HomeMy WebLinkAboutAngelina Ln. #60 - 4/26/1996TOWN OF MANSFIELD, MASSACHUSETTS
50 West Street, Mansfield, MA 02048
APPLICATION FOR PERMIT TO DRILL WELL
Name
Address
Location
Installer
Address
TYPE OF WELL:
_ Domestic Potable
p` Domestic Auxiliary
_Agricultural
Intended use' W�Y1
Fee
_Industrial/Commercial Potable
Industrial/Commercial Auxiliary
Local Water Supply
Date: Z ,
PERMIT TO INSTALL WELL
The above application has been approved and permission is granted
to install a J Ti &U X I C I `/ well for then purpose
of WOM1 A!6 L -L at %o �Y1C� (o, 4 LaK q_ .—
Date: `t �-�� Approved by:
for t63ard of Health
NOTE: Electrical permit required; underground cable trench must be inspected.