HomeMy WebLinkAboutDrain Layers Permit Lot 59 - Kent Lane TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMIT NO 1913
19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at
on the
_
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��A�.' � '-••: i.�.i pia � _
eceive .:��d Cyr -
m e,
y
01 ars =
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Amount gazd $
� 77 a S`c//
adawe gue $ _
Paper Patented By N.C.R.Co. N.B.B.Co. Made in U. S. A.-
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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
/q13
l///l7 f Signed
� ��
Connection Char a Paid Licensed Drain Layer
Issued by
Tax Collector /g! 3
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig) �D� 631 /",�
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR