The entity whose name appears on the permit application has submitted an inspection report, 2 bacteriologically clean water tests and $50.00 permit fee to complete the required provisions of the City of Neenah ordinances and Wisconsin state statutes.  The permit allows for operation of a private well at the well site address indicated on this form.

The permit expires October 31, 2027.  Prior to October 31, 2027 the private well owner will be required to renew the private well permit or abandon the well.