HomeMy WebLinkAboutDrain Layers Permit 166 Clinton Drive (3) TOWN OVS01R.TH. WINDSOR
DEPARTMENT 'OF POLLUTION CONTROL
South Windsor, Connecticut ,.
x DRAIN .LAYER'S PERMIT Q 264'
t7 7. 197
Pursuant to written r
rm}&sivn-isereby granted to the.License Drain Layer named herein to perform
the work indicated below at r' •p Jz
�± on the
f
at premises owned by (
whose address is
and to Lay House Drain,` Repair Housebfidtin, Lay Main, Other
f311
for
occupancy or use,
with `r' Family.Unit's, with acres.
Type of Sewage to be connected under this permit:
S .•~ y ry " ,.•.
ANITARY SEWAGE ,'; INDUSTRIAL WASTES,,OR +�
Connection will be made with
r
- i
Permit to be issued to
the holder of Drain Layer's,License No. Permit
will expire onr917
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 s tree t•excavation. - -
} SPECIAL CONDITIONS
fir. -�.;�i -. �r'�', ":�` ..a •.& .
Signed
Connection Charge Paid ;} ; F s% N ce s f ii
(Sig) Issued by
Tax Collector �• .
Permit Fee: Paid ems:
i""" .
INSPECTION:
INITIAL }• _ s J .-• f
(Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)