HomeMy WebLinkAboutFruit St. #150 - 4/5/2000j1� APPLICATION
PL^�ICA�TTIIO6N FOR PERMIT TO DRILL WELL
Name I ° 1lCir f�Q 1 l�/ &J- A
Registered
Well Driller
� U__ user welts five l Ql, :c_
TYPE OF WELL:
Domestic Potable (for household use)
_
Domestic Auxiliary (for watering, pools, etc.)
—Industrial/Commercial Potable (for human consumption, including food processing)
_ as er i Auxiliary (for manufacturing, etc.)
griculturai (for i 'gati n of land in the business of agriculture)
Fee: V Dorr
Date:
—Industrial/Commercial 100
Applicant Signature:
PERMIT TO DRILL A WELL
The above application has been approved
following use at
is granted to drill a well for the
_Domestic Potable (for household use)
DC -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 bi ess o g culture)
Date: A� � 7G>_ Approved by:
For the oard 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