HomeMy WebLinkAboutDrain Layers Permit 75 Highland Drive (2) TO W
.... N tFOUT1 WIN DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
*.
DRAIN LAYER'S PERMITTss
` . t# dart
!o _ , 19 7
Pursuant to written application, permission is hereby granted t}o, the Licensed Drain Layer named herein to perform
the work indicated below at +c
on the
j ». . side, between i„ t X `
at premises owned b
' whose address is "'`' '"' 4.
and to Lay House Drain, Repair House Drain, Lay Main, Other ,
for occupancy or use,
r. with at Family Units, with acres.
Type of Sewage to be connected under this permit:
f }}
(_SANITARY SEWAGh�',�' INDUSTRIAL WASTES, OR
_Connection will be-made with z
Permit to be issued to f ' r `' :` •.
the holder of Drain Layer's License No._#a f r f Permit will expire on t` / 19
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permitiand the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
Signed
Connection Charge iIid $. y "- �- Lice#sed Drain Layer
(Sig) Issued by ,'• *'' .. ""':
Tax Collector
Permit Fee: Paid $ jg.�
INSPECTION: �.`�9fllffs
INITIAL (Sig)
FINAL (Sig)
APPROVED "Mte 1973 (Date)
tt --(Sig)
INSPECTOR