HomeMy WebLinkAboutDrain Layers Permit 382 Beelzebub Road TOWN OF SOOTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT N� 405
Pursuant to written application, permission i' hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
side, between
at premises owned
whose address is
and to 4 Lay House Drain, Repair House Drain, Lay Main, Other
for nod'.1 - 0 - occupancy or use,
with ON W Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE) INDUSTRIAL WASTES, OR
Connection will be made with Ift + h �� 2114RUS Id*
Permit to be issued to W113
the holder of Drain Layer's License No. Permit will expire on "*T* 1
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 notM' 14M i* VOOO 0800 MI #
F
i
Signeyi'
Connection Charge Paid ' "' r Licensed Drain Layer
(Sig) Issued by YAM'*
Tax Collector
Permit Fee: Paid $ 1
INSPECTION:
INITIAL _ zxf2 " , (Sig)
FINAL (Sig)
APPROVED (Date)
l
�° ✓-�r .. _ (Sig)
INSPECTOR