HomeMy WebLinkAboutDrain Layers Permit 39 Pine Tree Lane (2) ti
TOWN OF .4QV 'H WI N DSOR
s DEPARTMENT OF POLLUTION CONTROL
7�d South Windsor, Connecticut
DRAIN LAYER'S PERMIT 0 356
`. 19"
. r
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at " ft" 111141i on the
0294 side, between
at premises owned by '
whose address is
and to KLay House Drain, Repair House Drain, Lay Main, Other
for occupancy or use,
with i Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE, INDUSTRIAL WASTES, OR .
Connection will be made with ANNA gap
jl
Permit to be issued to Jbk& `r
the holder of Drain Layer's License No."A" Permit will expire on1t 006, 1"—.
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 % WV14 01111116 0 1101611M O
Signed
Connection Charge Paid 4" Licensed Drain Layer
PW Be (Sig) Issued b 46
Tax Collector
Permit Fee: Paid $
INSPECTION:
INITIAL 1�cj (Sig)
FINAL ,11 (Sig)
APPROVED (Date)
✓ (Sig)
INSPECTOR