HomeMy WebLinkAboutMarie Dr. #7 - 2/20/2018Commonwealth of Massachusetts
Town of Mansfield
Board of Health
Application for Permit to Drill Well
NAME OF OWNER: 0,///C l 1` /)z!
ADDRESS OFOWNER:7 /'liz!fzf 4?P-
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6 Park Row
Mansfield, MA 02046---
REGISTERED PIL" L se,4'7-1 A' G n
WELL DRILLER: PA-7 L
MA LIC #: /';Z7
TOWN / STATE /ZIP: "�� � � BUSINESS lei
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TELEPHONENo: SL~`' u
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TYPE OF WELL: El Domestic Potable (for household use)
Wbomestic Auxiliary (for watering, pools, etc.)
El Industrial/Commercial Potable (for human consumption, including food processing )
j Industrial/Commercial Auxiliary (for manufacturing, etc.)
Agricultural (for irrigation of land in the business of agriculture)
FEE: 0 Domestic$75.00 i•a Industrial/Commercial$75.00 O Agricultural$75.00
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DATE: 2bohg APPLICANT SIGNATUR
Permit to Drill Well
The above application has been approved and permission is granted to drill a well for the following use
0 Domestic Potable (for household use)
A- Domestic Auxiliary (for watering, pools, etc.)
0 Industrial/Commercial Potable (for human consumption, including food processing )
Industrial/CommercialAuxiliary(for manufacturing, etc.)
O Agricultural (for irrigation of land in the business of agriculture)
DATE: APPROVED B J
F r the Board of Health
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. : l= a° 9j;.ta.r)'t)"`l
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PREPARED FOR WALSH BROTHERS BUILDING, CO.
11 SADDLE WAY
WALPOLE, MA 02081
508.668.3?34
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1-31
LOT 13
27,291 -�- sf
LOT 14 v -�
23,757± sf
LOT 17
25, 871 ± sf
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PLAN OF LAND FOR
LOT 94 MARIE DRIVE
MANSFIELD, MA
<u��f SEPTEMBER 12, 2016 SCALE: I" = JO'
}','_"'�' / BAY COLONY GROUP, INC.
.`J PROFESSIONAL CIVIL 'NOINEERS & LAND SURVEYORS
FOUR SCHOOL STREET P.0" 80X 9136
FOXHOROUGH AIA 02035
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LOT 15
32,133± sf
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