HomeMy WebLinkAboutDrain Layers Permit 340 Foster Road R TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL gip No.:
South Windsor, Connecticut
List.No.: P.1-j�—,Z-9--
DRAIN LAYER'S PERMIT NO 1667
Z� , 19 77
Pursuant to written applicatior, permission is hereby granted to the Lice ed Drain Layer named herein to-perform
the work indicated below at ® '
on the
side, between
at premises owned by
whose address is O
and to Lay House Drain, Repair House Drain, Lay-M in, —Otheryy-�
for (� occupancy or use,
with � Z9 Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE DUSTRR/IAL WASTES ( ), OR
Connection will be made with_ (`o
Permit to be issued to. 41
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
Signed
Connection Charge Paid 6--Z5".-7 Licensed Drain Layer
-*- 13 77
Issued by
Coliector_ - - - - -
Od
Permit Fee:. Paid $ __1.r
INSPECTION: Check Number: d7
- INITIAL (Sig)
FINAL p (Sig)
APPROVED '- Z S'' { (Date) -— _ /
INSPECTOR (Sig)
N
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-- -NO-TES SOUTH WINDSOR POLLUTION CONTROL
LOCATION 3 4 0
OWNER
TYPE OP WORK C,A'AlQ.
DATE - PERMIT PIPE Pf
INSTALLER Co V ^`
INSPECTOR Rk DRAWN BY