HomeMy WebLinkAboutDrain Layers Permit 8 Evergreen Lane TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
Z
B/P No.:
Li
South Windsor, Connecticut .j''
Y st S�'.No.: _ /�—�--3
DRAIN LAYER'S PERMIT NO 1$64
19
Pursuant to written applicatior, er fission i her�nted to the Licensed Drain ayer named herei to erform
o p
the-work indicated below at 2i on the
side, between
at p m' es owned by
r �
whose address is
and to Lay House Drain, Repair House Drain, La -Main, Other
for /
� occupancy or use,
with Y Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( ), INDUSTRIAL� WASTES ( ) OR ( )
Connection will be made with_ /4
r
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
f 1 y79 �/ Signed
Connection Charge Paid Y6o 0 O Licensed Drai ayer
Issued by
Tax Collector 79 l y
Permit Fee:. Paid $ S',D U_
INSPECTION: Check Number:
INITIAL
(Si )
_ g
FINAL (Sig)
----- - __ ---- _ APPROVED . _ (Date
INSPECTOR (Sig)