HomeMy WebLinkAboutDrain Layers Permit 61 Brian Road (2) TOWN OF SdUTH WI N DSOR
,q .,ep pI ..
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT 'O 421
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 61 Brim I*. on the
side, betweenChit 9"N"' 416 '
at premises owned by IOU—
whose address is arsrarf
and to K _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 SEWAGI), INDUSTRIAL WASTES, OR
Connection will be made with NiZ iMk (6) 2jNjjjj& �
Permit to be issued to Johm A.
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 kv" Ja .III' to rMt " %M*=
Signed _._... .. :.
Connection Charge Paid $ Licensed Drain Layer
Ame. Xa-. (Sig) Issued by YALI* A* 11t424VAftt1W 11lo
Tax Collector
Permit Fee: Paid $1
INSPECTION: ! � +�
INITIAL (Sig)
FINAL (Sig)
APPROVED ;' (Date)
'71
`► • (Sig)
INSPECTOR