HomeMy WebLinkAboutDrain Layers Permit 69 Hgih Ridge Road TOWN q OY SOUTH WI N DSOR
DEPARTMENT OFbLUFON CONTROL
South Windsor, Connecticut
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DRAIN LAYER'S PERMIT Np 338
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Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named,herein to per
the work indicated below at
on the
side, between
at premises owned b ING M�
whose address is
and to I Lay House Drain, Repair House Drain, Lay Main, Other
i ,
t.. for
o"upancy or use,
with
Family Units, with acres.
Type of Sewage to,be connected under this permit:
ESANITARY SEWAGE INDUSTRIAIASTRS:, OR
),Connection will be made with
Permit t&b e'issued tl� :
toe holder of Drain Layer's Licef S�No. f Permit will: spire on' 19
The undersigned Drain Layer hereby agrees 'o all the terms an conditions set forth on the permit and t e reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for•_street excavation.
�t
SPECIAL CONDITIONS
IF
Signed
Connection Chnrge� aid Licensed Drain Layer..
Aw IL Somas ` � (Sig) Issued by
Tag Collector ., ;
Permit Fee: Paid $ +l�
INSPECTION: „
INITIAL _ (Sig)
'FINAL (Sig) }
APPROVED - (Date)
(Sig)
INSPECTOR