HomeMy WebLinkAboutDrain Layers Permit 170 Beelzebub Road r TOWN SOUTH WI N DSOR
K
DEP TMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut H�-y
List.No.: _
DRAIN LAYER'S PERMIT NO 1505
19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at /10 9C61L2-.sg /$ Eno on the
side, between
at premises owned by 1h A 9jQ Ale&TZ-
E Z/glfZ
whose address is
and to _),Lay House Drain, Repair House Drain, Lay Main, Other
for 1�EtS/.D�^NT/,d occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( )Q, INDUSTRIAL WASTES .( ), OR
Connection will be made with_ __ 1 10— �CT/99 - Qom?, /n
Permit to be issued to PA(0.i4�TT INC ,
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 in Layer
Issued
Tax Collector
Permit Fee: Paid $ J�
INSPECTION: Check Number: y
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPE
N
� I
3
NOTES, SOUTH WINDSOR POLLUTION CONTROL
LOCATION lb &el-z e-"
OWNER Isar aYe-t \eez-a ck e_
TYPE OF WORK 1�ov e Coymectit7,,
DATE 9-Z'6-79 PERMIT In-5 PIPE " tr
INSTALLER
INSPECTOR DRAWN BY