Fillable City of Coppell P.O. BOX 9478 Coppell TX (City of Coppell)

Fill Online, Printable, Fillable, Blank City of Coppell P.O. BOX 9478 Coppell TX (City of Coppell) Form

Use Fill to complete blank online CITY OF COPPELL (TX) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

City of Coppell P.O. BOX 9478 Coppell TX (City of Coppell)

On average this form takes 13 minutes to complete

The City of Coppell P.O. BOX 9478 Coppell TX (City of Coppell) form is 1 page long and contains:

  • 2 signatures
  • 32 check-boxes
  • 28 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Coppell

BROWSE CITY OF COPPELL (TX) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
City of Coppell
P.O. BOX 9478
Coppell TX 75019
972.462.5177
WELL DRILLING OR MODIFICATION APPLICATION
Fill out this application, attach the applicable fees, and return to the City office at the address above.
Well Owner: ________________________________________________________________________________
Address: ____________________________________________________________________________________
City: State: ____ Zip: Phone: _____________________________________________
Licensed Well Driller: _____________________________________Phone: _____________________________
Address: City State: Zip: ______
Well Location:
Provide specific directions to well site and attach copies of property plat, USGS 7.5' topography map,
subdivision map, or other large scale maps which may be available to help accurately locate the well site.
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
Well Information:
New Well  Modify existing well  Type of modification
Proposed Depth: Feet Aquifer: Trinity  Paluxy  Woodbine  Other
Proposed Depth to bottom of casing: Feet Inside Diameter of casing: Inches
Casing Type: PVC  Steel  ; New  Used  Proposed Pump Size: HP Capacity: GPM
Anticipated Drilling or Workover Date: Anticipated Completion Date: _______
Lot Size: ; Septic System: Yes No ; Is there another well on the property? Yes No
Water to be used for: Residential Domestic (number of homes served )  , Commercial Domestic  , Public
Water Supply  , Commercial  , Industrial  , Irrigation  Agricultural Livestock  , Monitor Well  , Earth
Coupled Heat Exchange  , Other 
________________________________________________________________________________________________
I hereby make application to the City of Coppell to develop the water well described herein, and I certify that each
and all the statements herein are true and correct.
_______________________________________________ _________________________
Signature of Property Owner or Authorized Agent* Date
For City Use Only Special Conditions:
Public Water Supply
____ Residential/Domestic
Irrigation
Agricultural Approved  Denied 
Monitor
Other Date:
Check # ___________ Receipt # ______________ Signed:
click to sign
signature
click to edit
click to sign
signature
click to edit
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

City of Coppell P.O. BOX 9478 Coppell TX (City of Coppell)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 2 August 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document