HomeMy WebLinkAboutDrain Layers Permit 155 Pine Tree Lane TOWN 0 SOU SNDSOR
DEPARTMENT . OF POLLUTION CONTROL
South Windsor, Connecticut
16 'nt No.s 8-6016 3
! DRAIN LAYER'S PERMIT
O 214
soft � 19
Pursuant to written application, permission is hereby:granted to the Licensed Drain Layer named herein to perform
the work indicated below at ' '. �� bat ell) on the
side, between
at premises owned bye4*0
whose address is
and to _ Lay House Drain, Repair House Drain, Lay.hfaia .. Other
for !! occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
C 'SANITARY SEWAGE) // INDUSTRIAL WASTE6,.OR
Connection will be made with 4
Permit to be issued to
A* loans1
the holder of Drain Layer's License No: Permit will expire on .' 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 IM" ' t*, + 0MIA`
r f
;F
Signed C ,... ' f
Connection Charge Paid# 04" Licensed Drain Layer
fir ik�'%Mft
(Sig) Issued by
_ Tax Collector
P rmt Fu: Paid
INSPECTION: Rau
INITIAL r," ram'""'".." -`.. _ _ (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)