HomeMy WebLinkAboutDrain Layers Permit 60 Deming Street (3) OWN OF Sk. WINDSOR
DEPARTMENT OF POLLUTION CONTROL
x South Windsor, Connecticut
DRAIN LAYER'S PERMIT No 263
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_ a," 111MMA
at premises owned by _ 00
whose address is
and to 2 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) INDUSTRIAL WASTES, OR
Connection will be made with ilk ► ��T
Permit to be issued to a P* am"11
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
AM
Signed
Connection Charge Paid Licensed Drain Layer
(Sig) issued by
Tax Collector
Permit Fee: Paid $
i
INSPECTION:
INITIAL (Sig)
FINAL (Sig)
APPROVED 1ss tC (Date)
(Sig)
•1NSPE TOR
EJ .........
i OA -�,o 'I
NOTES
SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER
LD)
YPE 0 WORKTE G PERMITPIPENST L R
INSPECTOR ? DRAWN BY
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