HomeMy WebLinkAboutDrain Layers Permit 380 Felt Road (2) TOWN OF S01f H WI N DSOR
DEPARTMENT :OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: Z
DRAIN LAYER',S 'PER-MITO 606
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at Lot 0,� MR e, on the
side, between
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other
for occupancy or use,
with aw Family Units, with acres.
Type.of Sewage to be connected under this permit:
SANITARY SEWAGE (X), INDUSTRIAL WASTES _( ), OR ( )
Connection will be made with t Pax.
Permit to be issued toJ.C. Haunwa
the holder of Drain Layer's License No._ Permit will expire onAjj& ZZ 192
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�#�/?4 f Licensed Drain Lay
�M* his Issued by- P411 4* 6 **r Jr*
Tax Collector
Permit Fee:. Paid $
INSPECTION: Check Number:
(71
_ SCANNED
D
INITIAL = (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)