HomeMy WebLinkAboutDrain Layers Permit 43 Brewster Road V1 N yr 5QUTH WINDSOR %0-
DEPARTMENT OF POLLUTION CONTROL
South Windsor, C.on40c#icy!
s, .. List.No.: _s -73k_
BRAIN LAYER'S PERMIT
v s i'll y ' 19 r
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named hereinjo perform
the work indicated below at F "`
on the.
c:Jcl tL side, between ;. c`, ;v; :�idadl east 'Jrfi " V'aa ;
at premises owned by
whose address is
and to =a Lay 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 ( j, INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with 1.- y _ y
lateral, hnowu jig
depth of 10.0'-9 {
Permit to be issued to v3 ;r
the holder of Drain Layer's License No. V4%0-c `�
Permit will expire on i1`, �rc�t�ir.c�l�131' 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
Signed
Connection Charge Paid Licensed Drain Layer
Bssw. = a Issued by
Tax Collector
_ Permit Fee: Paid
INSPECTION: Check Number: G97
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
)
INSPECTOR,