HomeMy WebLinkAboutDrain Layers Permit 58 Highland Drive (2) Nl,. OF 40 WIN DSOR
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DEP AR
TMENT OF •P LUTIOy�;CO, ITROL }:
F� South Windso Connecticut
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DRAIN LAY _ "� 'S P•ERM"(.T O 268,
F MI IX, 19
Pursuant to wrioen application, permission.is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at "' _: on the
side, e�J.k4
at premise's owned by r � .k" •+' a�;
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other
for ."'r occupancy or use, ;
with Si ` ", + Family Units, with acres.
Type of Sewage to be connected under this permit:
(SANITARY SEWAGE,,
INDUSTRIAL WASTES, OR
Connection will be made with
Permit to be issued to : ; ° *< s x
' the holder of Drain Layer's License No.-.4ij Permit will expire on » _ 19y
The undersigned Drain Layer hereby a reel to al i ie iei i i and conditions set forth on the er r g y y g p m, and the,reverse side
thereof. Applicant'has received Town Permit No. and/or C H D Permit No.
for street excavation;
SPECIAL CONDITIONS tt :`. , �: .;• .ar i f,
Signed
a Connection Charge ii�d~ • �t., icre'fi et rain yer ~'
y &;
(Sig) Issued by
Tax Collector
Permit Fee: ` Paid
INSPECTION:
INITIAL (Sig) r
FINAL (Sig)
APPROVED 2 �i'1'?3 (Date) r
IN9PECTOR