HomeMy WebLinkAboutWildflower Ln. #6 - 3/27/2000APPLICATION FOR PERMIT TO DRILL WELL
Name lC� ✓ t j"r
Address
Location
Registered
Well Drilh
Address
TYPE OF WELL:
Domestic Potable (for household use)
,Domestic Auxiliary (for watering, pools, etc.)
—Industrial/Commercial
Potable (for human consumption, including food processing)
Auxiliary (for manufacturing, etc.)
_Agricultural (for irrigation of land in the business of agriculture)
Fee:�Domestic $ 10.00 Industrial/Commercial $ 100.00 N/C Agncul ral
Date:I3(2 ` Applicant Signature:
PERMIT TO DRILL A WELL
The above application has been approved and permission is granted to drill a well for the
following use at
Domestic Potable (for household use)
omestic Auxiliary (for watering, pools, etc.)
IndustriaUCornmercial Potable (for human consumption including food processing)
Industrial/Commercial
_ Auxiliary (for manufacturing, etc.)
_Agricultural (for irrigation of land in the nesfc-6 culture
`� �' Approved by:
Date: For. a BoardHah
ri SCELLAREOUi CASH
NOTE. Electrical permit required; underground eWMeLtre& f be inspected
Upon installation of well, call DepartmeWorks office at
CHLCR�,'
261-7331 to be added to well list CLERK REGISTER I