HomeMy WebLinkAboutDrain Layers Permit John Fitch Boulevard TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT NO 11
-sox, , 19
Pursuant to written application, permission is hereby granted to the Litens�d.Drain Layer named herein to perform
the work indicated below at Am use Ant"
i"S_ on the
! side, between—^mi /
at premises owned b
whose'address is Ut Jt~.*&&Ar wr
and to Lay House Drain, Repair House Drain, T Lay Main;, Other
for i v c 0,—
occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
ANITARY`S'ttA INDUSTRIAL WASTES, OR
_- Connection_will_be_made with d `
Permit to be issued to &MA#WWSAt
the holder of Drain Layer's License No. I jjjk . Permit will expire on 09 *'&&+,# 19 +1
The undersigned Drain Layer hereby agrees'tq 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 $ Licensed Drain Layer
(Sig) Issued by Aftt�A 4r iaA*O iL
Tax Collector
Permit Fee: Paid $. Ott
INSPECTION:
INITIAL (Sig)
FINAL (Sig)
APPROVED A (Date)
(Sig)
CTOR