HomeMy WebLinkAboutDrain Layers Permit 114 Clinton Drive (2) TOWN 01, TW WINDS'
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DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT223
S
►.'T 11
, 19_
Pursuant to written application; permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at '#
side, between
At premises owned bye +
whose address i
and to _Lay House Drain, Repair House Drain, Lay Mani;- —Other
for # -
occupancy or use,
with i Family Units, with
acres.
Type of Sewage to be connected under this permit:
(.SANITARY SEWAGL r
;INDUST.RIAL.WASTES,
" Connection will be made with
Permit tobe issued to
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 permit and the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CQNDITIONS. M 'ems + ails ,'
i
Signed_ ,
Connection Charge Paid " Licensed Drain Layer
Tag Collector (Sig) Issued by
P mit.F PaidWAS* MASS I
INSPECTION: +
INITIAL .....�*.""" (Sig)
FINAL (Sig)
APPROVED sn (Date)
(Sig)
INS ,_CTOR