HomeMy WebLinkAboutMayflower Ln. #11- 4/24/1998Name
Addre
Registered
Well Drilh
TYPE OF WELL:
MANSFIELD BOARD OF HEALTH
APPLICATION FOR PPERMIT TO DRILL WELL
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_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: YLIDomestic $ 10.00 —Industrial/Commercial $ 10 N/C gricultural
Date: Z U Applicant Signatur
PERMIT TO DRILL A WELL
The above application has been approved and permission is granted to drill a well for the
following use at
Domestic Potable (for household use)
o�Domestic Auxiliary (for watering, pools, etc.)
_Industrial/Commercial Potable (for human consumption, including food processing)
_Industrial/Commercial Auxiliary (for manufacturing, etc.)
Agricultural (for irrigatiiioon of land in the busi ss f griculture)
_
Date: i L - L � Approved by:
Fojjhe Board of Health
NOTE: Electrical permit required; underground cable trench must be inspected
Upon installation of well, call Department of Public Works office at
261-7331 to be added to well list.