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HomeMy WebLinkAboutDrain Layers Permit 710 Governors Highwa TOWN Of 'SOUT14 NVI N DSOR DEPARTMENT OF POLLUTION CONTROL B/P No.: South Windsor, Connecticut List No.: _ DRAIN LAYER' S PERMIT Np 618 Or 19 — Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform the work indicated below ati 'tiw& on the north side, between � !'. `j e at premises owned by * ' 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 permits SANITARY SEWAGE (A ), INDUSTRIAL WASTES _( ), OR ( ) Connection will be made with ( '143h Pilllc.. Permit to be issued to the holder of Drain Layers License No. Permit will expire ong$.. The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the pe�nd the reverse side e— thereof. Applicant has received Town Permit No. and/or C H D Permit No. for street excavation. SPECIAL CONDITIONS ' Signed Connection.Charge Paid 6,;6.44 Licensed Drain Layer Issued by Tax Collector Permit Fee Paid $5 INSPECTION: Check Number: INITIAL 'S ! is t > �r (Sig) -- FINAL a '#, .:x (Sig) APPROVED` C (Date) (Sig) INSPECTOR N ► o 7 1© L� - -------NOTES- SOUTH WINDSOR POLLUTION CONTROL LOCATION OWNER L ,� TYPE OF WORK s _ r1isL DATE PERMIT C Y PIPE Y E INSTALUK INSPECTOR .f' DRAWN BY S