HomeMy WebLinkAboutDrain Layers Permit 41 Hayes Road TOWN OF SOUTH WI N DSOR y
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.:
DRAIN LAYER' S PERMIT N? 747
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 141 tr.t•— `L,c r �S6 )
on the
side, between
at premises owned by "n a.•Z
whose address is t:cxtr•+
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 (X ), INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with 11�1 "n •' 171 a q4•4 r.r P4 two,
Permit to be issued to "t,' r l -,
the holder of Drain Layer's License No. W •a-'r, .ar 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
Signea
Connection Charge Paid Licensed Drain Layer
�'` ° .''�4 Issued by rrayt �. at,
• fir;:
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIALt"�''
(Sig)
FINAL '.e . (Sig)
APPROVED f •- e '(P 'KfI` (Date)
(Sig)
INSPECTOR
�A
N
t{
L
f
r q
ram:-._-----
LOCATION
OWNER . 1J
DATA
INS in
- - PERMIT
TA LE.
INSPECTOR DRAWN B�
r ,