HomeMy WebLinkAboutDrain Layers Permit 691 Governors Highwa (2) TOWN OF SOUTH WINDSOR ,Q
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT
N. 440
oc . 4 1973
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 691 Goviwrl, on the
mouth side, between Rt•, � � Rt. �
at premises owned by Awn St. r
whose address is
and to X Lay House Drain, Repair House Drain, Lay Main, Other
ReSi
for d . &al occupancy or use,
with One (1) Family Units, with acres.
# Type of Sewage to be connected under this permit:
'SANITARY SEWAGE,) INDUSTRIAL WASTES, OR
Connection will be made with Six inah(66 plastic pip
Permit to be issued to -0... $1&t*r
the holder of Drain Layer's License No.wg..206451 Permit will expire on Veo, 4 192
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 D I *r to pmproraA and backfill ftptio
Signed
Connection Charge Paid $ 10/4 Licensed Drain Layer
Per*. V-4 Houtz
(Sig) Issued by Ralph A* Satrkweathor Jr,
Tax Collector
Permit Fee: Paid $ 15.E
INSPECTION:
INITIAL {,' ' `'a1",' r( w (Sig)
FINAL <}, (Sig)
APPROVED <_ s" f ' -7 (Date)
�I
(Sig)
INSPECTOR~