HomeMy WebLinkAboutDrain Layers Permit 65 Birch Road TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.: 1 +.
List No.:
DRAIN LAYER'S PERMITS 883
-07 at1V , 19 Ret
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at }; _
on the
ouch side, between_ 'l�f ► gee at-
at premises owned by inn iia
whose address is
and to -X;—Lay House Drain, Repair House Drain, Lay Main, Other
foraaf
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 it ,r ieh� ti f
Permit to be issued to !- ....,
the holder of Drain Layer's License No.M206-t . Permit will expire on {i 19
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit an the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for-street excavation.
SPECIAL CONDITIONS t 7� ,ucOrr,�.4 ab a �,�d pit"
now—of 06 erne arr. 44*»
Signed—V4 � f
Connection Charge Paid License Drain ,ayer
Tax Collector Issued by N. ftsaft mad
Permit Fee: Paid $ _
INSPECTION: Check Number:
INITIAL (Sig)
r
FINAL ' (Sig)
APPROVED ` (Date)
(Sig)
INSPECTOR
t
s;