HomeMy WebLinkAboutDrain Layers Permit 678 Governors Highwa TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
i South Windsor, Connecticut B/P No.: f .FI. 4
74 List No.: 566-7,6,0
r
DRAIN LAYER'S PERMIT N? 934
1 a A-4- ber ' 19�
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 6'7$ t vernerI a4 on the
ne h side, between Belden Bond and Ellinatm Pload
at premises owned by — JAIM J tG ii,ne K-
whose address is Mank&
and to --_Lay House Drain, - Repair House Drain, Lay Main, - Other
for rcafdentfml occupancy or use,
with me (1) Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (X ), INDUSTRIAL WASTES -( ), OR ( )
Connection will be made with gsi xd- nah (6") plant i n yism to e lateral Imawn na fta
dex3th or 8.,5f
Permit to be issued toe Vo CpVe3tIft, dbit CO'Met1. 1~iCQtls1r1"Liation
the holder of Drain Layer's License No._ W9.25924 Permit will expire on12 NOV 9_r 19
The unders-igaed,. train 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 09.11-7,5 Licensed Drain Layer
ftowipt d� r3� Issued by Hel.lin EdwardB, r*
Tax Collector
Permit Fee:. Paid$
I P CTI eck Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)
N
y �s
20
- - - SOUTH WINDSOR POLLUTION CONTROL
LOCATION (o' E C a �
OWNER �< <�S-
TYPE OF WORK
DATE -75 PERMIT 9a4 PIPE sftc
INSTALLER
INSPECTOR �' DRAWN BY