HomeMy WebLinkAboutRumford Ave. #74 - 8/4/1999APPLICATION FOR PERMIT TO DRILL WELL
Name /t%1CGr0 Cky6,i/1q i./_=
Address 71' &PO 4kt 4.
Location - -4a46 -
Registered
Well Driller q�d _ _ �sT®
Address 41
TYPE OF WELL
_Domestic Potable (for household use)
7 5omestic 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: _Domestic $ 10.00 _Industrial/Commercial $ 100.00 NNIC Agricultural
Date: - 41- 6161 Applicant
The above appli
following use at
PERMIT TO DRILL A WELL
approved and permission is granted to drill a well for the
Domestic Potable (for household use)
p-Zomestic Auxiliary (for watering, pools, etc.)
_Industrial/Commercial Potable (for human consumption, including food processing)
—Industrial/Commercial Auxiliary (for manufacturin etc.)
_Agricultural (for irrigation of land in the bus' s agriculture) �s ,
Date; 57%4::ffi Approved by:
For t e 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