HomeMy WebLinkAboutDrain Layers Permit 15 Diane Drive (2) y a_ TOWN OF SOUTH WI N DSOR
-' DEPARTMENT OF aP01kLh;TION CONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT 404
PursugLnt to written application, permission is hereby granted'to.the Licensed Drain Layer named herein to perform
the work indicated below at 15 1"0 on the
side, betweent � .
at premises owned bye
whose address is SO"
and to L Lay House Drain, Repair House Drain, Lay Main, Other
for "ftu .
occupancy or use,
with { � Family Units, with acres.
' r Type of Sewage to be connected under this permit:
`SANITARY SEWAGE INDUSTRIAL WASTES, OR
Connection will be made with AAX 1Wh �
Permit to be issued to Jolm
the holder of Drain Layer's License No. Permit will expire on 1
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and
d the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITION$_ !. irM %Wk= �lil
Signed
Connection Charge Paid S Licensed Drain Layer
Am.39 (Sig) Issued by Ae. S 1 ► ltl�1NII' ��
Tax Collector
Permit Fee: Paid $ la
INSPECTION: Cho* 10
INITIAL !/-, (Sig)
FINAL lam" (Sig)
APPROVED G T 1.c 7 .? (Date)
f, (Sig)
j INSPECTOR