HomeMy WebLinkAboutDrain Layers Permit 37 Clinton Drive (2) TOWN OF sauv WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
;L Lint: s4o I48
p IN LAYER'S PERMIT NO 21$
` 22 , 19
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the.work indicated below at DATO (Lot 5) on the
mortk side, between AA' ury ftrmt tAw ariIiil md-da-mas
at premises owned by Cs&A Its ji
whose address is fiPf �
and to X_Lay House Drain, Repair House Drain, Lay Main, Other ,
i
for ramidestia occupancy or use,
with a&* W Family Units, with acres.
Type of Sewage to be connected under this permit:
(SANITARY SEWAGE) INDUSTRIAL WASTES, OR
Connection will be made with ; jd usk (6") yAC.P.
Permit to be issued to AdM W10104M
the holder of Drain Layer's License No. . Permit will expire on 22 July 19
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS DmiIi Wor to rm, *rusk 4ad t* f .0 MUs Uwk,
a
Signed
Connection Charge Paid , —73 Licensed Drain Layer
14r No (Sig) Issued by HolvU f4wards. Jr*
Tax Collector
Permit Fee: Paid $ 15
INSPECTION: lhub*gg
INITIAL (Sig)
FINAL (Sig)
APPROVED 13 max. (Date)
� �. (Sig)
INSPECTOR
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