HomeMy WebLinkAboutKing Arthur Way #44 - 8/6/1997MANSFIELD BOARD OF HEALTH
APPLICATION FOR PERMIT TO DRILL WELL
Name
Address
TYPE OF WELL:
Domestic Potable (for household use)
_
,� 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: � Domestic $ 10.00
Date:
Industrial/Commercial
Applicant
100.00 N/C Agricultural
PERMIT TO DRILL A WELL
The above application has been a roved and permission is granted to drill a well for the
following use at t4k4 V1 En (,00-� t
Iomestic Potable (for household use)
Doniesiic i ktyiiiacY for watering, pools, etc.)
_Indus,'_ it °a r. ,r61. K AVial Potable (for human consumption, iucivuk,i,_; food processing)
—Industrial/Commercial Auxiliary (for manufacturing, etc.)
_Agricultural (for irrigation of land in the business of agriculture)
Date: Approved by:
For the Board of Health
NOTE: Electrical permit required, underground cable trench must be inspected