HomeMy WebLinkAboutDrain Layers Permit 97 Farmstead Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
_
/ South Windsor, Connecticut B/P No.:
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List No.: _
DRAIN LAYER'S PERMIT NO 1171
l Z 9 , 191(-
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at_ � t"P►Zm�Tlt� on the
side, between`[
at premises owned by 1os4r-N*,ak q-t- a-V-6oLAVPY S
whose address is S wiMd:
and to Lay House Drain, Repair House Drain, Lay Main, Other
for 1t3S� T�A� 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
Permit to be issued to W 6S-L-G (
the holder of Drain Layer's License No. Permit will expire on 21 �AuvAP� 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__'�7 �C�
Connection Charge Paid -Zq�7(� censed Drain Layer
U S Issued by
Tax Collector
Permit Fee:. Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)