HomeMy WebLinkAboutDrain Layers Permit 65 Diane Drive TOWN OF „ S: 77,W WINDSOR
OEPARTMEF ' OF POLLUTION CONTROL BAP No.:
South Windsor, Connecticut t „
List No.
5 &0 -f
DRAIN LAYER'S PERMIT p 613
sM , 197_
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 63 Dismo L'y"a on the
side, between al ii�: lj.de
at premises owned by ' ' ZI 4
whose address is
and to X 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 NIX
Permit to be issued to J&
the holder of Drain Layer's License No.—V(94OM88 Permit will expire one s . lcl—
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the p Y and the reverse s
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
Signed
Connection Charge Paid JU2,%, Licensed Drain Layer
ro Z4 Issued by Aa Bt.%Akyortthor J
Tax Collector
Permit Fee: Paid S _.___
INSPECTION: Check Number:
INITIAL (Sig)
FINAL / J �``= Ili" (Sig)
APPROVED " `-� (Date)
)
r (Sig)
INSPECTOR '
r
N
rs 20
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION AQe
OWNER
TYPE OF WORK
DATE _ 7 4 PERMIT « PIPE ✓,C-,
INSTAkLEX
INSPECTOR IP,4, DRAWN BY ,S