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36 Kent Lane
TOWN OF SOUTH WI N DSOR DEPARTMENT OF POLLUTION CONTROL B/P No.: South Windsor, Connecticut List No.: _ DRAIN LAYER'S PERMIT N? 1912 19 ........................................... ............ ......................... .................. .. ............ .............................,..,..,.. ......,,.. ,................................................................,..,..,.................. rm. he -i ii ~] O. Mel el -lDtr�', 11aI^s t .;t 9`o '- - _ ,. :r q= u� se, oe Amount 9atd S Malance gue $ Paper.Patented By N.C.R.Co. N.B.B.Co. Made in U. S. A.— ................ /!•� - a.��.... .���..��........���..��.����.����������..���..�����.��..��..��..��.�������.���...............��...�������������������������������������������������������������������.��.��............ .11MM.1 I����.�����.��������.������.��.����. Permit to be issued to 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 YD©•oy Licensed Drain Layer �s asy/ Issued by Tax Collector Permit Fee:. 1 INSPECTION: Check Number. as� INITIAL FINAL (Sig) j"}• 9 APPROVED (Date) (Sig) INSPECTOR