HomeMy WebLinkAboutCarriage House Ln. #7 - 4/7/1998APPLICATION FOR PERMIT TO DRILL WELL
Name i ) ennIS' . )oU
Location YY) /) N S �I d M %� . Q aD L48
Registered
Well Drilk
IC6LIVI-
Se zVlcs
Address P.O. BoA 353 1AleS7rnvInsTeR�AlA 011473
TYPE OF WELL:
X 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.)
_Agricultural (for irrigation of land in the business of agriculture)
Fee: X Domestic $ 10.00 —Industrial/Commercial $ 100.00 N/C Agricultural
Date: 414198 Applicant
PERMIT TO DRILL A WELL
The above application ha
s been approved and , rmission is
following use atv'-
to drill a well for the
T%. 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.)
_Agricultural for irrigation of land in the bus'n of agriculture)
Date:" Approved by:
r e Board of Health
NOTE. Electrical permit required, underground cable trench must be inspected
Upon installation of well, call Department of Public Works office at
261-7331 to be added to well list.