HomeMy WebLinkAboutJames St. #26 - 6/28/2018Commonwealth of Massachusetts
Town of Mansfield
Mansfield 8 Park Row
Town of f Mansfield, MA 02048
Board of Health
Application for Permit to Drill Well
NAME OF OWNER: Susan McNeil REGISTERED George Zanellato's Well Services
WELL DRILLER:
ADDRESS OF OWNER: 26 James Street I MA LIC #: 94
TOWN /STATE /ZIP: Mansfield, MA 02048 BUSINESS 65 Laurel Street
ADDRESS: Bridgewater, MA 02324
TELEPHONE No: _,,,, ,,,.,,,,. ,,,, ,__�....,.
TYPE OF WELL: 0 Domestic Potable (for household use)
ijX 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: W Domestic $75.00
DATE: June 25,2018
O Industrial/Commercial $75.00
APPLICANT SIGNATURE
Permit to Drill Well
❑+ Agricultural $75.00
The above application has been approved and permission is granted to drill a well for the following use
fl!►i�1'+]
Domestic Potable (for household use)
Domestic Auxiliary (for watering, pools, etc.)
Industrial/Commercial Potable (for human consumption, including food processing )
EI Industrial/Commercial Auxiliary(for manufacturing, etc.)
[D Agricultural (for irrigation of land in the business of agriculture)
DATE: c6\ �Qj APPROVEDBY
For
NOTE: Electrical permit required; underground cable trench must be inspected.
Upon installation of well, call Department of Public Works at
508-261-7330 to schedule an inspection.
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