HomeMy WebLinkAboutDrain Layers Permit 382 Beelzebub Road (2) TOWN OF * U 'H WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
-s South Windsor, Connecticut
DRAIN LAYER'S PERMIT ND 405
a _ 10 , 19 73-3
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
Ad
the work indicated below at 382 $l4XXlWUU
on the
XDr side, between AT*37 & 902*03k
at premises owned by Alb*rt grim
whose address is SOM
and to X Lay House Drain, Repair House Drain, Lay Main, Other ,
for V*Si d=tfu].
occupancy or use,
with 0110 0) Family Units, with acres.
Type of Sewage to be connected under this permit:
{ SANITARY SEWAGE) INDUSTRIAL WASTES, OR
Connection will be made with_stX 12411 (6) D1SAW1 Id"
Permit to be issued to WAI-1 NOXIAW
the holder of Drain Layer's License No. W9-206M Permit will expire on X*T. 10 1973
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 Di4m l y*r to P=Vj at' ah md ba4 kfill t c tXk
1
Signedf 1 r'
Connection Charge Paid »73 Licensed Drain Layer t
(Sig) Issued by 1ap1 dR Stalty"thaft Jr*
Tax Collector
Permit Fee: Paid $. 13*00
INSPECTION• ` !
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INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
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(Sig)
el INSPECTOR IV
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION JV'2
OWNER
TYPE OF WORK
DATE - 2 7 PERMIT a r- PIPE �»ri7�'
INSTALLER
INSPECTOR ej, DRAWN BY s