Well Permit Signature

San Bernardino County EHS — Aversa, APN 0439-402-31

Connie Aversa

Property Owner

Please sign below to authorize the well permit application for your property at 12760 Japatul Road, Apple Valley, CA.

Your signature will be placed on:
  • Section 14 — Legal Purposes Declaration
  • MWA Notice of Intent — Property Owner's Signature
Sign Below

Sign here with your finger or mouse

By signing, you acknowledge that your electronic signature is legally binding and equivalent to a handwritten signature per Section 15 of the SB County well permit application.