HomeMy WebLinkAboutHampshire St. #100 - 11/2/1995Name
Address
Location
TOWN OF MANSFIELD, MASSACHUSETTS
50 West Street, Mansfield, MA.02048
APPLICATION FOR PERMIT TO DRILL WELL
C fl /S
C,413c�T 13LvD
Installer Ekf-57-1
Address
TYPE OF WELL:
/Ifomestic'Potablei
Domestic Auxiliary
Agricultural
Intended use:
E�PP)6A7T/I/\1
Industrial/Commercial Potable
_Industrial/Commercial Auxiliary
Local Water Supply
Fee: /0 Date: l� Z519J� '
PERMIT TO INSTALL WELL
The above application has been approved and permission is granted
to install a 4-4X/VA�-� well for the purpose
of t--"f`/J at t00 h4f01y1/0SH/2-£ S 7-
Date: I I - a cZS
Approved by:
or tEe Board of Health
NOTE: Electrical permit required; underground cable trench must be inspected.