HomeMy WebLinkAboutDrain Layers Permit 710 Governors Highwa (2) TOWN f F `SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut r
List No.: _
DRAIN LAYER'S PERMITO sib
, 19
Pursuant to written applic or, permission is-hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
side, between- Aim 2d.
at premises owned by__
whose address is
and to Lay House Drain, Repair House Drain, Lay Main,. Other ,
for �t,�:� �i6 ._,.�_
occupancy or use,
with €c Family Units,,with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( j, INDUftIAL WASTES ,( ), OR ( ) _
Connection will be made with ..
Permit CO. be issued to # V11Aof
the holder of Drain Layer's License No..- w Permit will expire on_ i, A 19AJ..
The undersigned Drain Layer hereby apes 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
p E Signed
Connection Charge Paid '` Licensed Drain Layer
E*
Issued by
Tag Collector
Permit Fee:. Paid
INSPECTION4 -Check 'Number:
INITIAL .. ' r (Sig)
FINAL t (Sig)
APPROVED ``« F; (Date)
(Sig)
INSPECTOR