HomeMy WebLinkAboutDrain Layers Permit 733 Governors Highwa (2) TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.:
DRAIN LAYER'S PERMIT N? 2459
f
19
Pursuant to written applicatior, permission is hereby.granted to the Licensed Drain Layer named herein to perform
the work indicated below at r t_ =1 .• on the
\�
side, between
at premises owned by Lk 22--y _` ?`.-A 4� x._ r-
tr
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 ( ), 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
Signed
Connection Charge Paid t_%j% "II f 5 1 e" f Licensed Drain Layer
( i
r t).._A_ Issued by
-A--A Issued i� i ,c 7-�-��t: _
Tax Gollectorj
Permit Fee:. Paid
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR