HomeMy WebLinkAboutDrain Layers Permit 220 Laurel Street (2) SOUTH� .:WINDSOR
DEPARTMENT.- OF POLLUTION CONTROL
i
Souf�i,.Windsor, Conn"ec.ticut' / 4
D-RAIN:.LAYER' ...RERMIT oo
y �90
J
Pursuant,to written ap Iicatio1.nx;permission is hereby granted to th'esi icensed Drain Layer named herein to perform
the work indicated below at_
f a - ° on the
side, between r '"
at premises owned-by. r e+1d 3` s , r t
whose address is a
and ao Lay House Drain, _ Repair House Drain, Lay Main, Other
.l
foI � /� r
occupancy or use,
Cum
with "Family Units, with acres.
1 Type of Sewage to be connected under this permit: '
f SANI.TARY SEWAGE - ,
INDUSTRIAL WA$TES, IQI� s
Connection will be made with
. .
Permit to be issued to , .. '
the holder.of Draip Layer''s License No. permit will expire on i9
4+ The undersigned Disin Layer.-her
eby agrees to aal the terms,and,condic�ions set forth on the pArmit and the reverse site
they eof. Applicant has received Tow:h Permit No. and'/or C H D Permit No.
'' far•�treet'e��vaCion. � _„ �„ } � r:
SPECIAL'CONDITrOgS A A $»s =
A,
Connection Charge'Raid J, ,. _ ' ', ; _ t Licensed Drain Layer
(Sig) Issued by F
Tax Collector
Permrit Fee: .Paid $ it'44.
INSPEC
TIO
INITIAL (Sig)
FINAL .
} (Date)
cw�wLt- S -,
(Si
g) t
11V NSW TOR