HomeMy WebLinkAboutDrain Layers Permit 121 Beelzebub Road TOWN OF SOUTH WI N DSOR
DEPARTMENT dF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT NO 477
Oot. 16 ) 1973
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 121 Xow4 Rd* Lts•z 2Z�
on the
O tit1 side, between lfto tr & ArM Ste
at premises owned by )I1s1 L. Flil tit
whose address is me"
and to X Lay House Drain, Repair House Drain, Lay Main, Other
for r*440AU4 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 AX fash (6) AmMC
Permit to be issued to Joba A. ?wit
the holder of Drain Layer's License No. W . Permit will expire on #4 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 Am" jMr to IM, a =44 b&et rLU 4=C
Signed
Connection Charge Paid $ 10 1 ' / Licensed Drain Layer
P*ro zo "Olds (Sig) Issued by 1* Aw 8 M#i r Jr#
Tax Collector
Permit Fee: Paid $ � *
INSPECTION: -
INITIAL OCl/ , 211) , 1 ? 2. (Sig)
FINAL /r /r 4/,1 (Sig)
APPROVED (Date)
(Sig)
INSITtCTOR
N
6�
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION ,e F j,
OWNER
TYPE OF WORK Ar ,�,e Lplr
DATE ci ERMIT PIPE
INSTALLER . z4llvllryAtl
INSPECTOR -F DRAWN BY r