HomeMy WebLinkAboutDrain Layers Permit 126 Highland Drive (2) NTH WTI N DSOR -
DE kARTMENT''QF �P-` LUTION COHTR'O'L a
South WindsdF�t Connecticut '
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t % DR:A;4N 'C� 1 -ER'S PERMIT O
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g Pursuapt to written application, permission is hereby granted to the Licensed Draip:Layer named heren.to perform "s
the work igdicated<below at '1 -on the •z
�: side, �^ ft'� S
At premises owned kY_AMk to r
whose address is
and:to _ Lay House Drain,= Repair House Drain,. yLay Main;• Other
for l ��f i
1 occupancy,_,or Else, ,,.
Wstli �€ Family Units with
- - ' aczes. Y �.
Type of Sewage to be connected under this permit 4
(SANITARY SEWAGE) INDUSTRIAL WASTES, OR
� y* Ctsrit;etq Mill be,made with
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1F (M 1Y f+r .^T�yYYYf ; .
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Perrhit to be isst<ed to
~ ?the of Drain Layer's°License No. - Permit wili'expire on 19 t
The iersigued Drain Layer hereby ngreesxo all the terms and conditions set forth on the permit and the re------------
verse side `
thereof A_P,Acant has recefted Town Permit No. and/or C H D Permit No. r:
for si'treet excavation. ?'
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(SPECIAL CONDITIONS A
' Signed
It IM
t "Connection Charge Paid g � Licensed Drain Layer
(Sig) Issued by.
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Tax CollgctoiF {'
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P m�it F Paid $ �1M '
INSPECTION.Ir
°
INITIA •�+*""""""" " (Sig)
FI1�7AL (Sig)
APPROVED M (Date)
loft& (Sig) ._
sARCTOR
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