HomeMy WebLinkAboutDrain Layers Permit 041 Ash Road r TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL,
B/P No.:
South Windsor, Connecticut
List No.: -60-C 6
DRAIN LAYER'S PERMIT0 687
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated-below at -10on the
Seim f
side, between
at premises owned by
whose address is 1111111110
and to Lay House Drain, Repair House Drain, Lay Main, Other
for Ilrt ,
occupancy or use,
with Family Units, with acres.
Type of,Sevage.to be connected:under this permit:
SANITARY SEWAGE (I), INDUSTRIAL WASTES .( ), OR
Connection will be made with 4112100
of +
Permit to be issued to *s ANWM
the holder of Drain Layer's License No. Permit will expire on 100016w, 19 rT
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
Signed '��a t ' ,•
Connection Charge Paid "'' "' Licensed Drain Layer
Issued by BRAWfte *0010
Tax Collector
Permit Fee:. Paid $ _ "_POOR
INSPECTfON: Check' Number: _
INITIAL 101A6 1 d t* -. (Sig)
FINAL li /fie . / -- (Sig)
APPROVED 14b Okgro,*Ar,9 t 97+f+ (Date)
INS TOR (Sig)