HomeMy WebLinkAboutDrain Layers Permit 178 Old Farm Road ` TP N OF WINDS,
ok,
" DEPARTMENT OF POLLUTION 6ONTR6L
South Windsor, oiteey.tituY � P No' —�
a List No:t _
b" AIN LAY.ER:'`SPERMI'T
. -0' ;
119
{ Pursua}�t to Tz' n ap ;licatior.., permission 's hereby granted to ache Licensed Drain Layer named herein to perform
the 44k indicated below at' Id Cr
on the
side, between
at premises-owned by d .1 ►"t r t S
whose-address is
t and''to'" _Lay House'Drain, epair House brain, ,#
y I,ay Win, -�-_Other'
for
• fir
occupancy or use, ;
with•, 'Family Uni4s, with acres.
Type of Sewage tb'be-'connected under•this permit:"
SANITARY::,SEWAGE ( , I TpUSTRIAL WWAS'TES .( ), OR ( v)
y y
_ �onnectiom will be made with
r' Pernik to l 'issued rd
' theio�der of Drain Layerte Lieehse Info. s;
jPermit,will. xplre on 19.
r The' tidersigned.Drain•Layereherebx agrees to-all the,terms amd conditionr,,set fyoxth on the permit and the reverse side.
' thereof` Applicant has received Town Permit No. - -- and/or_`H mit N'D_Pera. y
for. reef 0xeavatig f, y'
' SP C AL' CON I ITIO
51,
Signed { 7' W.
`4 `
Connectloritharge ISaldbb
Life ed.Drain La erIA
Issued by } •f ��,
�z a a Collectors
Permit Fee:. Paid s16,
INSPECTION. ;Check 'Number: Qd
(Sig),`
FINAL T= }
(Sig) �. X
APPROVED
(Date)
M i•,
Sid r �� ' � .A •� y ,}
INSPECTC)R -, (Sig)
4. JI t �r