HomeMy WebLinkAboutDrain Layers Permit Lot 4 Griffin Road I UWN vF SOUTH VYINDSOR
. DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMIT N0 2989
/3 , 193
Pursuant to written applicatior, permission is hereby ranted to the Licensed Drain Lay nWonthe
erform
' � � .�..
the work indicated below at � J� � 1 W
side, between
at premises owned by , AA,V_ t
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
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 ihe'reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
j�, 3q
Signed
C nnection Charge Paid/10 6 , (�d Q-/g. 3 Licensed Drain Layer
)Q�
_ Issued by
Colle r
Permit Fee:. Paid $
INSPECTION: Check Number:
INITIAL (Sig)
- - -- FINAL
- - - _ (Sig)
APPROVED (Date)
(Sig)
INSPECTOR