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
