HomeMy WebLinkAboutDrain Layers Permit 15 Diane Drive y:.
/ Y4-i5TOWN OF SOUTH WI N DSOR
DEPARTMENT OF RO.'LUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT N? 404
5Opt
J. t
Purs(int`to writtenj application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 15 Dian* ITT• on the
side, between B=nt & Kai a Rd.
at premises owned by Richard Q;jm3j*VjIIA
whose address is 4M*
and to X Lay House Drain, Repair House Drain, Lay Main, Other ,
for rosidentisaoccupancy or use,
with one 0) Family Units, with acres.
r Type of Sewage to be connected under this permit:
SANITARY SEWAGE, INDUSTRIAL WASTES, OR
Connection will be made with SIC 112611 (6) pjmtie rdro
Permit to be issued to jWM A_ Lmmmn
the holder of Drain Layer's License No. W9-X6i88 Permit will expire on- 2 19
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit dnd the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS tO ?W• Or-4 & =d
Signed
Connection Charge Paid $ 09-06-73 Licensed Drain Layer
r Per. Ns NQ (Sig) Issued by WVh A. Starkweathar Jr,
Tax Collector
Permit Fee: Paid $
INSPECTION: Ch*akr
INITIAL (Sig)
r
FINAL- (Sig)
APPROVED O R - Z " (Date)
(Sig)
INSPECTOR
7y1
NOTES SOUTH WINDSOR POLLUTION CONTROL
C/ LOCATION /s' /Awe
OWNER DPfr- R pkl114js-
TYPE OF WORK CC4At Aloi
Q_ ;7 ' DATE o - - -73 PERMIT ou PIPE ei4,71C
INSTALLER
INSPECTOR 4 ,c DRAWN BY it'j,