HomeMy WebLinkAboutDrain Layers Permit 66 Birch Road -TOWN OF SOUTH WINDSOR {
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT N? 275
19 Juno 19 73
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
11 side, between
at premises owned by ray
whose address is owft
and to _Lay House Drain, Repair House Drain, Lay Main, Other
for occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
(SANITARY SEWAGE) INDUSTRIAL WASTES, OR
Connection will be made with t ► elr d"
Permit to be issued to
the holder of Drain Layer's License No. I 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 street excavation.
SPECIAL CONDITIONS DIMAS 16M to Mt WA= SOU4
f 1
Signed.-..:
Connection Charge Paid + Licensed Drain Layer
(Sig) Issued by x1vu4st Jr#
Tax Collector
Permit Fee: Paid $ e
INSPECTION:
INITIAL (Sig)
FINAL } (Sig)
APPROVED /9 (Date)
E4. ►• r OFAI 0 4 (Sig)
RTSPECTOR
N
TI
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION " 6e,-q c g D
OWNER /;rocJ,j-c.
TYPE OF WORK e'OAIAI
DATE PERMIT S" PIPES
INSTAYMER
INSPECTOR ,l E _V DRAWN