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HomeMy WebLinkAboutDrain Layers Permit 17 Dogwood Lane TOWN OF SOUTH WI N DSOR DEPARTMENT OF POLLUTION CONTROL _ r South Windsor, Connecticut DRAIN LAYER'S PERMIT © 265 19 Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform the work indicated below at L : Qe moo' % . r' , � � 'T�t', on the Z0 09 side, between at premises owned by 9�,F�at�_ whose address is— and to 1ZLay House Drain, Repair House Drain, Lay Main Other for y� n occupancy or use, with ( ;� j�y(,Q . Family Units, with acres. Type of Sewage to be connected under this permit: %,SANITARY SEWAGE,,, INDUSTRIAL WASTES, OR i/ Connection will be made with 71 Permit to be issued to ; the holder of Drain Layer's License No.4',?— a0 7 6-6ZJ , Permit will expire on 19 , The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit nd the reverse side thereof. Applicant has received Town Permit No. and/or C H D Permit No. for street excavation. SPECIAL CONDITIONS <' � ✓, Signed Connection Charge e1d rf/ Licensed Drain Layer _(Sig) issued by Tax Collector Permit Fee: Paid INSPECTION: INITIAL (Sig) ' FINAL (Sig) APPROVED ) ¢ (Date) (Sig) INSPECTOR •s} ,. -'� ss` r� � ♦-j � �- - � # a� y # h y _+ ,r }�� � "�t3T �.s�' � F� t] t . a 14 v� J. +' Y WIN IN € a lAS W as +, ,x r-. 'T� -} `€£ - .tom t' x, 1"` 8. "< Srt _ _'�' '� � s t j� � s A ) 4 M ` R \ I L1 ti.. NO—ES SOUTH WINDSOR POLLUTION CONTROL LOCATION eja , OWNER TYPE OF WORK Sp�.r,. DATE / PERMIT INST LLER INSPECTOR 1 !, DRAWN