HomeMy WebLinkAboutRumford Ave. #69 - 4/5/1989TOWN OF MANSFIELD, MASSACHUSETTS
50 West Street, Mansfield, MA 02048
APPLICATION FOR PERMIT TO DRILL WELL
Name
Address
Location
Installer
Address
TYPE OF WELL:
_ Domestic Potable _Industrial/Commercial Potable
Domestic Auxiliary _Industrial/Commercial Auxiliary
_Agricultural _Local Water Supply
Intended use: L0C IP j -
Fee: 'Gi.liL> Date:
PERMIT TO INSTALL WELL
The abov application has been approved and permission is granted
to install a e well for the purpose
of i at
Date:
Approved by:
NOTE: Electrical permit required; underground cable trench must be inspected.