HomeMy WebLinkAboutDrain Layers Permit 60 Horizon Circle (2) TOWN OfQTH W1NDSOR
tkOMWT� 0� POLLVA ON CONT QL B/P No.;
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South WIndsgr, Connecticut
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DRAIN LAY R'S 'PE,RMIT `A 632
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19
Pursuant,to written applicatior permission is-hereby granted to she Licensed Drain Layer named herein to perform
the,,wgrk indicAted'below'at• r � .: i;4- on the
side, between
at. remise nets b
whose address is
and to Lay House Drain,+ Repair House Drain, Lay Main, Other
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for occupancy or use,
with Family Units, with ages.
Type of Sewage to be connected under this.permit:
SANITARY SEWAGE INDUSTRIAL WASTES .
- --Connection.will be made withabufta tft A000 `
Permit to be issued
the holder of Drain Layer's License No Permit will expire on—vv�
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
dim AWL
Signed
Connection Charge Paid 146ensed Drain Layer
Ilk 4
Tax Collector
Permit Fee:. Paid $ __VOW
INSPECTION: Check:Number: ka'"
INITIAL. , (Sig)
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FINAL (Sig
APPROVED r �� rO, !, r t i; ,; (Date) - -
- INSPEC `Olt