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HomeMy WebLinkAboutDrain Layers Permit 55 Horizon Circle (2) TOWN G iff { DPARTMIEN F �IAI�tUT10N`'�OIYrROL _`'g/P South W+tMsor, Connecticut F s {3 List No # DRAIN. LAYER S =f .•. R'M!T p 19, r F9irsuant to *ritten-applicatior, permission is.hereby granted to th Licensed Dram Layer named herein to perform . the wa�rk indicated', 'low at on the ` i = f ride, between a at remises ow ed b whose address is anti.to Lay House Drain, Repair House Dram; Lay Main, Other i for z oeoupancy or use, ` W4h Fa Y"Units, with acres Ty ,qr of Sewage.to be co�nrkected under this gimit: s SAICTITARY.SEWAGk '..j, INIUSTR�t1L WAS'I'E� .( )> �R —;. +` o nnection will_be--made iwith - �z , .7 Per`it to,be issued ti� 3 the ho r oE:dram Layer's License 140 ' P'ermit''will.expire on 19 The undersigped pram X.ayer Hereby agrees to all the terms anti conditions setlorth on the permit and.the#teve s side . thereiof A 'licant has received Town Permit No.' and/or C H D Permit No. for street etc avation .;� w a SPECIAL COND�TI©NS =. , r Signed - Connection'Charge Paid .. Licensled Dra.q Layer. Issued by Tax Collector Perms :)ace:..:Paid g INSR$C,TI01�T 'Check-Number. ► INITIAL (si�.) FINAL APPROVED Y .. .w •..,.h,,t�s,.(k, k t=*Kfs�,is._.`;:ic.�:r.+YA. FZ.