HomeMy WebLinkAboutHope St. #55 - 8/4/1994Name
Address
TOWN OF MANSFIELD) MASSACHUSETTS
50 West Street, Mansfield, MA 02048
APPLICATION FOR PERMIT TO DRILL WELL
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Location
Installer G{S� 1fi�Lt�[(,�2ZLL-1 V�G-�
Address P r� t"' �d �S (9 ti % 1- 'A 2l P g LYJ fz L • z2d) ' !
TYPE OF WELL:
Domestic Potable _Industrial/Commercial Potable
Domestic Auxiliary —Industrial/Commercial Auxiliary
_Agricultural _Local Water Supply
Intended use: ( /�z r` I Gf-� Iq
Fee• LL LO—L Date: :- 0�9 "5
Ll
The above, application
to install a
of
Date:
PERMIT TO INSTALL WELL
been approved and permission is granted
n
at
Approved
well for tlA purpose
NOTE: Electrical permit required; underground cable trench must be inspected.