HomeMy WebLinkAboutDrain Layers Permit 694 Governors Highwa (3) TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
" B/P No.:
South Windsor, Connecticut �ti�
List.No.: _
DRAIN LAYER'S PERMIT N? 1540
/VoVEm 9 , 19 -�7e
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at rrh v on the
Ot
side,.between
at premises owned :Z)a w /H UU�/Vz�D.�
whose address is
and to Lay House Drain, - Repair House Drain, Lay Main, Other INSTALL ,L47�kl9L,
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 P1�Cam' Q0 TQArT,#,e //U 1-0
texas7/L r )9t4t-- ALL t vow, C94l'j 4niD
Pegmi,Q to,by i,§sgerd AQ: G'6!UVs_rkui✓2
i r-'r I r 11 r i r i�n-rt itrrl•'riYi i�-�, i r--+ ,
-1!<'. 1•i'%(ll iir f-� (' it 7 Yr'�r; I , -I ii � i 'i ,1
the holder of Drain. ay�r'sc ns IY 1
1A a Q. Permit will'epsre'of 9
The undersigneriC1D�f4Iflt�yeh h ' efs to a tithe terms"and conditions' ?eeff fth oic4 ih berm �arid't e re rse side
- W Z1.31J 9a_(!j ,�13r I79r, I1 •'1t1W 3. 3 flo AlbbJ i.
thereof. Applicant has received Town Permit No. ":I C-1 .m.,; 0" ,'s
for street escaYation
2j Clh lI'Nu 1 9l 7 )i 1 It 1 )V t _. I1 , -9111
SPECIAL �CWMitiONS7- -
to 'Vt] Uy111li72llG (C37 )U rAmoul7C11) a);'Lrlr71 U' iU ? 1.:a fI OI71' 9..,^.1�J t)nB )bt•
B`1!I1/i nl f1lo-1) 1i111; il ,u! i.Stl7.i •':1I1 e0 113:JL7 ,I✓.hi;. !;,: ..fii `r)-dUii�It:3 :�.7r1..?i.l)C;r � 'r fl f: ,1.1'�L.1 .
r
Signed Ie_?
Connection Charge Paid N "` Licensed Drain Layer .
--- - - Issued by -
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
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