HomeMy WebLinkAbout1979-6-18 - 2042 John Fitch Boulevard - Well Drilling PermitWEll.DRIUJNG BOARDwon".69
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WELL DRILLING PERMIT
STATE OFFICE BUILDING,HARTFORD,CONNECIICUT 06H5
FERMIT NUMBER
60409
IOCA'IION OF WEll (rm)
SOUTH WINDSOR
OWNER OF WELL
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OWNEVS ADDRESS
2042 JOHN FITCH BLVD -"A
D om (specify)VICTOR ROMAN
165C TUDOR LANE,OAKLAND MANOR,MANCHESTER,CONN.
PROPOSE
USE OF
WELL
(Strut)(Lot Numbar)
BUS INESS
6/15/79
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90'
plefion Report"confaining consirudion details and informafion required under Sedion
the Board and the Water Resources Cori-mission on the form provided by the
Ihe undersigned is aware the!upon compietion of Ihe well a ”Well Com25-131 of Ihe 1969 Supplement to the General Slalules must’be sent to ihe owner,Board.This permit is not valid until all information is filled in and it has been coumer-signed by Ihe Diredor of Health or his agent.
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RETURN THIS COPY TO CONNECTICUT WELL DRILLING BOARD
U
-DATE
(yerar
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.\IATwnata)APPLICANT'S ADDRBS REGISTRATION NO.
W LAKE ST.,VERNON,CONN.IOO’v .0"
aHNOWD B BY (I'm Health Olficar r 01")ad;DATEmm
REMARKS i?-0 I
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