HomeMy WebLinkAboutDrain Layers Permit 19 Henry Road A
TOWN, OF SOUTH �IVI N DSOR `..
DEPARTMENT OF. . POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
�'�9�
List.No.: _
DRAIN LAYER'S PERMITp 965
4 dat bor , 19�_
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 10 r,* 3bad 114V i6) on the
ADUth side, between QftbM F48A +ir d BMk 8tx"t
whose address is"No
and to kLay;I1-ouse Drain, Repair House Drain, Lay-Main, Other
for "OLdMU-1 occupancy or use,
with =0 Family Units, with acres.
Type of Sewage to.be connects under this permit:
u:
SANITARY SEWAGE (I), INDUSTRIAL 'BASTES .( ), OR
Connection will be made with 66ft 1Q vivo"to at
sta. 3+I?, at a dimth of 8.39!.
Permit to be issued to 11}i .l31' 1. I119i
the holder of Drain Layer's License No... • 1 Permit will expire on 2' .1h44116..x► 19-25_
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.
SignedMEW
Connection Charge Paid 1O-i.-j �' ► icense AD'rain Layer
8ft- Issued by ITft WA ® i -
Tax Collector
Permit Fee:. Paid $ 1 D0
INSPECTION: Check: Number: 17-14
INITIAL /4 "/drt/ (Sig).
FINAL
APPROVED «11 (Date)
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-(Sig) — --- - - -
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