Loading...
HomeMy WebLinkAbout1964-1-31 - 725 Foster Street - Well Drilling PermitTOWN OF SOUTH WINDSOR South Windsor, Conn. NO 3 Date ...... .... ... �j 0 WELL DRILLER'S PERMIT 7� �..... ...r�.. .......... I, • � `'.• =`.. /SAPS.L............................�. �..�r�. ......• ............... of the firm of . Prr .................m.�C.t1...:.................. (address) .......4 ?.CS.y.... t7.t!'N....................... hereby stet ktat I (we) am {are) a weU driller duly and currently registered vith they State of 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 Cannectic}4 Legislature, for a,well,tq be, dril)6d on the property of: Name of Property Owner:. Address of Property Owner......... .... .........,7. •L........... ' r�f.[.� ...._._...... ..._........ ,..... .... ---- Address of Premises on which well is located:....:...,....................................._....._...... �- . .......... ............................ 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 Completio eport"which sbeen plied to reg' drillers; Applicant This permit is issued for a well located as shown to the above named well driller in Public Act 187 of the 1963 Session of the Connecticut Legislatu�-,�h........... WHITE —ISSUING AGENT GREEN — APPLICANT PINK —LOCAL HEALTH OFFICER CANARY —WATER RESOURCES COMMISSION (Over) Provisions of .•. � ■ �d b _ : ■ �} ■ 2� - .ki � � a � � ■ • .x : \ � ■ � . . , _ .| , © ~ . ■ §�— $ ■ s | ■ A_ f � a ` . 3 �