HomeMy WebLinkAboutDrain Layers Permit 20 Elizabeth Street r �
TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL gip No.:
South Windsor, Connecticut
List.No.:
DRAIN LAYER'.S PERMIT N? 1971
19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at °201 ZG b 2 /� s7�, on the
side, between
at premises, wned by— �n U P ri`,�c
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, _Other
for /cam of �/ � � occupancy or use,
with Family Units, with/ acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ), INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with
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Permit to be issued to ,(
at
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
Signed
Connection Charge Paid '90. Licensed rain Layer
;T de4_710�'07 Issued by
Tax Collector
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Permit Fee:. Paid $
INSPECTION: Check Number: -:2&
—Z'qC CC-i e0.y�+..�
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
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