HomeMy WebLinkAboutDrain Layers Permit 740 Governors Highwa TOWN OF SOUTH WI N DSOR
. DEPARTMENT OF POLLUTION .CONTROL Bhp No.:
South Windsor, Connecticut
List.No.: _ I b 3 —
DRAIN LAYER'S PERMIT N0 1249
- � , 1927
Pursuant to written applicatior, permi i n is hereby granted to the Li ensed Drain Layer named herein to perform
the work indica d below at U l� G(l��'!'JG on the
side, between !2 pr l,-,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 permit:
SANITARY SEWAGE (X}, INDUSTRIA 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
dzloe h
Signed mil/
Connection Charge Paid Licensed Drain Layer
- Issued by _
Tax Collector _
Permit Fee: Paid $ _ _ S .oo
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED Q (Date)
C (Sig)
INSPEC OR
enLIT
47
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171
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6,070 era e /x 1211r-
M�S /o +Q !�� SOUTH WINDSOR POLLUTION CO _ L
�/ LOCATION G •�
OWNER
TYPE OF WORK
DATE - - RMIT PIPE C, (J
INSTALLER
INSPECTOR DRAWN BY