Spacing Exception Waiver As provided in Panola County Groundwater Conservation District (“District”) Rule 5.3, any person that applies to the District to drill a new well may request an exception to the District’s water well spacing requirements in District Rule 5.2. Such a request must be accompanied by waivers signed by all landowners and well owners with property, existing wells or an approved well site that would be located closer to the applicant’s proposed well than what is provided by the spacing requirements in the District Rules. has submitted/will submit a Drilling Permit application to the District requesting authorization to drill a new water well located at * has submitted/will submit a Drilling Permit application to the District requesting authorization to drill a new water well located at Single Line Text * 1. Please select one of the following: 1. Please select one of the following: * Exception to Spacing Requirement from Property Line Exception to Spacing Requirement from Other Well Site Exceptions to Both Spacing Requirements from Property Lines and Other Well Sites 2. List the spacing requirement(s) under District Rule 5.2 and the spacing requested: Flow Rate (gallons per minute): * from property line: from property line: * North South East West spacing required by rules (feet): spacing requested by applicant (feet): from other well site: spacing required by rules (feet): spacing requested by applicant (feet): Land/well owner potentially affected: By signing below, I acknowledge that the Applicant has requested the above-described exception(s) to the District’s spacing requirements and as a landowner/water well owner potentially affected by the requested waiver, I hereby agree to waive any objection to the proposed location of the water well site. Signature * Clear Date * Print Name/Title * Business/Organization name (if applicable) Address of property/well location: * reCAPTCHA If you are human, leave this field blank.