HomeMy WebLinkAboutWell Correspondence 480 Clark Street V�
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Dear Homeowner:
The Town of South Windsor Health Department's goal is to keep you informed about the
status of water quality throughout the town whether you are served by and individual well
or by a public water source.
In an attempt to better serve you, we have reviewed our files to ensure we have the
most recent and accurate information possible. Our review has revealed that we do not
have any information regarding how your residence receives its water.
We are hopeful that you will take a moment to help us keep our records current. Please
indicate the type of water service by circling the appropriate entry below and return this
letter no later than in February 27, 2009, in the self addressed stamped envelope
provided.
If you receive your water from a private well, please let us know the location as it relates
to your home by providing two measurements from the foundation to the well in the
space provided and let us know if the well is used for domestic, lawn and garden, or
agricultural use. See example below.
Thank you in advance for your cooperation.
Any questions can be addressed to the South Windsor Environmental Health Officer,
Robert De Vito at 860-644-2511, extension 248.
Water service:
Circle the appropriate service:
WELL MDC (CEATER
WELL USE: DOMESTIC LAWN & GARDEN AGRICULTURAL
Well Location :
BACK DRAWING:
40 FT
A FRONT B Ltd ,i
30 F 14 FT SV� RANG DEPT'
ENGINES
WELL
STREET
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TOWN OF SOUTH WINDSOR
South Windsor, Conn.
NO25 Date .......... ................. ............5-1.............
WELL DRILLER"S PERMIT
. .......... ............. Zt,!zC-,/............................. 7Z
.................. of the firm of............. ..............__Z14.09
hereby state that I (we) am (are) a well driller duly and currently registered ............................
............................
...6...... . . ... (address) ..........
with�t he S t a f Connecticut Water Resources
Commission and do make application herewith for a Well Driller's Permit in accordance with the provisions of Public Act 187
of the 1963 Session of the Connecticut Legislature, for aw.�ll to be drilled on the property of:
Name.of Property Owner:................Q?,&000�v
f.0. .. ...... .................... . .... .... ............. ............ ............ ..............
Address of Property Owner:.............
;Oi7........ . ..............
.........................................................................................................................................
Address of Premises on which well is located:.......................................we (3/
.................................................................
The approximate location of the well will be as shown on the reverse side of this permit.
The.undersigned is aware that upon completion of this well the above data,together with a well log of information required
under (c):and (d) of Public Act 187 of the 1963 Session must be sent to: Water Resources Commission, 223 State Office
Building,Hartford, Connecticut on the form entitled"Well Completion BAport"whic has
14V_supplied to registered drillers.
..................(t�,
................................................... ...........................................................................
Applicant
This permit is issued for a well located as shown to the above named well driller in accordance with the Provisions of
Public Act 187 of the 1963 Session of the Connecticut Legisla re is.�.. 4,da Of..... ......................................................) 196..........
WHITE—ISSUING AGENT )K 4....... ... .. .................. .....................................................................
GREEN—APPLICANT
PINK—LOCAL HEALTH OFFICER Iding icial or Town Clerk V
CANARY—WATER RESOURCES COMMISSION (Over) V