HomeMy WebLinkAboutDrain Layers Permit 86 Elizabeth Street TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut �E-
List.No.:
DRAIN LAYER'S PERMIT ND 1958
19 '
Pursuant to written applicatioorr,, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at d y 'Ehz Ct bYld :5 on the
side, between
at premises owned by_ J-,e VtS y V -e. J-er-
whose address is
and to Lay House Drain, Repair House Drain, Lay-Main, Other
for �t'�� �i / occupancy or use,
with Family Units, with acres.
Type of Sewage to be c nected under this permit:
SANITARY SEWAGE ( ), INDUSTRIAL WASTES ( ), OR
Connection will be made withPermit to to be issued toy
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.
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SPECIAL CONDITIONS 2
Iiss�2
/a 7'7y Signe4,
Connection Charge Paid Licensed Drain Layer
Issued by
Tax Collector /a aq �f D
Permit Fee:- Paid $
INSPECTION: Check Number: /Ss
INITIAL (Sig)
FINAL (Sig)
APPROVED /2 'Z 7 (Date)
(Sig)
INSPECTOR
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