Location Permit

 

WEBSTER PARISH POLICE JURY (WPPJ)

COMMERCIAL VEHICLE ENFORCEMENT UNIT (CVEU)

LOCATION PERMIT

DATE: _________________

PERMIT #: _________________

 

NAME OF COMPANY: ________________________________________________________________________

ADDRESS: _________________________________________________________________________________

CITY: ___________________________________ STATE: ______________ ZIP: ________________________

PHONE #: _______________________________ FAX #: _______________________

CONTACT PERSON: ____________________________________________________

NAME OF WELL: _______________________________________________________  SERIAL #: ____________________________

SECTION: _____________________________ TOWNSHIP: _______________________________ RANGE: ____________________

PROPOSED TOTAL DEPTH: ________________________________________________________

MILES TRAVELED ON THE PARISH ROAD: ____________________________________________

LIST OF VENDORS ENTERING/EXITING SITE:

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

 

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ISSUED BY: _______________________________________________ APPROVED BY: ____________________________________

 

YOU MUST CALL THE PERMIT MARSHAL AT 318-377-7564 FOR A PERMIT NUMBER BEFORE WORK BEGINS. ALL CONTRACTORS MUST HAVE A NEW PERMIT NUMBER EACH TIME THE LOCATION IS CHANGED. THIS PERMIT IS $200.00 PER LOCATION. 100,000 PER MILE BOND MUST BE SUBMITTED FOR THE MILES TRAVELED ON A PARISH ROAD.  MAKE CHECKS PAYABLE TO THE WEBSTER PARISH POLICE JURY.

THE APPLICANT AGREES TO DEFEND, INDEMNIFY, AND HOLD HARMLESS THE WEBSTER PARISH POLICE JURY, CVEU, AND ITS DULY APPOINTED AGENTS AND EMPLOYEES FROM AND AGAINST ANY AND ALL CLAIMS, SUITS, LIABILITIES, LOSSES, DAMAGES, COSTS OR EXPENSES INCLUDING ATTORNEY FEES SUSTAINED BY REASON OF THE EXERCISE OF THIS PERMIT, WHETHER OR NOT SUITS, LIABILITIES, LOSSES, DAMAGES, COST OR EXPENSES INCLUDING ATTORNEY FEES SUSTAINED BY REASON OF THE EXERCISE OF THIS PERMIT MAY HAVE BEEN CAUSED BY NEGLIGENCE OF THE WEBSTER PARISH POLICE JURY, CVEU, ITS AGENTS, OR EMPLOYEES. THE APPLICANT WILL BE HELD RESPONSIBLE FOR ANY DAMAGES TO THE PARISH ROADS. ACCURACY OF THE PERMIT IS THE RESPONSIBILITY OF THE APPLICANT.

 

P.O. BOX 389, MINDEN, LA 71058

WPPJPERMITS@SUDDENLINKMAIL.COM

318-377-7564

 

 

Webster Parish Police Jury   -   Webster Parish Courthouse Annex

401 Main St., 1st Floor - P.O. Box 389 - Minden, LA 71058 - (318) 377-7564 Office - (318) 371-2366 Fax