HomeMy WebLinkAboutDrain Layers Permit 50 High Ridge Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
�. South Windsor, Connecticut
DRAIN LAYER' S PERMIT N? 283
a , 19
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at go BLA X*P am L u,r 1'91 on the
OpAft ide,�
at premises owned by_1=044 1
whose address is
and to Lay House Drain, Repair House Drain, Lay Main Other
for ti occupancy or use,
with me W Family Units, with acres. -
Type of Sewage to be connected under this permit:
SANITARY SEWAGE INDUSTRIAL WASTES, OR
Connection will be made with A$.,gea
Permit to be issued to s la- 222004
the holder of Drain Layer's License No. . Permit will expire on Ajgff&Ut 19
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permitand the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS >! ZOM to wren b&@W33 ONPUS
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Signed
Connection Charge Paid Licensed Drain Layer
X (Sig) issued by Ha3ft shea
Tax Collector
Permit Fee: Paid $2-.V6n
INSPECTION: Cho* 0060"
INITIAL (Sig)
FINAL (Sig)
APPROVED-1- (Date)
'raa �r.t,D Jf1r (Sig)
°INSPECTOR
Y
♦ 1 �
N
0
Nil/
IV
63
5�
4S"0 J y9 y'
13 fPr- ✓� d
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION S d 611 ; kcL
OWNER
TYPE OF WORKS
DATE04,4 22, PERMIT PIPE
INSTALLER
INSPECTOR DRAWN BY