HomeMy WebLinkAboutDeer Path Lane #40 - 7/15/1997APPLICATION FOR PERIVIIT TO DRELL WELL
Name 4s
Address q6 17Eer2 10,4T4 L4N c5
Location
Installer
Address
TYPE OF WELL:
_Domestic Potable (for household use)
2bomestic 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 business of agriculture)
Fee: �C Domestic $ 10.00 Industrial/Commercial $ Agricultural
Date: --7 A Applicant Signature:
PERMIT TO DRILL A WELL
The above application has bee approved and pen
following use at __ LLO /�� e n F-f %
to drill a well for the
Domestic Potable (for househc':: use) —� —
Vbomestic Auxiliary (for watering, pools, etc.)
Industrial/Commercial Potable (for human consumption, including food processing)
—Industrial/Commercial Auxiliary (for matufacturing, etc.) - --
_Agricultural (for irrigatinn of land i , he business of agriculture)
Date: �- / S '�? _ Approvedby: ��TI ��i1� K- J&-
For the Board of Heai h
NOTE: Electrical permit required, underground cable trench must be inspected