HomeMy WebLinkAboutDrain Layers Permit 10 Diane Drive vp •- 4
/� r OW :OF S0l�'TH 11 I DSO
DEPARTMENT 0� PQLLUTfON RpL e
B/P No . r
South M/indsor, Connee#leaf`
List.No. S
DR-A1N .LAYER'S `PERMIT " 11190
19
Pursuant t':written ap iggtior;,permisston is hereby granted to iheUcensed Drain Layer named bore ,tope
rform.
{ the work indicated�61o.w at
side, between ► ,�'�" &1d Mies d y
S
-at premises owned by imams A"-, Al Yt o w«
whose addt69s is
and to ::Lay House Drain, Repair House Drain, Lay.-Main, Other
ford . occupancy'or, use,
with Falbly`.Units, witi} acres `
07
s
Type of.Sewage to be connected under this permit; AL
.
SANITARY`SEWAGE (;X j, INDUSTRIAL WASTES ,( ), OR ( )`
Conszectton will be made.with Mi30r'1n*h f6�) 21alift Ides to a '� tAral knaves 04 r
d�MWAi
Permit to be sssued to J6b4 At � .
the hblde "af,Drain Layer's License No. $4'�8 Permit will expire onQ� e� �19z>c
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and.the re}+eri: r side
thereof Applicant has received Town Permit No. and/or`C H;D Permit Na.
for street excadation: ,
PECIA CODII3ITIONS
Signed
Connection Charge Paid '� �- _ Licensed rain L yer -
- $ti61Ao 8 Issued by $t'
Tas'Collector
Permit Fee Paid
INSPECTION: Check: Number: .
INITIAL (Sig)
FINAL
APPROVED ' (Date)
WPM, (Sig)
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