HomeMy WebLinkAboutDrain Layers Permit South Satellite Road (12) TOWN OF SOUTH ii`WI N DSOR
DEPARTMENT OF PO'LLIJTIVN CONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT N? 359
Aawo , 197
Pursuant to written application, permission is hereby granted to the Licensed Drain 'Layer named herein to perform
the work indicated below at fat" �ts aw ( 's 1',p a.7 t1# T`g;� 11W 31 # 73) on the
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at premises owned by tm �
whose address is ft"M ftm ft"s Nwom"a aft"
and to Lay House.Drain, Repair House Drain, 4 Lay Main, Other ,
for Now occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
(SANITARY SEWAGE INDUSTRIAL WASTES, OR
Connection will be made with_'A`/V-1442 t e #+Q f
Permit to be issued to :gr a-r 4, 2�,k a t,,!
the holder of Drain Layer's License No.%4%1 f?- 2..r- 3r' Permit will expire on E# +�►,ra , i 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
Connection Charge Paid $ Licensed Drain La
(Sig) Issued by ,
Tax Collector
Permit Fee: Paid $ � Q V
INSPECTION: co�cK S w j
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR