HomeMy WebLinkAboutDrain Layers Permit 125 Pine Tree Lane (2) TOWN OF S0 `*W1NDSOR
DEPARTMENT ,OF, POLLUTION CONTROL.
South Windsor, Connecticut
DRAIN LAYER'S PERMITO 314
19
Pursuant to written application, permission/his hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 12.- AW AL T.e a 4 wti on the
side, between
at premises owned bydr4;A� 2�4/?
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other
for d'.
occupancy or use,
with -, Family Units, with acres.
Type of Sewa a to be connected under this permit:
SANITARY SEWAGE INDUSTRIAL WASTES, OR
Connection will be made with
Permit to be issued to
the holder of Drain Layer's License,No% - -�14 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
Signed
Connect n Charge Paid'$ Licensed Drain Layer`
rt �� (Sig) Issued by
ax Collector
Permit Fee: Paid$ 4/.f
INSPECTION: - 'rw
-- INITIAL (Sig) ,
s
FINAL (Sig)
APPROVED M (Date').
a (Sig)
--�— +III►pd�ra �,
ECTOR