HomeMy WebLinkAboutSpring St. #35 - 3/24/1999APPLICATION FOR PERMIT TO DRILL WELL
Name
Address 3 S ; .. 57 Telephone .32 �i �
Registered Well Driller J ` > Number
Address / , P bLr ' t' S 7`
TYPE OF WELL:
Domestic Potable (for human consumption)
7bomestic Auxiliary (for landscape 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: tl-� Domestic $ 10.00 Industrial/Commercial $ 100.00 N/C Agricultural
Date: - -aq - A/- Applicant Signature:/
PERMIT TO DRILL A WELL
The above application has
following use at 3s
approved and permission is granted to drill a well for the
Domestic Potable (for human consumption)
7Domestic Auxiliary (for landscape watering, pools, etc.)
Industrial/Commercial Potable (for human consumption, including food processing)
_Industrial/Commercial Auxiliary (for manuf c.
_Agricultural (for irrigation of land in the bus f ulture)
Date:" �-�l� Approved by: —
Forthe
Follow-up notes for after the well is drilled:
1. Electrical permit required, underground cable trench must be inspected.
2. Upon installation of well, call Department of Public Works off ce at 261-7331 to be
11T o
added
to we is
3. Display "Well Water" sign.