HomeMy WebLinkAboutDrain Layers Permit 660 Governors Highwa TOWN OF S" WINDSOR
DEPARTMENT OF POLLUTION CONTROL Bhp No.: 0. *
South Windsor, Connecticut
List No =�
DRAIN LAYER'S PERMIT
N 512
Dec. 19?3
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated-:below at 660 (7 nr € r'g r5 &my on the
»sF side, between_ t '. Ellington - .
at premises owned by lersr= "a €aF
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other
for ,,.r,n :x.; �
e occupancy or use,
with ort (1) Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (nX
Y. INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with Six 1 t-ic h (6) ULNA
Permit to be issued to 11eba 1 . Ra'l c_5tt
the holder of Drain Layer's License No.W-- 645'4 Permit will expire on jean 28 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 irUa 1 or tgLiugzy, Cruwa I-cj .jjj &tjt3 t
�, Signed
Connection Charge Paid �. 2°#;. Licensed Draid'Layer
Fo • t. No ltz Issued by Rblr^i A*
Tax Collector
Permit Fee:. Paid $ _ "d
INSPECTION: Check Number:
INITIAL t) (Sig)
FINAL •. E3 (Sig)
APPROVED �' r"" �' ,? (Date)
(Sig)
INSPECTOR
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION O
OWNER
TYPE OF WORK
DATE PERMIT 3` PIPE C i? rri
INSTA LE
INSPECTOR DRAWN BY