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HomeMy WebLinkAboutDrain Layers Permit Goodhill Road (2) TOWN OF SOUTH WI N DSOR DEPARTMENT OF POLLUTION CONTROL South Windsor, Connecticut DRAIN LAYER'S PERMIT N© 476 Ott . 12 , 1923 _ Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform the work indicated below at 10% a cou a Nowks, on the side, between 3W3 A* at premises owned by 119040% Wman 9 1' whose address is 9" 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' INDUSTRIAL WASTES, OR Connection will be made with six Permit to be issued to the holder of Drain Layer's License No.�� - Permit will expire on l9aft 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 AU * +j Signed Connection Charge Paido lk _ Licensed Drain Layer t so Nods (Sig) Issued by auk A* Tax Collector Permit Fee: Paid $ INSPECTION: INITIAL f� { td! ) (Sig) FINAL /r, , i . (Sig) f APPROVED '— (Date) g (Sig) INSPE OR