HomeMy WebLinkAboutDrain Layers Permit 727 Deming Street i
TOWN OFH WINDSOR
DEPARTMENT OF P _UTION CONTROL BAP No.• 1
South Windsor, Connecticut ` :
List.No.: _
DRAIN .LAYER'.S PERMIT
a 550
- y , 19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at ' to t l 60 30 �i 4;t* on the
ti I side, between_ akland ice♦ t: Ante. 'St.
at premises owned
whose address is
and to' X Lay House Drain,' Repair House Drain, Lay Main, Other
for fidd mtial I9e 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 x (6) iach cloy- l
Permit to be issued to Aim WimiAwski
the holder of Drain Layer's License No._ 'a` 15' Permit will expire on €,a y 19 t`�
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 HD Permit No. 0{ 3
for street excavation.
SPECIAL CONDITIONS
Signed f s ' r,
Connection Charge Paid 5/ 4 - License Drain Laker
X'A 1 .. Issued by ` `) , E, xlwviX aITC.
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number: _
INITIALf ` (Sig)
FINALS::,f '�= (Sig)
s���y'
APPROVED , ' _, /� .. Y _ (Date)
INSPECTOR
N
e°
rjov
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION QZIV7,'Nc. s;,-
OWNER �r/ih%w FqL
TYPE OF WORK
DATE ;r PERMIT s�'� PIPE do
INSTALLER
INSPECTOR DRAWN BY r