HomeMy WebLinkAboutDrain Layers Permit 71 Breezy Hill Drive TOWN- -OF SOUTH WI N DSOR
L� DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.: f �
List.No.: _� Q -
/Y� DRAIN LAYER"S PERMIT � - -
` '- N. 2032
aea eL 19
Pursuant to written applicatti/or, Zrer
ssion is hereb /granted t the Licensed Drain Layer named herein to-perform
the work indicated below at %! /(� X
on the
side, between
at pre .ses owned by /� Gc i�I1 D. �t°r!t q m /
whose address is
and to Lay House Drain, Repair House Drain, Lay-Main, Othe
for nno 4 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 �® 1/Y L
Ic-
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 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
7-a4 Signed 1 tom- Gt
Connection Charge Paid D
44.iicensed Drain Layer
11-111 "<6,
Issued by
Tax Collector q
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig) r�
FINAL (Sig) ,
APPROVED (Date)04�� W;4 —
INSPECTOR (Sig)
N J A/4 f
;1 p
r
�o
-71
r
� 9c
NOTES SOUTH WINDSOR POLLUTION COMROL
LOCATION
OWNER
TYPE OF WORK
DATE -00.PERMI p pE �
INSTALLER
INSPECTOR RAWN BY