HomeMy WebLinkAboutDrain Layers Permit 435 Buckland Road TOWN OF SOUTH• WI N DSOR
/ DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut :
DRAIN LAYER'S PERMIT,°
' 19. 74
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 bye rfi,"
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other -
for.
-- occupancy or ug,
with` tw (a) Units, with acres.
Type of Sewage to be connected under this permit: .
SANITARY SEWAGE, - ► INDUSTRIAL WASTES, OR a
Connection will be made with '" i>1 1` L w", 1' yt
1s r ,
Permit to be issued to s
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
'�.. ...Sri• f W
Signed
Connection Cg har a Paid +'
r Iscensed' rain'La
AS Le. 1 .. ,
"(Sig) Issued by vo3
Tag Collector
P mt Fe Paid
INSPECTION: 'Alm
" ' '""
INITIAL (Sig)
FINAL t. (Sig)
APPROVED 01 1 (Date)
(Sig)
SPECTO