HomeMy WebLinkAboutLongwood Cir. #3 - 6/27/1997IN 0 1 D1 R 11 11117.1 Z4 1 1 .__
APPLICATION FOR PERMIT' TO DRELL WELL
Name
Address 7 l/> 60 5rD 666t,(
Location
Installer
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: X Domestic $ 10.00
Date: -!A? k
—Industrial/Commercial $ 100.00
Applicant
N/C Agricultural
PERMIT TO DRILL A WELL
The above application has been approved and p i`s�jio-n is granted to drill a well for the
following use at j jj<\ vela-u,0 12t lK
D-LMestic Potable (for ho:;seholl 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)
Date: CO (i' Approved by; =i{
" Fo the`l3catd'ofHealth
NOTE. Electrical permit required, undeij�blund c"'&4lnch must be inspected