HomeMy WebLinkAboutDrain Layers Permit 701 Governors Highwa TOWN OF oSJQUTH W I N DSOR
DEPARTMENT OF POLLUTION CONTRO
L B/P No.:
South Windsor, Connecticut
List No..
- -S G c,
DRAIN LAYER'S PERMIT N? 627
is ' 19 74
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to-perform
the work indicated below at `- ros KAftw on the
solo side, between XtUOStft NY
at premises owned by
whose address is AMM
and to I Lay House Drain, Repair House Drain, Lay Main, Other
for 1 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 flex (6) iwk moo.
Permit to be issued to
the holder of Drain Layer's License No. _ 9% Permit will expire ones +' 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 AAVA
Licensed Drain Layer
ftea 00 Issued by fay ' e* X0W Jt
Tax Collector
Permit Fee: Paid $ _
INSPECTION: Check Number:
INITIAL 2: (Sig)
FINAL ° _ (Sig)
APPROVED X< (Date)
}
(Sig)
INSPECTOR