HomeMy WebLinkAboutDrain Layers Permit 619 Graham Road TOWN OF SOUTH WI D N SOR
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DEPARTMENT OF POLWTION CONTROL ;
+ B/P No.: I&z
South Windsor,Connecticut, 5 -78�
List No.
DRAIN LAYER'S PERML:T., . ; p 980
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to-perform
the work indicated below at 619 Grmhft.Rag 1 on the
"at side,
at premises owned by STj0X= T
whose address is
? v and to.T ,Lay House Drain, ' Repair House Drain, Lay,-Main, Other
for rabidat 1 occupancy or use,
with one 0) Family Units,.with acres
Type of Sewage to.be coane. ted under this permit:
SANITARY SEWAGE AL`'SAS' &
Connection*will be made withx f 6-0 7 rust ,' +� _
st d of
Permit to be issued to V601 To. Si11at`
the holder of Drain Layer's License No. X9*' Okg . Permit will expire on-031Jti�1 19
T`he undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit andL the reverse sidel".
.___.thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for,street excavation:
SPECIAL CONDITIONS
's
.Signed. �•. n`7
Connection Charge Paid '�Qw 'f..� 3 Licensed Drain La er
Y_
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Tax Collector
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Permit Fee:. Paid 1
- INSPECI M. um r:
INITIAL ..+�*.�..... - (Sig) -
- - FINAL t - - (Si ) - - -
APPROVED 4, (Date)
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-CPA*