HomeMy WebLinkAboutDrain Layers Permit 74 Laurel Street 'TOWN OF. S µ WtNDSOR
DEPARTMENT OF POD; UTION''CONT1101,
t" South Windso.. nnecticut
` DRAIN LAYER'S. PER,MIT:. 21 .
P nt to written application, permission is herebyranted to the Iicensed in La er,.�iamed herein,to`pet form
g y.
the work indic below at
—�— the
side, qn
at premises owned by
Whose address isi::
and to _ Lay House Drain, Repair House.Drain La-y Maxnk Other for #
occupancy or use,
with
Family Units,,with - aces._:
Type-pf,Sewage'to be connected under this permit: .:
SANITARY SEWAGIEIND T§TRIAL WASTES:;
Connection will be made with,
--------------------
permit to be issued to
the holder of Drai .-Layer's License No.. Permit.will eg ire on Y T
The undersigned Brain Layer,he eby 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.
ra
SPECIAL .CONDITIONS ANi -Al
Signed
Connection Charge Paid 7 Licensed Drain Layer
M (Sig) Issued by •
Tag Collector -
P rmit Fee: Paid S
INSPECTION: - � rit.�lrRr► : ,
INITIAI,I +�..�"""".."" (Sig)
FINAL ./ (Sig)
APPROVED (Date)
-
INS R