HomeMy WebLinkAboutDrain Layers Permit 67 Brewster Road TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
Lr.sr e.c Q
DRAIN LAYER'S PERMIT
p 282
19 1*3
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at
on the
side, between
at premises owned by_A9*
all
whose address is
_ 41ft
and to _XLay 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 •i4aie.. .rr'l. ,�
■
Permit to be issued to
W.-
the holder of Drain Layer's License No. Permit will expire on I
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit an the3' reverse sid
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS _ !!!t
Signed
Connection Charge Paid Licensed Drain Layer
too ryx ,
X fi A
Tax Collector (Sig) issued by
s Permit Fee: Paid $ -
INSPECTION:
INITIAL
(Sig)
FINAL (Sig)
APPROVED 2¢ 4-446 t 9 i 3 (Date)
INSPECTOR (Sig)
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V
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6`
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NOTES
SOUTH WINDSOR POLLUTION CONTROL
LOCATIONl2-i .
OWNER
TYPE OF WORK
DATE � ,z. 7 PERMIT �-�z PIPES-..
INSTALLER
INSPECTOR lz DRAWN BY