HomeMy WebLinkAboutDrain Layers Permit 160 Laurel Street (2) TOWN OF ,QYOTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
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DRAIN LAYER'S PERMIT 0 398
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Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
ti side, between au
at premises owned
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other
for �i+�lsl�,►1
occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
( SANITARY SEWAG$, INDUSTRIAL WASTES, OR
Connection will be made with adLSC 1t� tIS) tr im
Permit to.be issued to
the holder of Drain Layer's License N _ Permit will expire on_Oalk "it
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS " s crush aimgout t
Signed
Connection Charge Paid ,$, Licensed Drain Layer
Po ro 14 110"s
(Sig) Issued by Nalk Ae S, �
Tag Collector
Perny t Fee: Paid $13W
_ . INSPECTION: •""""` " "'"'
INITIAL (Sig)
FINAL (Sig)
(Date)
- -, -(Sig) - -
Coll S Pymr