HomeMy WebLinkAboutDrain Layers Permit 124 Edgewood Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List.No.:
DRAIN LAYER'S PERMIT NO 1955
19 _
Pursuant to written applicatior, permission
is
hereby granted to the Licensed Drain Layer named herein to"perform
the work indicated below at k1104) on the
side, bet we n
at premises wned by 71,4 6 6 D + GIN e-
whose address is O) /
and to Lay House Drain, Repair House Drain, Lay Main, Other
��for o -•-- occupancy or use,
with rj7)jR- Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( , INDUSTRIAL WASTES ( ,) OR
Connection will be made with rl �N
Permit to be issued to
the holder of Drain Layer's License No. Permit will expire on 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 CONDITIONS
57'> Signed
Connection Charge Paid Z106 '6 d Licensed Drain Layer
Issued by 41A� 1
Tax Collector la onQ 7y � Sj
Permit Fee: Paid $
INSPECTION: Check Number.
INITIAL (Sig)
FINAL (Sig)
1
APPROVED G> (Date)
S
INSPECTOR
r
.f
I t8i
f .
t