HomeMy WebLinkAboutOld Stable Dr. #39 -10/12/1999APPLICATION FOR PERMIT TO DRILL WELL
Name f DV4 L1tVi(V q
Location �S F-fi r
Registered
Well Driller 4/x¢.rtCA,n Dr
Address
TYPE WELL:
_Domestic P otablee (for household use)
_Domestic Auxiliary (for watering, pools, Ftc.)
_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 _Industriai/Commercial $ 100.00 N/C Agricultural
Date: 16 /iIx Applicant Signature'_7:,�� zl( �4 0�c
PERMIT TO DRILL A WELL
The above application has been ap ro ed and permission is anted to drill a well for the
folloyring use at �J� 4 S74& (U
(_Domestic Potable (for household Musa)
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 busin ss of agriculture)
Date: �d "�a "%Gl Approvedby:
For the 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.