Please complete this application in its entirety in order to avoid delays in processing your permit.
Please print and submit along with ENC application.
An "Application to Install / Abandon Water, Monitoring or Emergency Well(s), or Any Other Excavation(s) That May Intersect Groundwater Within the City of Modesto" must also be submitted.
The applicant will be considered the primary point for all contact and correspondence from the City unless other arrangements are made in writing.
Corporate partnerships must provide a list of principals.
Deposit type applications may either have a refund due or additional fees due after the Final Inspection and/or before recordation can occur. You must provide the contact information above to receive a refund. NO REFUNDS WILL BE GIVEN FOR BALANCES LESS THAN $5.00
A signature will be captured at the time the permit has been issued.
**Note: if the applicant is not the property owner, the property owner shall designate the applicant as the authorized agent to act on his or her behalf and both shall sign an affidavit and submit it here or in person.
Please print, sign and submit this form with on-line application
This field is not part of the form submission.
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