HomeMy WebLinkAboutDrain Layers Permit 115 Gulley Drive TOWN OF ,,�P NTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.: —
ell DRAIN LAYER'S' PERMITpj34
0
Auril 415 19 -4
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at I?�+ Qtull:F Dn, on the
side, between
— at premises owned
whose address is
and to X Lay House Drain, Repair House Drain, Lay-Main, Other ,
for occupancy or use,
with ckw Family Units, with acres.
Type of Sewage to.be connected under.this,permit:
SANITARY SEWAGE ( j; INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with US "k MiAtid AIR
Permit to,be issued to Berama latult1 '
the holder of Drain Layer's License No. Permit will expire on 45 19 �14.
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 u���`� �:�a�_, _
Connection Charge Paid Licensed Drains sayer
Ps,r. Issued by24P% 4-6 'tAf-Nf :Offr Jr*
Tax Collector
Permit Fee:. Paid $
74
INSPECTION: Check Number: '
INITIALo (Sig)
FINAL ' s},t. ' r _ (S1'8)
APPROVED t ' >'� .. .. (Date)
(Sig)
INSPECTOR