HomeMy WebLinkAboutThomas St. #18 - 8/19/2002APPLICATION FOR PERMIT TO DRILL WELL
Name��1)ti�%�%//X/l
`Address: �C7
Location: VS %!�
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Registered
Well Driller: 6,W11/�L
TYPE OF WELL:
Domestic Potable (for household use)
_ Domestic Auxiliary (for watering, pools, etc.) +
Industrial/Commercial Potable (for human consumption, including food processing)
Industrial/Commercial Auxiliary (for manufacturing, etc.)
7 Agricultural (for irrigation of land in the business of agriculture)
Fee: _ Domestic $10.00 _ Industrial/Commerc' 100.00 N/C Agricultural + r
Date: jl- Zy' D Applicant Signature:
I WA EAVA-111 0 01111
The above application has been approved and permission is granted to drill a well for the
following use at l-'�& l 3�6 x G T—
e:
_ Domestic Potable (for household use)
_ Domestic Auxiliary (for watering, pools, etc.)
Industrial/Commercial Potable (for human consumption, including food processing)
ludustrial/Commercial Auxiliary (for ✓ manufacturing,'etc.)
Agricultural (for irrigation of land in the b}isiness7of agriculture)
Date: hVI, i e-i, f Q 7/ Approved by�'--
—� r the Board of Health
NOTE. Electrical permit required, underground cable trench must be inspected.
Upon Installation of well, call Department of Public works office at
261- 733 0 to b'e added to well list
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TOWN OF MANSFIELD, MASSACHUSETTS
50 West Street, Mansfield, MA 02048
APPLICATION FOR PERMIT TO DRILL WELL
Name -i-
Address
Location 5 ��
Installer G \ r
Address
TYPE OF WELL:
Domestic Potable Industrial/Commercial Potable
Domestic Auxiliary _Industrial/Commercial Auxiliary
_Agricultural _Local Water Supply
Intepded use: `-y Pl -f�
Fee:_ Date: /%y / / Z 9 S'
PERMIT TO INSTALL WELL
The above application has been approved and permission is granted
to install a well for the 'purpose
of at I Tri�� Si
Date: 5Xt Gj� Approved by:
for the Board of Health
NOTE: Electrical permit required; underground cable trench must be inspected.
TOWN OF MANSFIELD, MASSACHUSETTS
50 West Street, Mansfield, MA 02048
APPLICATION FOR PERMIT TO DRILL WELL
r
Name
Address
Location
Installer
Address /i %h-lqz-� J� f �" Fjlhl-ey � d i
TYPE OF WELL:
Domestic Potable
Domestic Auxiliary
Agricultural
In ended use: -
Fe Date: Z
Industrial/Commercial Potable
Industrial/Commercial Auxiliary
Local Water Supply
PERMIT TO INSTALL WELL
The above application has been approved and permission is granted
to install a �j �� Am IL- well for the purpose
of at 1$ Ac'S 1 i
Date: Z Approved by: -77
the Board of Health
NOTE: Electrical permit required; underground cab %ftrefith must be inspected.
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