HomeMy WebLinkAboutDrain Layers Permit 67 Blue Ridge Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.:
DRAIN LAYER'S PERMIT N? 2457
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Pursuant to written application, pe mission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
side, betw en
at premises owned by—
whose address is
and to /Lay House Drain, Repair House Drain, Lay Main, Other ,
for
occupancy of use,
with Family Units, with acres.
Type of Sewage to be connected under this permit: (r,
SANITARY SEWAGE (L,-), INDUSTRIAL WASTES .( ), OR ( )
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Connection will be made with 62 r yG
Permit to be issued to e 6 c
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 street excavation.
SPECIAL CONDITIONS
2vv $
Signed
Connection Charge Paid U 0- 65 16 I g+ ensea D ain
(
Layer
�11�wocl Issued by
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Permit Fee:. Paid $ _iLiOv ° 4
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
67
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121
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67
33 cc-fC4,
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