owner, contractor, work, and well details requested on the application.
- 3
Gather Required Materials
Include a copy of the Well Completion Report or equivalent for each well and complete the plot plan.
- 4
Submit to the City
Submit the application to the Development Services Department and pay the stated $75 survey and inspection fee.
Frequently asked questions
- Do I need a notary for the Well Destruction Permit Application?
- No. The application is signed and dated without a notary; it includes a signed certification but does not require a notarized or sworn attachment.
- How do I submit the Well Destruction Permit Application?
- Submit it to the Development Services Department. Check the city website for current contact details; the form states that a $75 survey and inspection fee is payable to the city.
- What information does the application ask for?
- It asks for the job address, work description, owner and contractor details, and well destruction specifications. It also includes a supplement and plot plan.
- What attachment does the application require?
- The supplement says to submit a copy of the original Well Completion Report (DWR Form 188) or equivalent for each well under consideration.