HomeMy WebLinkAboutDrain Layers Permit 232 Oak Street (2) ' TOWN OF 16thH WI N DSOR
s 7 DEPARTMENT 0'F POLLUTION CONTROL
.. South Windsor,Connecticut
DRAIN LAYER'S PERMIT XO 363
s ' 197
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at tt� on the
waft side, between 1fi� 1
at premises owned by ■mad :
whose address is ---_
and to _Lay House Drain, Repair House Drain, Lay Main, Other ,
for ...opa.....a- occupancy or use,
with (4) Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE, INDUSTRIAL WASTES, OR
r
Connection will be made with Ad" 4,04 V4 A_
Permit to be issued to
the holder of Drain Layer's License No. W111111111110M Permit will expire on_ 00tr 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 MM 10M IS MWe 0MA MM U04k= 44VU0
Signed .
Connection Charge Paid $ #Joe&*" Licensed Drain Layer
mm 16 Sam" (Sig) Issued by A& A tibmaw imb
Tax Collector
P=nit Fe Paid $ f&�
INSPECTION:
INITIAL (Sig)
FINAL ( (Sig)
APPROVED (Date)
j
�' f ! (Sig)
INSPECTOR - �^`