HomeMy WebLinkAboutDrain Layers Permit 529 Graham Road TOWN OF SOUTH :WI N DSOR
DEPARTMENT- OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut �c 7
List No.: _
DRAIN LAYER'S PERMIT XTp 776
M.4
, 19
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Pursuant to written app icatior,p mission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at M Q on the
side, between XM&4M ft&d-
at premises owned by 0 utwas
whose address is
and to _ Lay House Drain, Repair House Drain, Lay-Main, Other ,
for raddAMMAI occupancy of 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 44
Permit to be issued to ` Its MU441 Wit tM o
the holder of Drain Layer's License No. Permit will expire on 24 14RIVh 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 ontmtor to wa of arts "U• M4s
Signed :.fir'-fe, ` /- /"Z&
Connection Charge,Paid icensed Drain Layer
>a
Issued by
Tax Collector
Permit Fee: Paid $ _ *
INSPECTION: Check Number:
INITIAL . (Sig)
FINAL L4 (Sig)
APPROVED 1 (Date)
(Sig)
SPECTOR
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