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HomeMy WebLinkAboutDrain Layers Permit 40 High Street TOWN OF SOUTH WI N DSOR DEPARTMENT OF POLLUTION CONTROL gip No.: ,1. South Windsor, Connecticut List No.: _ —4916 6 DRAIN LAYER'S PERMIT N? 643 -06 r , 19 24 Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform the work indicated below at ,', e �L©i" Ze� on the side, between wQ .1.Vyn Ayeo sAd QMAM raj, at premises owned by t ' -v = whose address is t and to ?L Lay House Drain, Repair House Drain, Lay Main, Other for occupancy or use, with Oft 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 Ad= the holder of Drain Layer's License No nfi&;� Permit will expire oc66 L4yerfler 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 • a...a.t "`„ ... Issued by - NO Tax Collector Permit Fee: Paid $ A&5-!tL-j_ INSPECTION: Check Number: INITIAL -`-: (Sig) FINAL (Sig) APPROVED (Date) y (Sig) INSPECTOR I' To help locate your sewer connection on the main lire, please show Where you would like the connection by drawing a line from the house or the septic tank to the main line in the street. Also, install stake in yard to indicate line as shown on sketch.. Ifyouu have°any doubt please contact the Town, Engineering Department. Please draw important information such as driveways, large trees and other obstructions. PLEASE MAIL THIS FORM IMMEDIATELY.TO: JAMES S. HINGES & ASSOC. , INC. The Exchange Farmington Avenue Farmington, Connecticut 06032 i{ ;9 jN ,{ s r A/C Q ' I I N'. _ f�