HomeMy WebLinkAboutDrain Layers Permit 21 Apple Tree Lane 1' N OF` SOUTH WI N,DSOR
�b ARTMENT OF- POLLUTION CONTROL `. . .. '
�. DIP Noy
South Windsor, Connecticut , , rx� ,
List No.
DRAIN'-LAYER',S PERMIT ?
!1i so , 19 ..
Pursuant to written appl•catior :permission is:hat hy,;iianted to the Licensed Drain.Layer-named herein to perform
the work indicated below;at -+ on the
side, between_' i
at premises owned by '
whose address is
and'to Lay House Drain, Repair House Drain, ><.ay Main, Other ,
for occupancy or-use,
With' Family Units'"with
r ,,acres.
Type of Sewage to be connected under thisr permit: a
-SANITARY SEWAGE ,, ( INDUSTRIAL BASTES
Connectio will be made with fe sk '
,Kermit to lie issued to "
Z.
thexlolder of Drain.Layer's License No Permit will expire ion
The undersigned Drath Layer hereby.agrees td all the terms and cos diti lhsIet-'forth on the permit and the rei�erse, side f
thereof. 'Applicant has received Town Permit No. and/or C YH D Permit No.
for street excavation.
SPECIAL :CONDITIONS
Signed '
Connectipn Charge Paid 0
Ucensed Dr n Layer
top *04%'10 Afta
— Issued by
Tag Collector
Permit Fee:. Paid $ -4if
INSPECTION: Check Number: ;�`�'i
INITIAL (Sig)
FINAL (Sig
CANNED
APPROVED 4 itr` (Date)
1 �.
rx" ua ,x (Sig) _
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i SPirCTOR ,
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