HomeMy WebLinkAboutDrain Layers Permit 107 Hayes Road TOWN -Of SOUTH WI N DSOR -*
DEPARTMENT OF POLLUTION CONTROL gip No.: '�""
South Windsor, Connecticut
List.No.• ""�°d ►* i,
DRAIN LAYER"S PERMIT p 70
0
94 Octybw 19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at ftoo so"
on the
side, df 1 Wined
w
at premises owned b me qmMur
whose address is
and to Lay House Drain, Repair House Drain, Lay Ma"in, 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_ made with � - �4 -ids --
0 5'».
_ a
Permit to be issued to A-*
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 the reverse side'
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
Signed' _. � - #-• .
Connection Charge Paid Licensed Drain Layer
Ike Issued by AW1111VAs J
Tax Collector
Permit Fee:. Paid $ _
INSPECTION: `Check Number:
INITIAL tdzs lAa f r. ...+Y•••. (Sig)
FINAL 4-4+ /p9► " " ""' (Sig)
APPROVED to 4 Q -11 * (Date)
JL - : (Sig) _ -
IIVSPECTO b