HomeMy WebLinkAboutDrain Layers Permit 360 Abbe Road j
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
Soutl vc indsor, Connecticut
List No.:
DRAIN LAYER'S PERMIT Np 2680
Pursuant to written applicatior per ssion.i eby granted to the Licensed Drain Layer named_herein to perform
the work indicated below at v 9 0
on the
side, betwe
at premises owned by / i•'� 'j % 1
whose address is
and to Layllouse Drain, - Repair House Drairi, Lay Main, Other
for
occupancy or use,
with Family Units,.with
acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( j, 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
n
Signed
Connection Charge Paid Q G Licensed Drain Layer
,yt ( tii 1' %( 'Tc`CL i C Issued b
r Tax Collector y
1 ,-- Permit Fee:. Paid $RUM
-
� rt INSPECTION: Check Number:
\ INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
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CPO
CL6AN
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