HomeMy WebLinkAboutMayflower Dr. #15 - 08/13/1997APPLICATION FOR PERMIT TO DRILL WELL
Name rl�l�"lj6tJ
Location
Installer_
TYPE OF WELL:
_Domestic Potable (for household use)
X-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 _Industrial/Commercial $ 100.00 N/C Agricultural
Date: (t ,l % Applicant Signature
PERMIT TO DRILL A WELL
The above application has been
following use at 1 � t�)
is granted to drill a well for the
Domestic Potable (for household use) Domestic Auxiliary (for watering, pools, etc_.)
_ hidustrial/Commercial Potable (for human consumption, including food processing)
—Industrial/Commercial Auxiliary (for manufacturing, etc.)
_Agricultural (for irrigation of land in the business jnf agriculture)
Date: �� _ Approved by: —
For the Board of Health
NOTE. Electrical permit required; underground cable trench must be inspected