HomeMy WebLinkAboutDrain Layers Permit 062 Andreis Trail (2) TOWN OF SOUTH WI N DSOR
_ DEPARTMENT OF POLLUTION CONTROL gip No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT O 3157
,�9y "'73 , 19
Pursuant to written applic tior, permiss"'o is hereby granted the Licensed Drain Layer amed herein to erform
y P
the work indicated below at Lilu/Vl C�/J �C %LAN 6 I-Y '1/ .P on the
x
side, between
at premises owned
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other ,
for 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
Permit to be issued to
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
C2 2 3
Signed
Connection Charge Paid yOD,00 Licensed Drain Layer
Issued by
Tax Collector
Permit Fee:. Paid $
INSPECTION: Check Number: 3a��
INITIAL I 'gj
FINAL
NNED
APPROVED (Date)
(Sig)
INSPECTOR