HomeMy WebLinkAboutDrain Layers Permit 75 Birch Road TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.: 1 •$
# South Windsor, Connecticut
List No.: 54-�-734
DRAIN LAYER'S PERMIT NO 884
ly ' 19-73
-_
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at ` Kmh NO on the
mouth side, between LIUMI $$. Md Oak 111k
at premises owned by tlEorald ffiie
whose address is am*
and to X Lay House Drain, Repair House Drain, Lay Main, Other
for raiddatIMIL occupancy or use,
with on* Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (X ), INDUSTRIAL WASTES .( ), OR
Connection will be made with fi xx 4=h dus Wmi plastin34in
Permit to be issued to drQ A. LOMM
the holder of Drain Layer's License No.V%20&M Permit will expire onjV At2anat 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 DOW A1161huMe- agantabl e slMom 9ijaft 10 W NWr.
Main► of 06 NOYMbsr Ign
3
Signed
Connection Charge Paid t Licensed Drain Layer
-- Issued by --K&—ftWft IWOM
Tax Collector
Permit Fee: Paid $ ___ N
—00
INSPECTION: Check Number:
INITIAL "-F (Sig)
FINAL (Sig)
0
APPROVED_ t _: (Date) .
jI (Sig)
INSPECTOR