HomeMy WebLinkAbout Erick Rd. #10 - 9/14/1994TOWN OF MANSFIELD, MASSACHUSETTS
50 West Street, Mansfield, MA 02048
APPLICATION FOR PERMIT TO DRILL WELL
Name
Address
Location
Installe
Address (?/"" �
TYPE OF WELL:
omestic Potable
Domestic Auxilia
_Agricultural
Inteu ed use:
Fee: //p 00
The ab
to install
of
C'< P
Industrial/Commercial Potable
_Industrial/Commercial Auxiliary
_Local Water Supply
Date:
PERMIT TO INSTALL WELL
application has been approved and permission is granted
1 �3tIC XGV-1 l(Qti(4 well for the purpose
Date:�_ (.�- q q_
Approved by: w� y de-,
for the Board of Health
NOTE: Electrical permit required; underground cable trench must be inspected.
APPLICATION FOR PERNIIT TO DRILL WELL
Name
Address C
Location
M
Address Z5'3A1Yc1 w�^ o "c /p �✓ ass c��� �
TYPE OF WELL:
Domestic Potable (for household use)
IV Domestic Auxiliary (for watering, pools, etc.)
_Industrial/Commercial Potable (for human consumption, including food processing)
_Industrial/Commercial Auxiliary (for manufacturing, etc.)
_-Agricultural fo " ' tion of land in the business of agriculture)
Fee: ' Domestic $ 10.00
/ 3 w i ! Applicant
The above application
following use at
$ 100.00 U//C Agricultural
PERMIT TO DRILL A WELL
and permission is granted to drill a well for the
DDomestic Potable (for household use) ^Y
omest+ Auxiliary (for watering, pools,
—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)
Date: _ ' Approved by:11
For the Board of Health
NOTE. Electrical permit required; underground pakle treni�h must be insp
SP 1 5
I fib$ M E,i �k 'k