HomeMy WebLinkAboutDrain Layers Permit 166 Clinton Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor Connec#icut
S
DRAIN LAYER'S PERMIT `O 264
19
Pursuant to written application, permission is hereby granted to the Licensed Drain Layernamed herein to perform
the work indicated below at 4` , j 1', L L z 9 J on the
at premises owned by
whose address is # '
and to Lay House Drain, Repair House Drain, Lay Main, Other
for r -� <"�a
occupancy or use,
with Family Units, with acres.
Type of;Sewage to be connected under this permit:
r �
SANITARY SEWAGE' INDUSTRIAL WASTES, OR
Connection will be made with
Permit to be issued to_ _J 47- `�` ;e
the holder of Drain Layer's License No. Permit will expire on 19
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permi and the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
Signed -
Connection Charge Paid , - Licensed Drain La er
" - (Sig) issued by. ..- .
Tax Collector
Permit Fee: Paid $" 2,C
INSPECTION: " '
INITIAL (Sig) l
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR