HomeMy WebLinkAboutDrain Layers Permit 75 Horizon Circle TOWN OF SQUTW WI N DSOR
DEPARTMENT OF POLLUTION CONTROL gip No.:
South Windsor, Connecticut
List No.: =�—66 7 te
DRAIN LAYER' S PERMIT N? 541
23 A02tt , 19 74-
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 1S 2-.:1111 L�r 2 on the
side, between
at premises owned
whose address is
and to ✓Lay House Drain, Repair House Drain, Lay Main, Other
for 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
Permit to be issued to �Nr! e "'o
the holder of Drain Layer's License No. Permit will expire on 19
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.
for street excavation.
SPECIAL CONDITIONS
Signed
Connection Charge Paid 4s2 3-74- Licensed Drain Layer
Issued by Az,0,
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
/ cAs� (Sig)
INSPECTOR