HomeMy WebLinkAboutDeer Path Lane #35 - 10/3/2002APPLICATION FOR PERMIT TO DRILL WELL
Name_ Ke\1 \h ��0CRk�t1
Address: 2� ®0_r-_,(e0,�k 0.h Lr
Location:
Registered
��Well Driller:
Address:
TYPE OF WELL:
Domestic Potable (for household use)
Domestic Auxiliary (for watering, pools, etc.)
Industrial/Commercial Potable (for human consumption, including food processing)
_ Industrial/Commercial Auxiliary (for manufacturing, etc.)
_ A cultural (for irrigation of land in the business of agriculture)
Fee: Domestic $10.00 _ Industrial/Commercial $100.00 N/C Agricultural
Date: ) 0 — 03 —Oa
Applicant Signature:_
The above application has been approved .iermission is granted to drill a well for the
following use at S o n ��w l L �,, _
_ Domestic Potable (for household use)
X Domestic Auxiliary (for watering, pools, etc.)
_ Industrial/Commercial Potable (for human consumption, including food processing)
Industrial/Commercial Auxiliary (for manufacturing, etc.)
_ Agricultural (for irrigation of land in the busine „s of agriculture)
Date: /o �3 A Approved by: -
For the Board of Health
NOTE: Electrical permit required; underground cable trench must be inspected
Upon Installation of well, call Department of Public Works office at
261-7330 to be added to well list