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HomeMy WebLinkAboutDrain Layers Permit 350 Diane Drive TOWN OF 4OU T H WI N DSOR DEPARTMENT OF POLLUTION CONTROL South Windsor, Connecticut �b DRAIN LAYER'S PERMIT N° 374 An- 15 , 197_ Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform the work indicated below at Dell* Dr* on the 448* side, between Ke17.r & BT11,t at premises owned b onh Vitt -Ifni whose address is_3M_ DiM! Dr* and to X_Lay House Drain, Repair House Drain, Lay Main, Other for Y'esid<el occupancy or use, with onwa {1} Family Units, with acres. Type of Sewage to be connected under this permit: SANITARY SEWAGE, INDUSTRIAL WASTES, OR Connection will be made with_N.X_ T2 11 {6) plafne pipe Permit to be issued to delis A. T.et_rmon the holder of Drain Layer's License No.W9-206188 Permit will expire on0ets 15 1973 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 Drain lay* ' to p p4 emsh and b*e1fill Septi* tank Signed Connection Charge Paid *10-73 Licensed Drain Layer Par. Xs Iftis (Sig) Issued by Ralph As $twkw t er Jr** Tax Collector F' Permit Fee: Paid $. 1 5&00 INSPECTION: Cheek INITIAL Aee (Sig) FINAL (Sig) APPROVED 0 R'^ © 7 (Date) (Sig) INS CTOR D NOTES SOUTH WINDSOR POLLUTION CONTROL LOCATION So 1;4NP- 2 - OWNER vi'%I TYPE OF WORK S.E ,�-4 r.�r � DATE a8-- PERMIT L PIPE �T/c INSTALLER INSPECTOR DRAWN BY