HomeMy WebLinkAboutDrain Layers Permit 19 Brian Road (2) TOWN OF SOUTH WINDSOR `
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor,�.; , Connecticut
List No.: _
DRAIN LAYER'S PERMIT
0 704
26 09101M 19. 74
Pursuant to-written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below atti on the
i t - t
side, between a* ftawt
At premises owned by "I" 16 01 1t.
w +wnn w�pr�
whose address is ANN
and to L Lay House Drain, Repair House Drain, Lay-Main, Other
for $'Mrl occupancy or use,,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (X j, INDUSTRIAL WASTES ,( ); OR ( )
r. .
Connection will be ade withSUM to IN .ferr�awo. ►t �_
Permit to be issued to k
the holder of Drain Layer's License No. SIR" 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
Signed
Connection Charge Paid
s Issued by kl%kreja. Or&
Tag Collector
Permit Fee:. Paid _'* '
INSPECTION: Check Number:
INITIAL ; ,. = U __ .�..,,,,.
(Sig)
FINAL i «: > '' ., ..�..r,.: (Sig)
APPROVED + (Date,)
f. (Sig)
INSPECTOR