HomeMy WebLinkAboutDrain Layers Permit 330 Governors Highwa (2) TOWN 0Fi ' CIfH WINDSOR
DEPARTMENT CW 'HOt-LUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT N? 393 /
A 27 ) 19�
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at Q0y*n*= N3$�rh on the
Werth side, between dOhn Xj,,C1AlVd & KA eg
at premises owned by- � p- $A# R �
whose address is fete
and to X Lay House Drain, Repair House Drain, Lay Main, Other
for indust2'l i occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE, INDUSTRIAL WASTES, OR
Connection will be made with it & nht �
Permit to be issued to � 8 #
the holder of Drain Layer's License NA- Permit will expire o0et,
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. 2 ,
for street excavation.
SPECIAL CONDITIONS fro
Signed
Connection Charge PaidlfA Licensed Drain Layer
P"* I* M04X (Sig) Issued -
Tax Collector
Permit Fee: Paid $Z%QQ
INSPECTION: blok
10
INITIAL .t` r' /�: (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR