HomeMy WebLinkAboutDrain Layers Permit 070 Ash Road TOWN OF SOUTH 'WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List.No.: _
DRAIN LAYER'S PERMIT
p 677
4•11OV4 , 19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 0 7 Aah Ai on the
side, between
at premises owned by 1A
whose address is >
and to : Lay House Drain, Repair House Drain, Lay-Main, - Other
• for
a
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 Jobn A«
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
Signed
Connection Charge Paid, Licensed Drain Layer
10/"4 ,
Issued by P*Mk Je Wth
Tag Collector
as
Permit Fee:. Paid $
f \ INSPECTION: Check Number
INITIAL /,.� ,4�- • ' (Sig)
FINAL '=- � (Sig) _
APPROVED '' '� (Date)
(Sig)
INSPECTOR