HomeMy WebLinkAboutDrain Layers Permit 55 Autumn Drive iLWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List.No.: _
DRAIN LAYER'S PERMIT NO 1353
, 19 ?7
Pursuant to written applica iorr,, permission is hereby r e to .he Licensed Drain Layer named herein to perform
the work indicated ow at I �/ j�` t
/ � � on the
/v4/t side, betwee CkW4 lo%<
at premises owned by
whose address is
and to 7` 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�ASTES .V, OR ( )
r
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
Signed
Connection Charge Paid /A/7 Licensed Drain Layer
77 Issued by
Tax Collector
Permit Fee:. Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED ��'�,3-77 (Date)
(Sig)
% j) INSPECTOR
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TOWN OF SOUTH WIIVDSOR
_TOWN HALL
SOUTH WINDSOR, CONN. 06074
DEPARTMENT POLLUTION CONTROL
. �Date 2 . . . . �. . . . . . . .
The Sanitary Sewer .
x. . . Septic System
at .
or lot #. . . .
een
in accordance with the Town of
So Installed and completed
uth Windsor ordinances
and regulations.
Accepted and Approved
Y Date