HomeMy WebLinkAboutDrain Layers Permit 441 Governors Highwa TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL gip No.:
South Windsor, Connecticut
List No.:
DRAIN LAYER"S PERMIT NO 1875
2— , 19 7�
Pursuant to written applicatior, ermission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at -1 / 1�-O y on the
side, between
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 permit:
SANITARY SEWAGE (X), INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with
Permit to be issued to
the holder of Drain Layer's License No. Permit will expire on 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
7�-/y8' '7 a-7/-7 I
G4-�. //S- UV Signed l' �,�
Connection Charge Paid 6)00 Licensed Drain Layer
- - Issued by _ __ _ -
Tax Collector '91d 71 7cr /9. 9S`
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
3
FINAL (Sig)_ — g _c4S a i As
APPROVED (Date)
(Sig)
INSPECTOR