HomeMy WebLinkAboutDrain Layers Permit Edwin Road - Electro d TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
� �
List No.: _ —
DRAIN LAYER'S PERMIT N9 629
A JAY ) 19� +
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at (X ) on the
side, between 6 .31tW! 1.34 0
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, + Other
for occupancy or use,
with fin) Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (' . j, INDUSTRIAL WASTES OR ( )
Connection will be made with AT34 Vk") Cat !" to H 10 s'
Permit to be issued to
the holder of Drain Layer's License No. "` Permit will expire on Cis"ObW 19 !' .
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and the-reverse side
—--the-- Applicant-has nec-eivezi T-own Permit Nam— ---and/or-E ii D-Permit No--------- -- — —---
for street excavation.
SPECIAL CONDITIONS
i ill ♦ ' ^ ice. ,60 ice #,! ouwtw
. :
Signed
Connection Charge Paid ' ' gensed Draiq+ayer
rot` K"#. 33
Issued by
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL - (Sig)
APPROVED,* hWa-yam+ A 27AL (Date)
(Sig)
INCTOR