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HomeMy WebLinkAboutDrain Layers Permit 113 Beelzebub Road (2) TOWN OF %)U H WI N DSOR DEPARTMENT OF POLLUTION CONTROL South Windsor, Connecticut /0 f. DRAIN LAYER'S PERMIT �, 0 445 Oct* 9 , I9 73 Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform the work indicated below at 113 2104"Iblulb * on the tb side, between fto 30 a Aws'Sr $t* at premises owned by whose address is AIM and to XX Lay House Drain, Repair House Drain, Lay Main, Other , for Rtt occupancy or use, with 0) Family Units, with acres. Type of Sewage to be connected under this permit: SANITARY SEWAGE, I INDUSTRIAL WASTES, OR Connection will be made with SIX ilWh (6) rp►UM111 t min Permit to be issued to JAW A* the holder of Drain Layer's License No.' :a*$q Permit will expire on_ .Ili 9 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 Dft Uq* pxo* =4 bbek= 80tic to* Signed Connection Charge Paid $ Licensed Drain Layer ftr! Ze (Sig) Issued by �'I* As S�ttlr Jr, Tax Collector Permit Fee: Paid $ 1300 INSPECTION: INITIAL I C" / %f % 7 f (Sig) FINAL i /l. y S (Sig) APPROVED '! % /� /tj ,� r (Date) f" .�f INSPECTOR (Sig)�— 2pi j Q Q q3 NOTES Cl SOUTH WINDSOR POLLUTION CONTROL LOCATION E ,? N3 n OWNER -<A•q © rrDr o TYPE OF WORK ,q TPr�c DATE PERMIT PIPE F' *� INSTALIER INSPECTOR f DRAWN BY S