HomeMy WebLinkAboutDrain Layers Permit 120 High Street TOWN OF SOUTH WI N USOR
DEPARTMENT OF POLLUTION' :CONTROL
South Windsor' Connecticut B/P No.:
List No.:
DRAIN LAY,< - E'R.AIT1 NO 986
Pursuant to written applicatior, permission is-hereby granted to the Licensed Drain Layer named herein to:P erform
1:Y
the work indicated below at /.0 &04"* Street �-
svuth. e, between th
._ -side, one e
r at premises owned by 81rnr�'�w; `
whosk.Address is
and to Layo`use Drain, - Repair House Drain, La Main
.{ y a Other
for • l�l ��dtl
occupancy or use,
with Q1t Family Units,with
acres.
Type of Sewage to be connected under this permit: S
SANITARY SEWAGE ( j, INDUSTRIAL WASTES .( ), OR ( `
Connection will be madeK
Permit to be issued to I# Za ftiecj
the'hol&r 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 an the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for.street excavation.
SPECIAL: CONDITIONS
{
s` .
Connection.Charge Paid Signed '�� �►
la License rain
y
Issued by H '
• Tag Collector-_ "_. .. _ _. ..
Perinit Fee:. Paid $
INSPECTION: Check Number: �3"1'T
INITIAL (Sig)
FINAL _
(Sig)
APPROVE
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. ter+
�iVS.�EE-TOI�-
(Sig)
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