Gas Well Development Application
GAS WELL DEVELOPMENT APPLICATION
PROJECT APPLICATION WILL BE REVIEWED IN ACCORDANCE WITH CITY OF DENTON ORDINANCE NUMBERS 2015-233
AND DCA19-0009E, UNLESS ACCOMPANIED WITH A VESTED RIGHTS PETITION SUBMITTED PURSUANT TO DDC
SECTION 2.5.6.
D E V E L O PM E N T S E R V I C E S D E P A R T M E NT
401 N. Elm St., | Denton, Texas 76201 | (940) 349-8451
www.cityofdenton.com/gaswellinspections
DRILLING AND PRODUCTION SITE INFORMATION
Site Location (circle one): COD ETJ
Drilling and Production Site Name:
Distance (in feet) to nearest Protected Use (See Site Plan Checklist for Computing Distance):
Setback Reduction Distance (if applicable): Date of Ambient Noise Study:
911 Address: DCAD Property ID Number:
Site Acreage: Parent Project No. (If amendment):
Reason for Amendment (If applicable):
OPERATOR INFORMATION
Company: Name of Co. Representative:
Address: City: State: ____ Zip:
Phone Number: Email Address:
REGISTERED COMPANY AGENT TO RECEIVE NOTICE (must be a Texas resident)
Name:
Address: City: State: ____ Zip:
Phone Number: Email Address:
APPLICANT INFORMATION (provide only if different from Operator or Agent Information)
Applicant Name: Company:
Address: City: State: ____ Zip:
Phone Number: Email Address:
SURFACE OWNER INFORMATION
Surface Owner Name:
Address: City: State: ____ Zip:
Development Application Type* (circle one) Site Plan ** Plat ** Amendment
* Additional applications may be required based on proposal, to include: Watershed Protection Permit (WPP), ESA Assessment, or Specific Use Permit (SUP)
** Development Site Plan submitted for sites within the City of Denton and Development Plat applications shall be submitted for sites in the City’s ETJ.
GAS WELL DEVELOPMENT APPLICATION
D E V E L O PM E N T S E R V I C E S D E P A R T M E NT
401 N. Elm St., | Denton, Texas 76201 | (940) 349-8451
www.cityofdenton.com/gaswellinspections
I certify that the information submitted is correct and complete. I further certify that I have read, understand, and will
comply with the Denton Development Code.
***NOTE***
GAS WELL DEVELOPMENT APPLICATIONS:
WILL BE REVIEWED FOR COMPLETENESS OF THE CITY’S TECHNICAL REQUIREMENTS RELATING TO FORM
AND CONTENT WITHIN TEN (10) BUSINESS DAYS. THE CITY WILL PROVIDE WRITTEN NOTICE TO THE
APPLICANT, NOT LATER THAN THE TENTH (10TH) BUSINESS DAY, STATING EITHER THAT THE
APPLICATION IS COMPLETE OR THAT THE APPLICANT FAILED TO PROVIDE NECESSARY DOCUMENTS OR
OTHER INFORMATION. THE CITY’S NOTICE WILL SPECIFY THE DOCUMENTS OR OTHER INFORMATION
NECESSARY FOR THE APPLICATION. IN ADDITION, THE CITY WILL INDICATE THE DATE THE APPLICATION
WILL EXPIRE IF THE NECESSARY DOCUMENTS OR OTHER INFORMATION IS NOT PROVIDED. THE
EXPIRATION DATE WILL BE ON OR AFTER THE FORTY-FIFTH (45TH) DAY AFTER THE DATE THE
APPLICATION IS FILED.
______________________________________ ___________________________________
Operator’s Signature Printed Name
State of Texas
County of _______________________
Before me, _______________________ (insert the name and character of the officer), on this day personally
appeared_______________________, known to me (or proved to me on the oath of ______________ or through
_____________ (description of identity card or other document) to be the person whose name is subscribed to the
foregoing instrument and acknowledged to me that he executed the same for the purposes and consideration therein
expressed.
GIVEN UNDER MY HAND AND SEAL OF OFFICE THIS ______ DAY OF _______________, 20____.
(SEAL)
___________________________________
Notary Public Signature