HomeMy WebLinkAboutDrain Layers Permit 122 Dogwood Lane TOWNS OF $QVIH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
#1tooS it N0•1 8-60168
DRAIN LAYER' S PERMIT N? 206
19 my 119 73
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 1JV O on the
INNIft side, between to T Md (kdlWr DriTo`
at premises owned by •Pwp"ekudk
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other ,
for 1*AdAW' occupancy or use,
with mo W Family Units, with acres.
Type of Sewage to be connected under this permit:
(SANITARY SEWAGE) INDUSTRIAL WASTES, OR
Connection will be made with (601 gurAls
Permit to be issued to jis R. Kneft
the holder of Drain Layer's License No. Permit will expire on 18 JU1Y 19
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 C(INDITIONS ," to P=Vq iVW* Md backfill mptAs .
Signed �, r' -- -�•__
Connection Charge Paid '" °'" Licensed Drain"Layer
Ior so No"s (Sig) Issued by SUVOY Wo
Tax Collector
Permit Fee: Paid $15*00
Ckook burl 75940
INSPECTION:
INITIAL (Sig)
FINAL (Sig)
APP40VED (Date)
(Sig)
INSPECTOR
f.