HomeMy WebLinkAboutDrain Layers Permit 87 Clinton Drive (2) TOWN OF OUTH wtNDStJR
DEP,(,TM NT OF -P LLUTION 'CONTROL
Sout6.Windsor, Connecticut BJP.No,:
List.No::
9AIK LAY!ER'S PERMIT K? 580
19 _
Pursuant to written applcatior;, permission is hereby'granted,to the Licensed Drain Layer named herein to perform ¢
the work indicated:below at . .
40
} y on the
-side, bgt�eeh� � � �-Usk&,
at premises' weed by
whose address is 4
and to Lay House Drain, Repair House Drain, L•ayi main, � Other
for
occupancy or use,
with'
Family Upits, with . acres.
Type of,Sewagc.ro be connected under this,hermit: d _
St1NITA" SEWAGE + j, INDUS L WASTES ( ), OR (
Con'neCtj6nL ovi11 be made with
Permit to:be issued to y
the holder of Drain Layer's License No. : 'PermiE'vvill expire on 19
The undersigned•Drain Layer hereby agrees 1t6 afl the•terms'Arid 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 CONDITION$
Signed. r'F
Connection Charge Paid`'., .4 , 3
License>3.Drin:Layer
Issued by ,
Tax Collector
Permit Fee:. Paid $ _
INSPECTION: Check Number: .
INITIAL (Sig)
FINAL (Sig)
:APPROVED (Date)
• jam. _
r• (Si
D) -
INS PE TOR C