HomeMy WebLinkAboutDrain Layers Permit 113 Clinton Drive (2) TOWN OV SQUIN I N DSOR
•' DEPARTMENT OF POLLUTIOW CONTROL
40
South Windsor, Cpnnectiout B/P No.: w.
List.No.:
DRAIN LAYER'S PERMIT 523
hbo An , 19 74
Pursuant to written applicatior; permission is hereby granted to the Licensed-Drain Layer named he to-perform
the work indicated below at
try on the
side, between . {
at premises owned by- riiYr 1 _ �a --
whose address is a �
atl to _ Lay House Drain, Repair House Drain, Lay Main, Other
occupancy or use,
%Mlth Family Units,with
acres.
Type of,Sewage to.be connected under this permits
SANITARY SEWAOh ( X), INDUSTRIAL *ASTBS:.( ), OR
Connection will be made with #
` Pertgit to+be �ssud,tq
kw I•'4. � -1 L tea' S. ,.. __. � ..-. k J i' ..:.
thel holder of Drain Layer's License N-o Permit will-ex 'ate on
P 19 • .
The undersigned Timm Layer hereby agrees to``a'1l the"terms and conditions set forth on ttie'per It and't a reverse side
thereof. Applicant has received Town Permit No, and/or C H D Permit No.
for street excavation._,
SPECIAL CONDITIONS r .
---------------------
------------
t Signed
Connection Charge Paid ',,f Lioensed Drain Layer
Issued by 1630 A& SOW ,
Tax'Collector
Permit.Fee: Paid !
INSPECTION: Check Number:
INITIAL , .:� k �� *� !. . � � , (Sig)
FINAL (Sig)
APPROVED sC (Date)
(Sig)
INSPECTOR