HomeMy WebLinkAboutDrain Layers Permit 166 Old Farm Road TOWN QF OU` WINDSQR
Di*PAR.TMENT OF PqttLUTION.CONTROL
B/P No.:
Soy,h Windsor, Connec-ticufi
List No.
DRAIN ,LAYER
',S PERMIT 30 .
..._.___ ,61
r, (�C✓f` �7 19 .E
7
Pursuant co written ap 1' atior, fermi ion 's her,'t��yrantied tot Licensed Drain Layer named herein toper€orm
T s
the'work'indicated below at (X an the
fide, between.` �
*' at premises owned by
whose address is ;> ,
and to Lay.House Drain, Repair House}Drain, ay- aln, Other 5
for . . ,,..
occupancy or use;
:<r with Family Unjts:; with acrear,
l'f
Type of Sewage to be connected under this permit:
' SANITARY SEWAGE ,(. ), INDUSTRIAL WASTES,.(., ), ,OR
-' �,r`.S- it :.•. ,
Connection will be made with - •: •
`. Permit to-.be issuedL to
the holder of Drain Layer's Licee Norz� ,F. Permit willtegpire on 19
The undersigned.Drain Layer Aeleby,agreeaFw,,all the terms,an gong--'On set forth.on'the ermit-and the reverse side
thereof. Applicant has received Town Permit No. and%o"r C H`� Per-mkt Nor
for street excavation.
SPEItIAL CONDITIONS' j
. s '
4
yea
Signed
Connection Charge Paid yQ� `� '' : ' Liceti 'd=Dtalti'LayerL
Issued by
Tax Collector
Permit Fee:.'Paid
`` -- INSPECTION: Check Number: a9
INITIAL (Sig)
-,
FINAL (Sig)
APPROVED
(Date)
IlVSPECTOR
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