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191 Hillside Dr - Tie Card
TOWN OF SOUTH WINDSOR SANITARY SEWER LATERAL FIELD LOCATION DATE OF CONSTRUCTION: BUILDING ADDRESS STREET SUBDIVISION: NORTH ARROW ?-(p 12-©'2-3 1� 1 A- I) Y c, P 2I\)mf gz CONTRACTOR (PRINT) *4y 5A yoll,`�ag av6 STREET ADDRESS 6 TOWN STATE ZIP NAME OF�R'S SUffRYISOR (PRINT) SIGNATURE ln. _ An UtU�I Z� DATE INSPECTED( TOWN J v DATE TELEPHONE NUMBER WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER