HomeMy WebLinkAboutDrain Layers Permit 669 Governors Highwa W ' TOWN OF SOUTH WINDSOR
. DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut Z List.No.: A{ ?�
DRAIN LAYER'S PERMIT NO 185
— I , 19
Pursuant to written applicatior, permission its hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at cc 9 VF AC&II& is .4 G//1 Ly on the
side, between
at premises owned by A r a haw, So D
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 CIO V�i�l l'QLST
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 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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k
l CAI IGlI" �V("w
+5
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45°
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1
- 4.5
— TOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION CoCoQ GOVERNOR
OWNER A b ra ho.,-, So4o
TYPE OF WORK +-IOU L c'^,m - i
DATE 8 1'-/198 PERMIT PIPE
INSTALLER COVt W rni
INSPECTOR t DRAWN BY j_ L.