HomeMy WebLinkAboutDrain Layers Permit 77 Birch Hill Drive (2) w�
TOWN *bFAOUTH WINDSOR
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DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
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DRAIN LAYER'S PERMIT
p 39
AAI4y 1 19
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at_. , _ �� . ���a ai
^""�." "'�.�.. on the
side, between
at premises owned by
whose address is
and to ,._Lay House Drain, Repair House Drain, Lay Main, Other
for
occupancy or use,
with /4) Family Units, with
� acres.
Type of Sewage to be connected under this permit:
,(SANITARY SEWAGE INDUSTRIAL WASTES, OR
Connection will be made with LA
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 a�erms 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 - jr SALA -a
Signed
Connection Charge Paid 49 '!` Licensed Drain Layer
(Sig) Issued byValmdm
Tax Collector
Permit Fee: Paid $
INSPECTION: 11111111111111wt
INITIAL (Sig)
FINAL (Sig)
APPROVED _Ilk 414 j. #9.13 (Date)
INSPECTOR (Sig)