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HomeMy WebLinkAboutWell Correspondence 59 Cliffwood Drive 10 mN Sf4 C o ' 7-0�. Oleso� ?d C V .i y 1540 SULLIVAN AVENUE • SOUTH WINDSOR, CT 06074 SOR-CO TELEPHONE (860) 644-2511 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. RECEIVED Water service: Circle the appropriate service: FEB 18 ?nnp ED MDC CT WATER SOUTH WINDSOR ENGINEERING DEPT, WELL USE: DOMESTIC LAWN & GARDEN AGRICULTURAL Well Location : BACK DRAWING: 40 FT A FRONT B 30F 14FT 6T r7 WELL 1�fQ 0/1 fi j6 STREET WL-5L.L Location of Well: Town of SKETCH SHOWING LOCATI6N OF PREMISES IN TOWN .(Show distance and direction from road intersection or other landmark) � F y Diagram Showing Location of Well on Premises: f t 1. t 1 i"'" r Route Directions for Reaching Well Site from Nearest City or Village Center: TOWN OF SOUTH WINDSOR � South Windsor, Conn. .4 91 Date .. ..._......... ..E..... ...... ............��� LL DRILLER'S PERMIT I, ...:. . . ..... .. ...-., of the firm of..93.'��.... ... .. ........... . 00 ............................................. (address) ............................... .. ..... ............... ...e.. .................................. - hereby.state that I (we) am (are) a well driller duly and currently registered with the Sta of nnecticut ater Resources Commission and do make application herewith for a Well Driller's Permit in accordance with the proviso of Public Act 187 of the 1963 Session of the Cwectieut sla e, for a well to be drilled on the property of.: , Name of Property Owner:.../.../—... ............. r ......... Addressof Property Owner:................................................................ ......:. . ............._ ....._.......,...._....__..__.._.... . :.................... .... Address of Premises on which well is located:............. ............................... The approximate location of the well will be as show 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 CommissloiL 223 State Office Building,Hartford, Connecticut on the form entitled"Well Completion PE's"+Vhich has bee lie to r gistered drillers ................ . ..................... 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 Legislature this....................................day of........................ ........., F96 WHITE—ISSUING AGENT .............................................. ..........`�C3��v.....y... ........ .. .............. ..................................................................... GREEN—APPLICANT Bui icier PINK—LOCAL HEALTH OFFICER CANARY—WATER RESOURCES COMMISSION (Over)