HomeMy WebLinkAboutDrain Layers Permit 105 Pine Tree Lane (2) TOWN OF S T WiNDSOR
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J DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT N? 351
T 19_� '
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
90k ` !111side, between
at premises owned by
whose address is
and to X Lay House Drain, Repair House Drain, Lay Main, Other ,
for 1 occupancy or use,
with 00 •) Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE) INDUSTRIAL WASTES, OR
Connection will be made with— MILSOAN&
Permit to be issued to A* loom
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 11M I Book am 1111101111111M 9404 *Mk*
Ao
Signed C..: ' ,
Connection Charge Paid s 04 Licensed Drain Layer
aw so No" (Sig) Issued by
Tax Collector
PA[Tit,F:Paid $
al r�rNrrw
INSPECTION:
r .
INITIAL (Sig)
FINAL (Sig)
APPROVED 3 (Date)
Of
4 2-044e — (Sig)
INSPECTOR