Application to Drill an Oil Well

Application to Drill an Oil Well

Fee: $1000
Applicant Information
Name*

First NameLast Name
Company*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Oil Well Information
Location of Well to be Drilled:*
Section, Township, Range
The following information must be submitted with the application:
1. Scale drawing of the property and appropriate dimensions.
2. Scale, north arrow, date and legend.
3. Name, address and telephone number of property owner and applicant.
4. Location and size of existing easements, utilities and right-of-ways.
5. Location and dimensions of all vehicular entrances, exits and drives.
6. General drainage system.
7. Location of all physical facilities to include proposed wells, structures, portable toilets, and relationship to all buildings within a 660 foot radius.
8. Statement describing all pollution prevention equipment to be utilized. Blowout prevention devices are required.
9. Location of mud pits.
10. Location of tank batteries and size of battery site.
11. Any oil, gas or water lines to be utilized.
12. Type of screening devices or construction to be utilized around the pumping site.
13. Proof of insurance.
14. Public streets to be utilized.
Application Documents:*

Cancelof

Application Fees*

Application to Drill Oil Well

$1,000.00

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty: