Laserfiche WebLink
12, Wim? Is the depth to groundwater? Le <br /> Describe the source of information: <br /> IJ. Are there any water wells on this parcel or adjacent properties? <br /> yE,g [ ] NO <br /> TYPE OF Wrus DISTANCF.TO TANK-9V9) <br /> Public Well R• <br /> Private Well It <br /> Irrigation Well It. <br /> Monitoring Well it. <br /> Other fl <br /> 14. Will file tnnk(s) pending closure be replaced with nn aboveground or underground storage tonk(s)? YES( ] NO,, <br /> 15. indicate the responsible party Io he billed for additional PIIS-EllD stnlf(line expended beyond J hour minimum <br /> permit payment per lnnk. Ir the pnrty designated below Is different than the permit nppllcanf, e.g. properly owners <br /> the party must acknowledge this responsibility for file billing by signature and dale below. <br /> NameG'72! <br /> Halling Address <br /> Day Phone Number ( ' �C ) --3 /2 <br /> Slgnnlure Date <br /> Page 6 <br />