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76 LAFAYETTE STREET & NEW DERBY STREET - WELL a � CITYrOFrSALEM MASSACHUSETTS OF HEALTH y WASHINGTON STREEM 4TH FLOOR SALEM,MA 01970 TEL 978-741-1800 FAic 978-745-0343 WWW.SALEM.COM Kimberley Driscoll JOANNE SCOTT, MPH, RS, CHO Mayor HEALTH AGENT WELL CONSTRUCTION PERMIT Location: 76 Lafayette & New Derby Streets Owner: Dodge Area LLC Address: 17 Ivaloo Street, Somerville, MA This permit is granted in conformity with the statutes and ordinances relating to well permits. Well Construction permits are non-transferable. This permit shall be on site at all times that work is taking place. Permit shall expire one (1) year from the date of issuance unless revoked from cause. This permit does not constitute a Water Supply Certificate. Permit#: 008-06 Date Issued: 7/6/06 (Monitoring Wells) (TED Inc. — Reg. #560) HEALTH AGENT 0, - ..— d�iD CL Utl U$idli Joarme/ JYu✓4 a...<n. .,... �,.,, ,_, _„ . O CITY Or SALEM,MASSA41HIVSET7S HC AtACI OF HLA.TM ap 180 WA S?W&CM eSAtLT.A IN r� ca SAL&W, MA*1970 O Tm.979.141-tWO O FNr TlaY7afa.pAdD cx� o STANACr J_USA'vtc7.JR. JCANME SCCTT, WH.R%CHO MAYOR HE&t-lr lt6E7+r N u7 O ' Wau Consftc o PsrmUtAngkodon Date: �a Fee-SIDD.CteCk Wpble bine CAy of Salon(mo cash) p y ccs Loc0on l i Salam.MA, alvo o�G Owner. t1_ IAddressr` n� )f,�ru3l� N 1/> .r.;, c�j' r'r� C?A'•t'k4Y n4 .V�rc+ Too of we.i: Wet use: '!1� .,(+s Cy[ ^,tom__ Weft Co*actar Puny ColU-ectOr. nddnna. Attd ves: �t�} Pfiaae-. Sit 5ik-k 4kW P►}one � Rag.Ah 0 Have aOvtbe�e t�eeR tu7Ufbd? t(YA HOW? 7R mo Weoa mWow Arfar 1260N boo slur ce ia'f7e A,-40"awet as ae,Gatri to m�rrilgcrp�q�oo�abcraM/gloNSmlrrasbr�Gu'es. Ada90'gMinc0lisCi9priarardCl'trmf `�� ... 41 hoe arse aMe2dr i 100)tact otlse caopased aec r<hxla aysreaara E Oa'-"ems' sa.'rce M - �.ti CC"SYC4}-''+[L.J Q1'CTC` �f�1: ?�!__`~•.- -,/�,�,�� � :d�.i. ,�,�y 'ff mhWleelanwisavapweaZ'tD�f�permr<i611aquV tkch'SeQeIaS�+. B.O.H. ube n:/, cmak Gsd Cade: Pev rA owl vet ee.*+:WVA wWri',AMC r sac) R � [J�N4'awya(^1Y,(.v Al Y`.5A town 16 lclL v,S U4/ r L�� e= ts;