HomeMy WebLinkAboutDrain Layers Permit 167 Laurel Street (2) E 'OWN OF $OUTH., WINDSOR
�. DEPARTMENT OF :POLLUTION CONTROL. ,°
i South Windsor, Connecticut F
. DRAFN 2.
LA ( R, S. PERMIT
19
Alf
,.
Purswnt.to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
,a
the work indicated below at on the
AA 4 4 side, between .• 1 s
at premises owned by k— *.#-q r .h 'i --'a'a Az ` k_# : --' kx be
.
3
w ose address is
1.
and _, _Lay.House Drain, . Repair House Drain, Iray Main, „ ether< .. ..
for ,. '
• ��-r �+ #�. occdpancy'or use,t
s with �' + ^' ;' -Tamil Units, with acres. t
Type of Sewage to be connected under this permit: ;
ANITA RY SEWAG 4 INDUS tIAL W48TES,.OF, ; -
a C: 9
Connection will be made with ,
Permit to be issued to *"K
the holder of Drain Layer's License No. Permit will expire on
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the die njif nd'the reverse side
thereof. Applicant has received Town Permit No. and/or`C H D Permit No. .,
for'street excavation.
,SPECIAL CONDITIONS 2
Signed .0
Connection Charge $ `flcensecii Drain ayer. y
f. (Sig) Issued by_
Tax Cohector h x a :. 9a
a
Permite c hai $ x i' ik1i
$ INSPECTIb�T;, ..; � ' n'' '. !�` ��r'•�'."'�;��t
�.
INITIAL
FINAL S (Sig)
a
r �
----- —_ - _ - __ ��`�0,� -
INPEC TOR k r
i