HomeMy WebLinkAboutDrain Layers Permit 38 Elizabeth Street TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.:
DRAIN LAYER'S PERMIT NO 1976
'--1- 1 1 9-�"—
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to"perform
the work indicated below at a`z 2417 �� on the
side, between /
at premises o, ned by—, 140a.L &i' �!-
whose address is (, l-e—
and to Lay House Drain, Repair House Drain, Lay Main, _Other
for ,/' occupancy or use,
with c k. Family Units, with acres.
Type of Sewage to be connected under this permit: '
SANITARY SEWAGE ( ,"INDUSTRIAL
//WASTES , ), OR ( )
Connection will be made with
Permit to be issued to
the holder of Drain Layer's Licepse 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 7? /(,. z ,
O p Signed
Connection Charge Paid Licensed Drain Layer
n� Issued by {
'1—axCollector
v�
Permit Fee: Paid $
INSPECTION: Check Number: 7/ O
INITIAL j Y — ��' ��nC'v �rcc CA/1J7' ,
ig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)
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6
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31
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