HomeMy WebLinkAboutDrain Layers Permit Felt Road (2) TOWN OF -NTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL Bhp No.: A M
„ South Windsor;Connecficwt
r
List No.: _
DRAIN �.AY`ER'S PERMIT Na 57
— 19- .—
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at o "14 - on the
side; between
at premises owned byi
whose address is
and to Lay House Drain, Repair House Drain, _ Lay-Main, Other
for occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( 3D, INDUSTRIAL WASTES .( ), OR
Connection will be made with
Permif to be issued to .
the holder of Drain Layer's License No. "' '! Permit will expire on- a" IS 1974
The undersigned Drain'Layer hereby agrees to a l 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 + jAM - " `ARWA Of U#w4tuw VA—UM
Signed
Connection Charge Paid' : . Licensed Drain Layer
Issued by ai&a s �rari
Tax Collector
Permit Fee:. Paid $ _
INSPECTION: Check Number: '
INITIAL Ns J _ R (Sig)
FINAL - x (Sig)
APPROVED "± (Date)
(Sig)
INSPECTOR