HomeMy WebLinkAboutDrain Layers Permit 19 Birch Road (2) TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER"S PERMIT Np 1363
Pursuant to written applicatior, permi ion is reby granted to e Lic �se.�
Dr in Laye namedherein to perform
the work in iics ed 1 at ~ /Q on the
V U(J
- side, bet n
at premises owned by /11� er- .K.✓C?r7 6`
whose address is `
and to Lay House Drain, Repair House Drain, Lay-Main, Other /11
for
occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ; INDUSTRJAL.W S ( ), OR { )
Connection will be made with
Permit to be issued to
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 sweet xcavation.
1
ECIAL CONDI IO S e �P . co
Sig nea `f
Connection Charge Paid
Tax Collector Issued by
ermlI * 3 O Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL —} (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
BIRCH
- - - - 2!' E3 cow oP o F
- L CT -
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- _ q5 BEND `v 30� —I I10�
_ 3 q '
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