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ay ARENT DEVSION OF y AG, As ENVIRONMENTAL PROTECTION FAX # (34%) 714-9528 Pre # (344) 774-3320 ly SS Star ES chs S GOVERNMENT OF THE UNITED STATES VIRGIN ISLANDS a arn DEPARTMENT OF PLANNING AND NATURAL RESOURCES DIVISION OF ENVIRONMENTAL PROTECTION CYRIL E: KING AIRPORT TERMINAL BUILDING, SECOND FLOOR ST. THOMAS, U.S. ¥.1. 00802 _ APPLICATION FOR GROUND WATER APPROPRIATION New OQ Renewal - Q) In compliance with Title 12, Chapter 5, V.I. Code, the undersigned: (Name of Property Owner) (Mailing Address) (Telephone #) hereby applies for a permit to appropriate ground water. The well(s) will be located at (Estate, Lot Number and Island) (Property Tax Number) (Well Drilling Permit Number") * = if applicable Proposed use of well(s): Check ONE use only. DOMESTIC QO Number of apartments Number of people to be served ‘Ore fe? Application for Ground Water Appropriation Page 2. FARM OPERATION OQ Land acreage reserved for crops Type and number of livestock COMMERCIAL (WATER SALES) Q Estimated water production Gallons per day Proposed cost of water at site Per 1,000 gal. …
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ay ARENT DEVSION OF y AG, As ENVIRONMENTAL PROTECTION FAX # (34%) 714-9528 Pre # (344) 774-3320 ly SS Star ES chs S GOVERNMENT OF THE UNITED STATES VIRGIN ISLANDS a arn DEPARTMENT OF PLANNING AND NATURAL RESOURCES DIVISION OF ENVIRONMENTAL PROTECTION CYRIL E: KING AIRPORT TERMINAL BUILDING, SECOND FLOOR ST. THOMAS, U.S. ¥.1. 00802 _ APPLICATION FOR GROUND WATER APPROPRIATION New OQ Renewal - Q) In compliance with Title 12, Chapter 5, V.I. Code, the undersigned: (Name of Property Owner) (Mailing Address) (Telephone #) hereby applies for a permit to appropriate ground water. The well(s) will be located at (Estate, Lot Number and Island) (Property Tax Number) (Well Drilling Permit Number") * = if applicable Proposed use of well(s): Check ONE use only. DOMESTIC QO Number of apartments Number of people to be served ‘Ore fe? Application for Ground Water Appropriation Page 2. FARM OPERATION OQ Land acreage reserved for crops Type and number of livestock COMMERCIAL (WATER SALES) Q Estimated water production Gallons per day Proposed cost of water at site Per 1,000 gal. MUNICIPAL QO Area to be served Estimated population to be served OTHER (Laundry, etc.) OQ Details Plan for development, or use of the water including the capacities of any proposed impounding reservoirs, cisterns, storage tanks, etc. Estimated quantity of water proposed to be extracted daily: ___. Gallons. Name of proposed Driller & License Number: Fee of $10.00 is required and should be attached. (If paying by check, please make payable to the Government of the Virgin Islands). Signature of Property Owner Date FOR DEPARTMENT USE ONLY: DATE: APPROVED: DISAPPROVED: REMARKS and/or SPECIAL CONDITIONS: SIGNATURE OF WELL INSPECTOR: GROUND WATER APPROPRIATION PERMIT NUMBER (if approved): gwapprappi/retyped 2/2001