HomeMy WebLinkAboutDrain Layers Permit 694 Governors Highwa (2) TOWN OF WINDSOR
DEPARTMENT Oi= PO >LUTION CONTROL B/P No.:
South-Windsor, Connecticut
List No.: jN
DRAIN LAYER"S PERMIT Np 510
. 23 19
Pursuant.to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated,below at - on the
side, between two & AW.30
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain, Lay-Main, --Other-
for
for occupancy or use,
Witt" (1) Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE j, INDUSTRIAL WASTES .( ), OR ( )
Connection will be madeth
Permit to be issued to WOW
the holder of Drain Layer's License No: Permit will expire on 1
The undersigned Drain Layer hereby agrees to all the terms and condition's 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 CONDITIONS urw I* o
Signed
Connection Charge Paid ' ' ' ; Licensed,Drain Layer
Issued by ftao A* *W11rk%bW
Tax Collector
Permit Fee: P _
INSPECTION: Check Number:
INITIAL _ _ 4 s; (Sig)
FINAL E s (Sig)
APPROVED " r .` "" (Date)
L'. (Sig)
INSPECTOR