HomeMy WebLinkAboutDrain Layers Permit 15 Pine Tree Lane (2) TOWN OF SOLI IN WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut t g_
DRAIN LAYER'S PERMIT0. 334
19—
�53 .
Pursuant to-written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated.below at on the
ilk ` side, between
at premises owned by
whose address is
and to 9 Lay House Drain, Repair House Drain, Lay Main, Other ,
for MAIN occupancy or use,
with Family Units, with acres.
Type of Sewage.to be connected under this permit:
(SANITARY SEWAGE). x INDUSTRIAL-WASTES, OR
Connection will be made with
Permit to be issued to a* &.. F
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 om 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
R
Connection Charge Paid r ; ;. . Signed Licensed Drain Layer a
- (Sig) Issued byF
Tax Collector
P mi F : Paid SAP
INSPECTION:
INITIAL (Sig)
FINAL (Sig)
APPROVED ' , y �+►�y R t (Date)
A
(Sig)
INS TOR