HomeMy WebLinkAboutHillside Terr. #17 - 7/16/1997APPLICATION FOR PFIthM TO DRILL WELL
Name . f A W l
Address
TYPE OF WELL:
Domestic Potable (for household use)
I—CDomestic Auxiliary (for watering, pools,. etc.)
Industrial/Commercial Potable (for human consumption, including food processing)
—Industrial/Commercial Auxiliary (for manufacturing, etc.)
_Agricuhural (for irrigation of land in the business of agriculture)
_ wee: V Domestic $ 10.00 —Industrial/Commercial �$ 1000..000 N/C Agricultural
Date: _ 746 -97 Applicant signatur<e:�✓�/CLFZ�C
PERMIT TO DRILL A WELL
The above application has been approved an permission is granted to drill a well for the
following use at l -7 �f l l e Sl �.�- (ze4c� ,,4G£.
Domestic Potable (for househc':: use) —�-
1 -1 mestic Auxiliary (for watering, pools, etc.)
—Industrial/Commercial Potable (for human consumption, including food processing)
.dustrial/Commercial Auxiliary (for iaawfacturing, oic.) --
_,Agricultural (for irrigation of land in wt: business of agriculture)
Date: 7 - i �a - `? 1 Approved by: jet d- &,-k de -
For the Board of Health
NOTE. Electrical permit required, underground cable trench must be inspected