HomeMy WebLinkAboutDrain Layers Permit 410 Beelzebub Road .-A ,, TOWN OF SOUTH WI NDSOR
t DEPARTMENT OF POLLUTION CONTROL gip No.
South Windsor, Connecticut 23
List No.: _
DRAIN LAYER'S PERMIT
N. 886
air , 19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 440 b" 11,. on the
3orm side, between AYlM-at, arc$ FGAMw fto
at premises owned by �t�yr3_wvrs�serw4�r
whose address is l
and to _Lay House Drain, Repair House Drain, Lay Main, Other
foraieRrt��1 occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (X), INDUSTRIAL WASTES OR ( )
Connection will be made with dot judh pllamt4a Ida
-
Permit to be issued to Job& Ae LoOM
the holder of Drain Layer's License No Permit will expire on 08 Aye# 19-a
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 D ain Layer
Tax Collector Issued by Ks
00
Permit Fee: Paid $ _ 0
INSPECTION: Check Number:
INITIAL (Sig)
FINAL - (Sig)
APPROVED d ; (Date)
(Sig)
iINSPECTOR