HomeMy WebLinkAboutAvon St. #8 - 2/23/1998MANSFIELD BOARD OF HEALTH
APPLICATION FOR PERMIT TO DRILL WELL
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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.)
_Agricultural (for irrigation of land in the business of agriculture)
Fee: _Domestic $ 10.00 _Industrial/Commercial $ 100.00 N/CC Agricultural
Date: 2 ' 2 3 " g � Applicant Signature: t/jd L" �--
PERMIT TO DRILL A WELL
The above application has been /� pproved a o permission is granted to drill a well for the
following use at Mon L-r
_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 busine" of agriculture)
Date: 0 ' a�' Approved
NOTE: Electrical permit required; underground cable trench must be inspected.