Fort Bend Subsidence District
Serving the Gulf Coast Community Since 1975

New Well Permit Application
(Well has not been drilled)
Instructions:
Submit this form for each well system.
Send an application fee of $200.00 for each well to be permitted to the address at the bottom of this form within seven (7) days.

Items marked with an * are required.

General Information: 
(Do not put any driller or engineer address information if you are not the owner of the well)
*Well Owner:
  
Title
*Attention:
   
Correspondent:
(If correspondence is being sent to a large organization, insert the specific person's name to whom you wish it directed. If self, enter self.)
*Owner Email:
 
*Mailing Address:
   
Address 2:
*City:
 
*State:
    *Zip:    
*Owner's Phone #:
 (###-###-####)      Ext.:  
Mobile:
 (###-###-####) 
Well Data:
*Physical Location of Well:
   
Latitude:
Degrees:       Minutes:       Seconds:    
Longitude:
Degrees:     Minutes:     Seconds:    
 
*Total Depth:  ft.  
*Depth to First Screen:  ft.  
*Inside Diameter of Casing:  in.  
*Well Casing:
 
*Expected Production During the Next Twelve Months:  (MG)  
*Amount of Alternate Water Metered in previous Twelve Months:  (MG)  
 
*Select intended use:    








*Provide detailed description of intended use.  If commercial or industrial, describe type of business, number of employees, type of product produced or sold, etc.  If for new house or development, include construction start date.  If agricultural, include crop type and acreage.

   

*Describe any other water supply available at this location.  For example, is there a municipal water line available for potable service or a canal or other raw water source for non-potable uses?

   

*Status of this well as of given date:  

Year:  
Year:  
Aggregation:  If this well is to be placed in aggregate with other permitted wells, give lead well number
of aggregation:    
Does the "well owner" own any other well in Fort Bend county?  
If yes, explain:   
*Is this well replacing an existing well?   If yes, give well no. of well being replaced   and length of time owned or leased:
If this well is a replacement well, what will be the status of the old well? If status of old well is "In Use", explain:     
*Applicant/Agent Name:
   
*Applicant/Agent Phone:
 (###-###-####)   Ext.:
Submitter's Email
   
*Confirm Email:
   
If this is an emergency application, you must also include the following information
and send a fee of  $500.00  for each well to the address at the bottom of this form within seven (7) days.
Such action is: (check those applicable)

State the reasons why you cannot wait approximately 75 days for your Permit to be processed. Your statement should include:
1 The reason the application was not submitted in time to allow standard processing (approximately 75 days) and
2. The reason the requestor or owner cannot now follow the normal process.
This portion must include detailed financial losses, health hazards, and/or safety factors that the applicant or owner faces if the standard process is followed.
 
Rule 5.8.a Exclusions and Exemptions:

a. Single-Family Dwelling Wells Excluded: A well with a casing diameter of less than five inches that serves only a single-family dwelling is excluded from the permit requirements of these Rules. Serving only a single-family dwelling means the well supplies groundwater for domestic use inside one home located on property that does not have an available alternative water supply. Domestic use includes water used inside the home for any purpose and may also include use outside the home for landscape irrigation, irrigating a garden or providing water to domestic livestock.
Richmond, TX 77469-0427  •  P.O. Box 427
Phone: (281) 342-3273  •  Fax: (281) 232-3355
www.fbsubsidence.org