HomeMy WebLinkAboutDrain Layers Permit 486 Graham Road F
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
S 17y/
List No.: _
DRAIN LAYER'S PERMIT Np 848
--75 , 19
Pursuant.to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at ',1 'Iri anr, Roves on the
side, between
at premises owned by 122
whose address is
and to ,L' Lay House Drain, Repair House Drain, Lay Main, Other
for j z i nftx ;j occupancy or use,
with 0-Ae Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (X ), INDUSTRIAL WASTES .( ), OR
Connection will be made with
inch xt tip.. t' ae solvest Joint Pipe)
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 Licensed Drain Layer
Issued by
Tax Collector
? .
Permit Fee:. Paid $
INSPECTION: Check Number:
INITIAL fjs (Sig)
FINAL f' _ __ - (Sig)
APPROVED (Date)
(Sig)
INSPECTOR